Psychological Effects of Acne1,2
Acne affects us socially and psychologically.
Even mild acne can be significantly disabling.
Acne can affect people of all ages but it predominantly occurs during the teenage years. Approximately 85% of people between the ages of 12 and 25 develop acne.
The psychological and social impacts of acne are a huge concern, especially because acne affects adolescents at a crucial period when they are developing their personalities. During this time, peer acceptance is very important to the teenager and unfortunately it has been found that there are strong links between physical appearance and attractiveness and peer status.
Screen image from a forum to support acne sufferers. This thread has 390,000 views. The emotional and psychological effects of acne are significant.
In recent years, open discussions between patients and medical professionals have revealed the impact acne has on the psyche. The following are some of the problems that patients with acne face.
Self-esteem and body image
1. Some embarrassed acne patients avoid eye contact.
2. Some acne sufferers grow their hair long to cover the face. Girls tend to wear heavy make-up to disguise the pimples, even though they know that this sometimes aggravates their acne. Boys often comment: "Acne is not such a problem for girls because they can wear make-up".
3. Truncal acne can reduce participation in sport such as swimming or rugby because of the need to disrobe in public changing rooms.
Social withdrawal/relationship building
1. Acne, especially when it affects the face, provokes cruel taunts from other teenagers.
2. Some find it hard to form new relationships, especially with the opposite sex.
3. At a time when teenagers are learning to form relationships, those with acne may lack the self-confidence to go out and make these bonds. They become shy and even reclusive. The main concern is a fear of negative appraisal by others. In extreme cases a social phobia can develop.
1. Some children with acne refuse to go to school, leading to poor academic performance.
2. Some people with acne take sick days from work, risking their jobs or livelihood.
3. Acne may reduce career choices, ruling out occupations such as front-line reception and sales that depend upon personal appearance.
4. Acne patients are less successful in job applications; their lack of confidence being as important as the potential employers' reaction to their spotty skin.
5. More people who have acne are unemployed than people who do not have acne.
6. Many young adults with acne seek medical help as they enter the workforce, where they perceive that acne is unacceptable and that they "should have grown out of it by now".
Does acne cause depression?
In some patients the distress of acne may result in depression. This must be recognised and managed. Signs of depression include:
Loss of appetite
Feelings of unworthiness
In teenagers, depression may manifest as social withdrawal (retreat to the bedroom or avoidance of peers) or impaired school performance (lower grades or missed assignments). Severe depression from acne has resulted in attempted suicide and, unfortunately, successful suicide. Worrying statements include: "I don't want to wake up in the morning"; "I'd be better off dead"; "I'm worthless"; "You'd be better off without me". Parents, friends and school counsellors need to take heed when they start to hear these types of comments.
Suicide thread in Acne Support Forum. The thread was shut down because the support board could not ensure that correct advice was being given by the public to suicidal acne sufferers.
Rarely, depression can be associated with acne treatment, particularly oral isotretinoin. There is much controversy about whether the drug causes depression. However, it is clear that depression often results from acne and the psychological disturbances described above.
Regardless of the cause, depression must be recognised and managed early. If you think you or someone you know may be depressed, call KMC at 6256 6353 for acne treatment. Acne CAN be controlled.
2. DermNet New Zealand Trust