Psychosocial impact of acne vulgaris: evaluating the evidence

BACKGROUND: Although knowledge concerning the impact of acne vulgaris on quality of life has increased in recent years, relatively few studies have assessed the effect of a change in clinical severity on psychosocial state. OBJECTIVE: Assessment of the effect of a change in clinical acne severity on psychosocial state. METHODS: This was investigated by means of questionnaires and clinical assessments by acne patients and dermatologists. Fifty females with mild to moderate facial acne were seen before and after a 9-month treatment with oral contraceptives. RESULTS: The results showed a great variability in psychosocial impairment between individuals. After 9 months, a significant reduction in clinical severity was seen overall which did not relate to the significant improvements in self-esteem, stability of self-esteem and acceptance of appearance. CONCLUSION: Perceived psychosocial impairment is individually based, is greater in women who subjectively overrate their acne and does not relate to clinical improvement.

Pakistan Journal of Medical and Health Sciences

Objective: To determine the frequency of different category of Dermatology Life Quality Index (DLQI) in patients with Acne Vulgaris visiting to tertiary care hospital. Study Design: Descriptive Cross-Sectional Study. Place and Duration: This study was conducted at the Department of Dermatology, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan during the period from August 23, 2019 to February 22, 2020. Materials and Methods: All patients who fulfilled the inclusion criteria and visited to SMBBMU, Larkana were included in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study. In our study, patients with acne vulgaris were diagnosed on the basis of relevant clinical history and examination. Patients were asked to fill the DLQI questionnaire themselves to assess the DLQI. All the collected data were entered into the proforma attached at the end and used electronically for research purpose. Results: Mean ± SD of age wa...

Annals of Punjab Medical College, 2020

The study was conducted after informed consent; 158 patients diagnosed with acne vulgaris were evaluated for the impact it had on their self-esteem by using Rosenberg's Self Esteem Scale (RSES). Chi square test was used to determine the correlation among different categorical variables. Results: Total 158 adolescent and young adults with acne vulgaris were included in the study, with 126 (79.7%) being females and 32 (20.3%) were males. The median age was 22.0 ± 4.62 years. Mean RSES score was 14.94 ± 0.141 and low self-esteem was reported in 67 (42.4%) participants. Conclusion: Acne vulgaris adversely effects self-esteem of patients, with one-third of the study population reporting low self-esteem. It was significantly low in females as compared to males.

Khyber Medical University Journal, 2020

Study was approved by ethical board of Shifa hospital. One hundred and fifty-six acne vulgaris patients of both genders, aging ≥16 years were selected by convenient sampling technique. Informed consent was taken from all participants. After collecting demographic details, each patient was assessed for psychological morbidity using General Health Questionnaire (GHQ-12) and self-esteem was measured by Rosenberg self-esteem scale (RSES). Data collected was analyzed by using SPSS version 20. RESULTS: Out of 156 enrolled patients, 108 (69.2%) were females and 48 (30.8%) were males. Mean age of was 22.03±5.96 years. Mean duration of acne was 25.69±21.74 months. The most commonly affected area of the body with acne was face (n=108/156, 69.2%) followed by chest (n=24/156, 15.4%), shoulders (n=13/156, 8.3%) and back (n=11/156, 7.1%). A dominant proportion of the sample had positive family history of acne (82/156, 52.6%), were unmarried (118/156, 75.6%) and had a good educational background [graduates=53/156 (34.0%)]. A total of 27 (17.3%) patients had low esteem reported as per RSES and 146 (93.6%) were labelled as having psychological morbidity as per GHQ-12 scale. Fisher's exact test showed no statistical significance between low esteem and psychological morbidity (p=0.2126). CONCLUSION: The patients suffering from acne can suffer from low selfesteem. However, the proportion of patients having psychological morbidity because of acne is much higher and independent of self-esteem.

Acta Dermato Venereologica

Acne is one of the commonest dermatological diseases and this is a first large-scale case control study aiming to reveal psychosocial impact. This analysis was based on a multicenter study including 213 acne patients over 18 years and 213 age-sex matched controls. We found that patients with acne are more likely to express anxiety, depression, pain and discomfort, and suicidal thoughts than the general population. Clinicians must be alert to these symptoms and where present consider the possibility of an underlying psychiatric component. This awareness may improve recognition of patient concerns and allow clinicians to optimize treatment. The link between acne and psychiatric morbidities has been demonstrated in many studies; however, large scale studies aiming to reveal the psychosocial impact of acne are rare. The aim of this study was to assess the psychological burden of adult acne patients. This analysis was based on a multicenter study including 213 acne patients and 213 controls from 13 European countries. The Hospital Anxiety and Depression Scale (HADS), Dermatology Life Quality Index, and EuroQol 5 dimensions 3 levels scores of the patients with acne were analyzed. Patients with acne (n = 213) had higher HADS scores for anxiety (mean ± standard deviation 6.70 ± 3.84) and depression (3.91 ± 3.43) than the controls (p < 0.001 for both). For patients with acne, 40.6% reported that they were very concerned about their skin disease, 12.3% had suicidal ideation, and, among those, 10 (4%) patients implied that acne was the cause of their suicidal thoughts. After adjusting for other variables, patients who had suicidal ideation (p = 0.007, and adjusted odds ratio 3.32 [95% confidence interval (CI): 1.39-7.93]) and stressful life events (p < 0.001, and adjusted OR 5.85 [95% CI: 2.65-12.86]) had a greater chance of fulfilling the HADS criteria for anxiety. This study highlights the need for a psychotherapeutic approach in order to recognize the concerns of acne patients and optimize their treatment.

Journal of the European Academy of Dermatology and Venereology, 2000

Background There is a considerable number of studies linking acne with psychological and psychiatric morbidities, although this literature is not entirely consistent and is largely cross-sectional in methodology. Objective This study aims to establish the relationship of acne and psychological and psychiatric morbidity in adolescents in a community setting and, via a longitudinal methodology, provide evidence for causality in the relationship. Methods The study was a 12-month cohort study. Two hundred and forty-four students in Years 8, 9 and 11 (ages 14-17) at four Australian high schools were assessed at baseline 6 months and 12 months. Presence and severity of acne were assessed, along with a number of psychological and psychiatric morbidities and personality traits (depression, anxiety, overall psychiatric morbidity, self-consciousness, neuroticism and introversion/extraversion) and other demographic variables. Results Of the 244 participating students, 209 (86%) completed all three rounds of data collection. A further 26 (11%) completed two rounds. The study failed to demonstrate an association of the presence of acne or of acne severity with the examined measures of psychological and psychiatric morbidity, and no evidence for an effect of acne in their causation. Conclusion The relationship of acne and psychological morbidities found in previous health care settings was not found in this community sample. This may be due to differences between community and clinical acne populations. Other possible reasons for this finding are attenuation of psychological morbidity in subjects in this study by successful acne treatment, and the role of personality traits in the complex relationship between acne and psychological morbidities. It is suggested that this relationship would be best investigated by means of longer-term cohort studies enlisting subjects at an zearly age, prior to the onset of acne.

J Eur Acad Dermatol Venereol, 2010

Background There is a considerable number of studies linking acne with psychological and psychiatric morbidities, although this literature is not entirely consistent and is largely cross-sectional in methodology.

Egyptian Journal of Health Care, 2019

Background: Acne vulgaris is chronic inflammatory skin disease impacts on patient's physical and mental health. The aim of this study was to examine the psychological problems of adolescent related to acne vulgaris (depressive symptoms, body image and self-esteem). Descriptive correlational design was utilized to achieve the aim of this study. This study was conducted at the outpatient clinic of the Dermatological Hospital in Benha City. A convenience sample of 200 patients fulfilled the inclusion and exclusion criteria during the spring season were selected from the above setting. The study tools were composed of four Tools (1): Socio-Demographic and Clinical Data, Tool (2): Beck Depression Inventory Scale to measure depressive symptoms, Tools (3) Rosenberg Scale to assess self-esteem, Tool (4) Body Image Scale to measure body image. The results of the study revealed that there was a statistical significant relationship between acne vulgaris and depressive symptoms, body image and selfesteem. Based on the results of this study it was concluded that: Acne vulgaris influence negatively on patients' psychological status. The study recommended that: Psychological counseling should be integrated as nursing intervention for acne patients to improve their mood, self-esteem and body image.

Journal of Cosmetic Dermatology, 2020

BackgroundAcne vulgaris is a highly prevalent skin condition associated with considerable psychological burden. Acne and its sequelae can affect many domains of life leading to social dysfunction, psychiatric issues and educational shortcomings. Psychiatric conditions like depression is found to be more prevalent in acne patients as compared to general population.AimsTo evaluate importance of screening for depression in acne patients since screening tools in outpatient departments can help dermatologists assess the psychological state of the patient.MethodPapers selected for the review included review articles in English language and all original research relevant to the topic, in the form of cohort studies, and case–control studies.ConclusionsThis article studies the impact of acne across the various aspects of life and highlights the importance of a timely diagnosis and referral. This can be helpful in preventing the long‐term consequences of acne in terms of physical as well as p...

Pediatric Dermatology, 1991

To describe the psychosocial impact of acne on adolescents, and, in particuiar, to assess whether seif-concept is affected by medical treatment, we evaluated 39 teenagers presenting for care to a communitybased dermatologist. Prior to and following treatment, subjects completed a self-assessment questionnaire, the Piers-Harris self-concept scaie, and underwent an objective assessment of acne severity. Fiftyeight percent of subjects were dissatisfied with their facia! appearance and this in turn was corre!ated with feelings of embarrassment and social inhibition (for each, r = 0.48, P ^ 0.005). Subjects' rating of acne severity, but not the dermatoiogist's, was correlated with dissatisfaction with facial appearance (r = 0.45, P ^ 0.005). Despite these findings, the mean Piers-Harris total t-score (55.4 ± 7.4) was within the normal range. Fourteen subjects (36%) returned for follow-up and 71% of these were judged by both the dermatologist and themselves to have !mproved. Following therapy, significant reductions in the adverse consequences of acne were observed with 42% of subjects reporting that their facial appearance was more acceptable to peers, 50% being !ess embarrassed, and 58% feeling less socially inhibited. Minimal improvement in mean Piers-Harris total t-score was observed (54.6 to 57.4, P = 0.004, paired t-test). Our data demonstrate that acne is perceived by adolescents to have Important negative personal and social consequences, and that improvement in these areas may accompany medical treatment.