Nearly everyone is affected by acne at some point in life. In fact, Acne is the most common reason for visiting the dermatologist.  The very high prevalence of acne with its associated demand for effective solutions and therapies has prompted the development of a large industry of skin care products and clinical treatments.

Despite the recognition of acne’s importance in the marketplace, however, sufficient attention to the psychological impact of acne often goes unrecognized and underserved.   Acne is often thought of as a temporary rite-of-passage limited to teenagers that should just be left alone since it will “just go away on its own anyway.”

Some parents delay seeking help for their children with acne because of this false premise.  Even our healthcare system treats acne almost as an afterthought.

Insurance coverage for many acne treatments is often unavailable and many healthcare providers think of acne as a mere cosmetic problem while prioritizing other medical conditions as more deserving of their time and attention.  Nothing, however, could be farther from the truth.  Acne can affect people of any age and can have very profound physical and emotional consequences in need of prompt intervention.

Apart from the physical discomfort caused by acne especially in its severe forms such as pain, itching and the eruption of large disfiguring cysts, it is the psychological and emotional consequences of acne that often cause the most damage.

According to the American Academy of Dermatology Association, acne can lead to a number of significant mental health consequences.  Low self-esteem, low self-confidence and feeling insecure are just a few of the more common mental health effects of acne that can take a significant toll.

In response, many acne sufferers become withdrawn and limit their social interactions.  In some, even more dangerous mental health effects are seen including depression and thoughts or actions of self harm.

While the effects that acne can have on one’s quality of life are important, they can often go unrecognized.  The tendency of acne sufferers to camouflage their feelings and hide their emotions can often lead to silent sufferers who internalize the negative impact of acne on their psychological health.

For example, avoiding eye contact, remaining silent or not raising their hand in class are common attempts used by acne sufferers in hopes of deflecting attention and remaining unnoticed. In addition to psychological maneuvers, it is also very common for acne sufferers to employ physical adaptations to avoid exposing their complexion, such as wearing hair styles that cover the forehead or much of the face to hide acne breakouts in those areas is common.

In addition, the loss of self-confidence and the low self-esteem that often accompanies acne can affect the desire to wear the latest fashions or accessories, preferring to select a wardrobe that is bland and less likely to be noticed.  In effect, acne sufferers seek to become socially invisible as a coping mechanism in an attempt to hide their affliction from others.

Taken a step further, acne can become an overwhelming preoccupation that can prevent acne sufferers from engaging in many aspects of life such as attending school, going to work and attending social functions.

Often, those who are experiencing acne breakouts on their chest or back forego opportunities to enjoy a beach outing or wear clothing that exposes those body areas.  For some, the emotional effects of acne can dampen the motivation to move forward in their careers or explore their innate talents and can lead to the avoidance of romantic relationships due to feelings of embarrassment and low self-worth.

Taken together, acne can have a very profound impact on one’s overall quality of life.

Who Is Most Likely to Suffer Emotional Effects of Acne? 

As it was outlined in a popular dermatology journal, these serious consequences of acne can impact people of all ages across all parts of the world. Though, findings did suggest that young children had more life-impacting anxiety than their older counterparts.

Additionally, teenagers experiencing acne associated with the hormonal changes of puberty can experience a variety of psychological impacts including low self-esteem and low self-confidence. Although both adult men and women have been found to suffer from these negative effects as well, women more so than men were found to internalize feelings of self-doubt and self-consciousness, leading to more pronounced feelings of despair.

Are Certain Types of Acne More Likely to Cause Negative Psychological Effects?

While there are many ways to classify acne severity, in general, a useful although very oversimplified way to categorize acne is to consider breakouts as mild, moderate, or severe. In this scheme, images of mild acne as blackheads and whiteheads with few pimples versus moderate acne with more obvious, larger pimples and severe acne as more numerous large pimples and acne cysts are commonly envisioned.

The presence of scarring must also be taken into consideration when classifying the severity of acne.  Of course, in practice, acne severity is not just a physical characteristic and must also take into account the emotional consequences it is causing.

For example, one can have only blackheads and whiteheads and feel very self-conscious and insecure whereas one may be affected by large acne cysts without feeling significant emotional effects.  Each acne sufferer is unique in that the consequences of acne that he or she may experience can greatly differ.

Nevertheless, from an overall perspective, Many studies found that psychological effects manifested more frequently in those individuals who had more severe cases of acne. The greater visibility of more severe physical breakouts can be more difficult to downplay and camouflage thereby leading to an increased likelihood of anxiety and depression.

Some individuals even suffer from dysmorphophobic acne, which is a body-image disorder that causes people even with mild acne to feel as if they have severe acne. The effects of dysmorphophobic acne are just as disabling as actually having more severe acne and may require psychological or psychiatric intervention.

What Types of Specialized Psychological Treatments Are Available for Acne Sufferers?

The first step in getting help is to reach out to a professional dermatologist, one who can recommend the best treatment path forward and one who can recognize the very significant effects of acne, both from a physical and mental health perspective.

Often, effective medical treatment alone can lead to significant improvement in both physical acne breakouts as well as start to improve the underlying psychological consequences of acne as well.  Acne sufferers can experience dramatic, life-changing effects on their emotional well-being following effective treatment of their acne.

However, if it’s clear that an acne sufferer requires further mental health intervention, a specialized psychological treatment plan can then be considered.

A variety of tools that can help ascertain if a patient is suffering psychologically from acne are available. Acne patients can fill these forms out in the clinic while they are waiting to be seen, and referrals can be made that very day.

Below are some standard screening forms that can be used for the above purposes:

• APSEA: Assessment of the Psychological and Social Effects of Acne
• Acne-QoL: Acne Quality of Life and Acne-Q4
• AQOL: Acne Quality of Life Scale
• ADI: Acne Disability Index
• CADI: Cardiff Acne Disability Index

Dermatologists can partner with local mental healthcare facilities, particularly ones that specialize in body-image disorders, anxiety, or depression. The earlier the treatment (and subsequent mental health intervention), the greater the chances that the silent suffering caused by acne can end sooner.

At the Advanced Acne Institute we recognize the very significant impact that acne can have on quality of life and the importance of seeking help right away.

The Advanced Acne Institute is a unique dermatology practice located in Miami, Florida specializing only in the treatment of acne.   We focus solely on providing the most effective treatments to help our patients achieve clear skin.  We are pleased to share our insights and perspectives in acne treatment as an educational service, however this information is provided strictly for educational purposes only and should not be considered medical advice and is not a substitute for seeking the advice and treatment by an appropriate medical professional.