The consequences of living with acne What psychological impact can it have?

Acne depression
Acne can be difficult and depressing to live with

Facebook, Instagram, films, magazine covers. You name it. Wherever we look we’re surrounded by images of beautiful people. It’s easy to forget that they’ve been heavily retouched. 
This article examines the particular pressures that looking good can have on people with acne. We explain the correlation between acne, anxiety and depression and make suggestions on how to stay positive.

Living with acne

What are the pressures of living with acne?

Our skin is one of the first things that people notice about us. While most of us realize there’s more to life than appearance, those with acne can feel at a disadvantage in a society that seems to put more and more emphasis on looks. Some cope better than others, but many are psychologically as well as physically affected by living with acne. Why is this?

Catching someone’s eye across the room: easier said than done if you have acne

  1.  Ignorance
    There are still those who are prejudiced against people with acne. Sad, but true. They mistakenly believe that people with acne have lower hygiene standards. Even experts frequently use the language of ‘impure skin’.

  2. A lack of empathy
    People who don’t have acne often don’t truly understand what it feels like to be a sufferer. They can say hurtful things without meaning to. Comments about how you’re wearing “too much make-up” are distressing when all you’re trying to do is hide your blemishes.

  3. It’s harder to flirt with acne
    People with acne often feel less confident and shier than those without blemishes. Acne can get in the way of flirting.

  4. Bullying
    Young people often act rashly and say things they later regret. Bullying and social during the impressionable teenage years can have a significant impact on someone’s personality as they grow older. 

  5. Professional discrimination
    First impressions count and acne can make the job application and promotion process harder, especially in industries where looks are important.

The consequences of acne

How does acne affect feelings and behavior?

Both teenage and adult acne can lead to a loss of self-esteem, and sometimes even an inferiority complex.  

Studies show that people with acne are more likely to suffer from depression, anxiety and social phobia than those without acne.(1-7) Other studies demonstrate that anxiety and acne often go hand in hand. (2-4), (7-12)  Research also suggests that acne has a greater psychological impact on women than men.(1)

Acne can cause depression: don’t suffer in silence

The psychological impact of acne can lead to behavioural changes and many sufferers:
avoid eye contact with others

  • come across as shy
  • hide behind scarves, caps, long hair and/or too much make-up
  • wear make-up at night as they’re ashamed of their partner seeing the true state of their skin
  • stop taking exercise or joining in with sport
  • refuse to be in photos
  • avoid social interaction
Acne can cause depression: don’t suffer in silence

 Acne can be a huge psychological burden as sufferers feel anxious, embarrassed and stigmatised. Don’t suffer in silence. My best advice is to consult your doctor and get treatment as soon as possible. This will stop the disease from interfering with your life and help prevent depression.

Dr med. Markus Reinholz, Dermatologist

Advice

What can I do to help me feel better?

Renowned dermatologist and acne specialist, Dr Markus Reinholz, shares his advice on how to cope better with the psychological impact of acne:

1. Get help
The sooner you start medical treatment, the sooner you’ll get your feelings under control. Research shows that anxiety and depression generally reduce when acne is treated medically. 5-9 Your doctor will be able to advise on, and prescribe, the best treatment for your skin as well as to answer any questions you may have. Read Dr Reinholz’s advice on when to consult your doctor here. You can also find out a bit about your options in acne medication: what are the most common treatments?  And acne treatments and their possible side effects.

Your doctor will help you to beat acne: physically and psychologically

2. Use appropriate skincare products
Tinted creams and cover-sticks help to mask blackheads and pimples. This can be a real bonus for self-esteem, but is easier for women than men. Be sure to choose products that are non-comedogenic (meaning they wont clog your pores) and, ideally, that also have a positive effect on your skin. The Eucerin DERMOPURIFYER Cover Stick helps to reduce pimples at the same time as concealing them, so you get both care and coverage in one. Read more in How should I choose and apply make-up to my acne-prone skin.

And, importantly, be sure to remove your make-up at the end of the day so your can regenerate itself overnight. You can find out more about how to cleanse and care for acne-prone skin in What skincare products and routine are best for acne-prone skin?

Friendship and laughter help to overcome feelings of depression caused by acne

3. Look after yourself
Exercise (ideally in a group rather than on your own), a healthy lifestyle (time to quit those cigarettes) and a balanced diet. These are just some of the steps you can take to boost your self-confidence, keep your spirits up and support your skin. Find out more in what effect does exercise have on acne, acne and diet: the background and what changes can I make to what I eat to help my skin?

4. Maintain friendships
We’re social beings, and quality time with friends is important for our overall wellbeing. People with acne sometimes stop going out, which only makes them more rather than less stressed. If you find it difficult to discuss your feelings with friends and family ask your doctor for advice or consider joining a therapy group.

5. Try not to get stressed
Easier said than done we know, but stress is known to trigger acne. 13 You can find out how in  acne and stress. Try some of the various techniques that help people to unwind (read about these in tips for reducing stress) or ask your doctor for his/her advice.

Flawless skin is an ideal that’s hard to achieve, but there’s lots you can do to support your skin and keep your spirits up.

Sources

1 Ramos-e Silva et al., BJD, 2015, 172 (Suppl. 1): 20-26

2 Yazici K, Baz K, Yazici AE, Kokturk A, Tot S, Demirseren D, et al. Disease-specific quality of life is associated with anxiety and depression in patients with acne. J Eur Acad Dermatol Venereol 2004;18:435-9.

3 Sayar K, Ugurad I, Kural Y, Acar B. The psychometric assessment of acne vulgaris patients. Dermatol Psychosom 2001; 1:62-5.

4 Khan MZ, Naeem A, Mufti KA. Prevalence of mental health problems in acne patients. J Ayub Med Coll Abbottabad 2001; 13:7-8.

5 Gupta MA, Gupta AK. Depression and suicidal ideation in dermatology patients with acne, alopecia areata, atopic dermatitis and psoriasis. Br J Dermatol 1998; 139(5):846-50.

6 Preston K. Depression and skin diseases. Med J Aust 1969; 1(7):326-9.

7 Polenghi MM, Zizak S, Molinari E. Emotions and acne. Dermatol Psychosom 2002; 3:20-5.

8 Aktan S, Ozmen E, Sanli B. Anxiety, depression, and nature of acne vulgaris in adolescents. Int J Dermatol 2000; 39(5):354-7.

9 Schulpis K, Georgala S, Papakonstantinou ED, Michas T. Psychological and sympatho-adrenal status in patients with cystic acne. J Eur Acad Dermatol Venereol 1999; 13:24-7.

10 Wu SF, Kinder BN, Trunnell TN, Fulton JE. Role of anxiety and anger in acne patients: a relationship with the severity of the disorder. J Am Acad Dermatol 1988; 18(2 Pt 1):325-33.

11 Grahame V, Dick DC, Morton CM, Watkins O, Power KG. The psychological correlates of treatment efficacy in acne. Dermatol Psychosom 2002; 3:119-25.

12 Medansky RS, Handler RM, Medansky DL. Self-evaluation of acne and emotion: a pilot study. Psychosomatics 1981; 22(5):379-83.

13 Impact of psychological stress on acne. Jović et al. Acta Dermatovenerol Croat 2017; 25(2): 133-141.