Acne, scarring cause lasting psychological impacts

Individuals with acne and acne scarring experience deep psychological and physical burdens due to their conditions, according to a study.

“Acne scarring is a long-term complication experienced to some extent by most who have had acne and can persist for a lifetime,” Jerry Tan, MD, of the Schulich School of Medicine & Dentistry at Western University in Windsor, Ontario, Canada, and colleagues wrote. “Evidence suggests that acne scarring can negatively influence the self-esteem and self-confidence of individuals, leading to anxiety, depression and perceived decreased employability, which in turn can affect their social and vocational functioning.”

Most studies in this area have focused on dermatology-specific questions regarding acne and acne scarring’s effect on psychosocial well-being, the authors added.

In the qualitative study, researchers asked participants with facial or truncal acne (FTA) or acne scarring (AS) to complete a personification exercise titled “Letter to my Disease,” which required them to imagine their acne or AS with human qualities or characteristics and engage with it in writing.

The letters were then assessed with thematic analysis.

Of 60 participants, 56 completed the exercise, including 28 in each the FTA and AS arms.

Analysis found three main themes in the letters: burden of the condition, attitudes and beliefs, and relationship to the condition.

Many psychological consequences of acne and acne scarring were detailed, including poor self-esteem and feelings of unattractiveness, which led to avoiding being photographed and other consequences of a broken image of self.

The treatment burden of the conditions included a financial burden and inconvenience.

Additionally, many participants explained how their condition left them with negative feelings of self-worth and impacted social relationships.

“The findings of this qualitative study suggest that FTA and AS inflict considerable psychological and physical burden on individuals with these conditions,” the authors wrote. “These consequences should be considered in patient treatment through awareness, education and appropriate symptom management to address insecurity and provide a greater sense of control.”