Acne Can Take Serious Toll on Adolescents' Self-Esteem, Study Results Show

Female adolescents and adolescents with darker skin are disproportionately affected by acne's psychological impacts, which calls for a more aggressive approach to treat the condition from a dermatology perspective and to address the psychological toll, according to investigators from the University of California at Riverside (UCR).

"Acne is pervasive, physically harmless, and painless, so we all-too-often underestimate its impacts as the quintessential nuisance of adolescence and puberty," Misaki Natsuaki, PhD, a coauthor of the study and a UCR associate professor of psychology, said in a statement.¹

The psychological effects of acne among adolescents are often "toxic," according to the study authors.

The investigators noted that 20% of adolescents have moderate to severe acne and 85% experience recurrent bouts.

Numerous studies have shown the direct links between acne and anxiety, depression, and suicidal thoughts.

Teenagers with acne have more difficulty forming friendships, feeling connected to school, and finding romantic partners, according to the study authors.

When shown a picture of a teenager with facial acne, 65% of adolescents said that skin was the first thing they notice. However, in a picture of a clear-skinned teen, the adolescents said that they noticed skin first just 14% of the time. They associated teens with acne with traits such as "lonely," "nerdy," and "stressed."

Research has shown that females experience negative psychological impacts at a rate higher than males, according to the investigators.

"Aesthetic ideals of clear and unblemished skin are held by both sexes," the investigators wrote in their paper, Adolescent Acne and Disparities in Mental Health, published in Child Development Perspectives.² "But females experience greater social pressure to attain these ideals than males."

Additionally, adolescents with darker skin color, many of whom come from ethnic-racial minority backgrounds in the United States, are likely to have disproportionate effects of acne due to a heightened incidence of scarring and hyperpigmentation, the study results show.

The authors argue that structural systems of inequality, which fuel health care disparities in the United States, further intensify acne and related psychosocial distress among individuals receiving public health insurance.

Further, the complex infrastructure of health insurance system, reluctance to provide dermatology appointments to children and adolescents with public insurance, and uneven geographical density of health care providers all contribute to these disparities, according to the authors.

"According to dermatology research, the psychological burden of acne is on par with that of other serious illnesses such as diabetes," study coauthor Tuppett M. Yates, PhD, a professor of psychology at UCR, said in a statement. "Acne is a medical condition with clear psychological effects, effects that are nonrandomly distributed as a function of gender, skin color, and socioeconomic status."

REFERENCES

1. Warren JD. Study: acne treatment only addresses half of the problem. UC Riverside. February 11, 2021. Accessed February 16, 2021. https://news.ucr.edu/articles/2021/02/11/study-acne-treatment-only-addresses-half-problem

2. Natsuaki MN, Yates TM. Adolescent acne and disparities in mental health child development perspectives. Child Dev Perspect. 2021;15(1):37-43. doi:10.1111/cdep.12397