Psychological distress a burden many acne patients bear

Key Points

Yardley, Pa. - Acne patients live with more psychological distress than the published numbers would have you believe, according to an expert who is both a dermatologist and a psychologist.

"The psychological component of acne is ubiquitous but not often obvious," says Richard G. Fried, M.D., Ph.D., clinical director of Yardley Dermatology, Yardley, Pa. "The studies show that 17 percent to 34 percent of people with acne have a significant psychological impact such as depression, anxiety, impairment in psychosocial function. It's a big deal."

However, those statistics may under-report the psychological toll of acne, Dr. Fried says. "As is true for any assessment of psychological impact, people are not always forthcoming. They find it too embarrassing, too much of an admission of vulnerability." Furthermore, people who live with emotional distress sometimes assume that their feelings are normal, he says.

Subclinical depression

The broader psychological burden of acne is more evident to dermatologists when they consider patients who have subclinical depression.

"These patients go to work, play, go to parties and seem just fine," Dr. Fried says. "But the shine is gone. The vibrancy of life is not what it used to be. Food doesn't taste as good as it used to. Sex isn't as fun as before."

Subclinical depression has such an insidious onset that the patient may not notice the change, he says.

Disease severity does not necessarily correlate to the toll. Some people with mild disease can be suicidal, while people with cystic acne can be only mildly dismayed, Dr. Fried says.