Q&A: Addressing mental health effects of acne
The effects of acne go beyond the skin, often having an impact on an individual’s social life, self-esteem and mental health.
As the COVID-19 pandemic ushered in an era of mask wearing and, in turn, an increase of mask-related acne or “maskne,” dermatologists need to be watchful of harmful mental health problems that can arise.
Healio spoke with Robin M. Schaffran, MD, chief dermatologist at BalmLabs who practices in Beverly Hills, California, about how acne can affect mental health and how dermatologists can best help their patients.
Healio: Why are we seeing a resurgence in acne in adult populations?
Schaffran: The answer to this is likely multifactorial. That being said, the increase in the amount of stress in our daily lives is a big culprit.
Healio: How can acne affect mental health in adolescents and adults?
Schaffran: Acne can be debilitating at any age. For teenagers, a few pimples can be enough to keep kids from wanting to go out and interact with others. On top of that, when breakouts become persistent and are deeper and more cystic, they can linger much longer and start to leave scars. This can trigger or aggravate depression in those who are susceptible. For adults, too, having breakouts can really impact self-confidence and interfere with how people interact with others in negative ways, thus leading to social isolation.
Healio: Do different populations experience different levels of risks in terms of mental health concerns caused by acne?
Schaffran: I think that teenagers are likely at the highest risk due to so many other factors that contribute to stress and anxiety in this population. Also, those who have underlying depression or genetic predisposition to depression or other mental health issues are at a greater risk for mental health issues caused by acne.
Healio: What are some symptoms of mental health issues that dermatologists can look for in their acne-prone patients?
Schaffran: Some signs that patients might have mental health issues related to their acne are when you see that they are “picking.” Picking is often a sign of stress or OCD tendencies. Another sign particularly found in teens is when they refuse to make eye contact or constantly have their head down. Finally, when there is a large discrepancy between how much acne they have and how bothered they are by it. Ultimately, if there are very few blemishes but the patient is debilitated by them, that can be a troubling sign.
Healio: How can dermatologists help their patients control their acne to reduce mental health issues?
Schaffran: I believe the best thing is to treat their acne and to keep following up with them. Acne can be highly variable in how it responds to various treatments, so it is important to remind patients that they need to be patient and give things enough time to work. Give them hope that there will be something that works for them and remind them that it is not unusual to have to try many different things before finding something that works. Keeping the lines of communication open can be helpful so patients do not feel like they will be battling this forever.
Healio: What other help can dermatologists offer, or who can they refer patients to deal with mental health issues caused by acne?
Schaffran: If symptoms are severe, then enlisting the help of mental health providers (psychiatrists or psychologists) can be a big part of treatment.