Facial acne causes stigmatization among adolescents: A cross-sectional study

Stigmatization and Psychosocial Burden in Acne Patients

BACKGROUND

Acne vulgaris, a common dermatological condition, has physical manifestations and significant emotional and social implications for those affected. This study aims to assess the stigma experienced by acne vulgaris patients and identify relevant physical, social, and psychological factors.

METHODS

The research involved individuals aged 12-45 diagnosed with acne vulgaris. The authors recorded each patient's demographic information, global acne severity, and acne scar severity. Additionally, each patient completed the Dermatologic Life Quality Index, Beck Depression Inventory, Liebowitz Social Anxiety Scale, and 6-item stigmatization scale. Using the scale scores, the authors categorized the severity into subgroups and compared the results within these subgroups.

RESULTS

The severity of acne was positively correlated with DLQI scores (r = 0.196, p = 0.004) and stigmatization scores (r = 0.156, p = 0.024). Higher stigmatization scores were associated with increased levels of depression (r = 0.461, p < 0.001) and anxiety (r = 0.336, p < 0.001), as well as a significant impact on quality of life (r = 0.472, p < 0.001). Upon stratification of patients into three age groups (adolescence, late adolescence, and adulthood), the comparisons between these groups did not reach statistical significance.

CONCLUSION

The results of the current study reveal a clear connection between the severity of acne and psychosocial disturbances, irrespective of age. The authors advise incorporating psychosocial screening, especially for severe acne vulgaris patients of all ages.

Investigating the impact of perceived social stigmatization and social appearance anxiety on quality of life among patients with facial skin diseases

BACKGROUND

This study investigates the interplay between perceived social stigmatization, social appearance anxiety, and quality of life in individuals with facial skin diseases. Furthermore, it undertakes the psychological and social impact of visible skin diseases, such as acne, atopic dermatitis, rosacea, enlarged pores, and vitiligo, on individuals' quality of life. These conditions not only cause physical discomfort but also lead to feelings of sadness, anxiety, and low self-esteem. The research aims to investigate how perceived social stigmatization and social appearance anxiety affect the well-being of individuals with facial skin diseases. By examining these factors, the study highlights the need for dermatology-tailored interventions to address the psychological and social challenges faced by this group.

METHODS

This study was conducted between July to October 2023. A purposive sample (N = 250) included both men (112) and women (138) with an age range of 18 to 45 years (M = 28.01, SD = 4.65). The study utilizes standardized measures of the Perceived Social Stigmatization Questionnaire, Social Appearance Anxiety Scale, and Skin Related Quality of Life Scale, to assess the study variables. The data were collected from various hospitals and clinics in Islamabad and Rawalpindi.

RESULTS

The results revealed that perceived social stigmatization and social appearance anxiety negatively impact skin-related quality of life among individuals with facial skin problems. Females exhibit higher levels of these concerns compared to males, leading to a more impaired quality of life. Additionally, individuals suffering from specific skin conditions for a long time experience elevated levels of stigmatization and anxiety, further impairing their quality of life.

CONCLUSIONS

These findings highlight the significance of addressing social stigmatization and social appearance anxiety in dermatology-tailored interventions aimed at the quality of life for individuals dealing with facial skin concerns.

Comparison of blue laser and red light-emitting diode-mediated aminolevulinic acid-based photodynamic therapy for moderate and severe acne vulgaris: A prospective, split-face, nonrandomized controlled study

BACKGROUND

Acne is a chronic inflammatory skin disease. Photodynamic therapy (PDT) is a highly effective and safe drug-device combination treatment, typically using red and blue light. However, direct comparisons of aminolevulinic acid (ALA)-based PDT using these two light sources are lacking. Therefore, we compared the efficacy and adverse effects of ALA-based 450 nm blue laser-mediated PDT (BL-PDT) and 630 ± 10 nm red light-emitting diode-mediated PDT (RL-PDT) in the treatment of moderate-to-severe acne vulgaris, including analyses of different lesion types.

METHODS

Sixteen patients with moderate-to-severe acne vulgaris were recruited. All patients underwent BL-PDT on the left side of the face and RL-PDT on the right side. Treatments were administered thrice at 2-week intervals, and follow-up continued for 2 weeks after the final treatment. The average rates of improvement in inflammatory and non-inflammatory acne lesions, IGA (Investigator's Global Assessment) scales, and IGA success rates were calculated. In addition, adverse effects during and after each treatment were recorded.

RESULTS

At the 2-week follow-up after the final treatment, the average rates of improvement in total acne, inflammatory, and non-inflammatory lesions were 48.0 %, 63.0 %, and 30.0 % in the BL-PDT group and 42.2 %, 58.1 %, and 27.5 % in the RL-PDT group, respectively. The IGA scores for the two groups decreased by 1.8 and 1.7 points, respectively, and the IGA success rate was 53.3 % in both groups. There were no significant differences between the BL-PDT and RL-PDT groups in any measure of effectiveness. However, the BL-PDT group exhibited more severe adverse effects, especially pain and hyperpigmentation.

CONCLUSIONS

BL-PDT and RL-PDT have similar efficacies in moderate-to-severe acne vulgaris and are particularly effective for inflammatory acne lesions. RL-PDT benefits from milder adverse effects than those of BL-PDT.

Exploring the Intersection of Body Dysmorphic Disorder (BDD) and Dermatological Conditions: A Narrative Review

This narrative literature review examined the intricate relationship between body dysmorphic disorder (BDD) and dermatological conditions, with a brief focus on those characterized by conspicuous skin irregularities such as acne vulgaris, psoriasis, and vitiligo. Highlighting the significant prevalence of BDD among individuals afflicted with dermatological issues, our analysis illuminated the profound psychological repercussions stemming from an exaggerated preoccupation with perceived skin imperfections. Through an exploration of the underlying BDD symptoms, we analyzed the complex dynamics between skin health and mental well-being, emphasizing the disorder's impact on patients' psychological and social functioning. This narrative review further investigated the consequential effects of BDD on essential aspects of dermatological treatment, including patient adherence to therapeutic regimens, overall quality of life (QOL), and the effectiveness of available treatments. In addition to presenting current therapeutic approaches, we advocate for the integration of psycho-dermatological interventions tailored to mitigate the dual burden of skin conditions and psychological distress. Future research directions proposed include longitudinal studies to assess the long-term effects of BDD on skin disease prognosis and psychosocial well-being, which aim to refine and optimize treatment modalities to contribute to a more holistic understanding of BDD within dermatological practice.

Acne influences life-changing decisions among young adults

BACKGROUND

Acne is a chronic inflammatory disease predominantly affecting young people. This study was undertaken to assess the impact of acne in young adults on their major life-changing decisions (MLCD), paying attention to the relationships between major life-changing decisions profile (MLCDP) and Quality of Life (QoL), feeling of stigmatization and acceptance of the disease.

METHODS

The study was performed on 213 young people diagnosed with acne. A variety of questionnaires were employed to measure the clinical and psychological aspects of acne.

RESULTS

The majority of patients (N.=148, 73.3%) reported at least one MLCD that acne affected in any way (mean number 2.9±3.2, range: 0-18). The most common MLCD influenced by acne appeared to be a decision of changing eating habits (N.=132, 65.3%), followed by changing habits associated with smoking and alcohol (N.=85, 42.1%) and deciding to be more active physically (N.=61, 30.2%). The total score of MLCDP ranged from 0 to 33 points (mean 5.41±6.23 points). MLCDP total score significantly correlated with clinical acne severity (P=0.006), QoL (P<0.001), stigmatization (P<0.001) and illness acceptance (P<0.001).

CONCLUSIONS

Acne has an important impact on life-changing decisions in young adults. MLCDP correlates with impaired QoL, level of stigmatization and degree of illness acceptance. This should be taken into consideration in the holistic approach to acne patients.

Anhedonia in Acne Vulgaris: A Cross-Sectional Study of 104 Consecutive Acne Patients

Background

Anhedonia is defined as a reduced ability to experience or even a total loss of pleasure.

Purpose

This study was undertaken to evaluate anhedonia in 104 consecutive acne patients.

Material and Methods

Acne severity was assessed with Investigator Global Assessment (IGA), anhedonia was studied with the Snaith-Hamilton Pleasure Scale (SHAPS), Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS) and Temporal Experience of Pleasure Scale (TEPS). Moreover, the quality of life (QoL) and stigmatization, as well as depression and anxiety (Hospital Anxiety and Depression Scale - HADS), were additionally evaluated.

Results

Anhedonia was found in 20.19% of acne patients and was more common (p=0.007) in males (34.29%) than in females (13.04%). Based on SHAPS, males with acne showed significantly (p=0.049) higher levels of anhedonia (2.39 ± 3.18 points) than acne females (1.26 ± 2.36 points). Anhedonia significantly correlated with the clinical acne severity (SHAPS: r=0.205, p=0.038 and ACIPS: r=-0.222, p=0.026). Although the intensity of anhedonia did not show any relationship with QoL and stigmatization assessments, there was a significant correlation between anhedonia and depressive symptoms (SHAPS: r=0.310, p<0.001; ACIPS: r=-0.364, p<0.001). Such dependency was not documented for anxiety.

Conclusion

Anhedonia seems to be a common phenomenon in acne and should be considered in the holistic approach to acne patients.

Females May Have Less Severe Acne, but They Suffer More: A Prospective Cross-Sectional Study on Psychosocial Consequences in 104 Consecutive Polish Acne Patients

Acne is a common skin condition affecting both adolescents and adults, and it can profoundly impact patients' quality of life and mental well-being. This prospective cross-sectional study aims to explore the differences in psychosocial aspects between male and female acne patients in Poland. A total of 104 consecutive acne patients were included in this study. Clinical severity, patients' quality of life, stigmatization levels, and psychiatric disturbances were evaluated using the following instruments: Investigator Global Assessment (IGA), Dermatology Life Quality Index (DLQI), Cardiff Acne Disability Index (CADI), 6-Item Stigmatization Scale (6-ISS), and Hospital Anxiety and Depression Scale (HADS). This study found that female patients exhibited significantly less severe acne and experienced significantly decreased quality of life and increased levels of stigmatization. Furthermore, anxiety levels among female patients exceeded those observed in their male counterparts. Notably, no disparities in the severity of depression were observed between the two gender groups. Correlations were discerned among all psychosocial parameters in the entire study cohort and in the female subgroup, while such correlations were not uniformly observed among male participants. This study underscores the importance of considering psychosocial aspects and implementing routine measurements in the management of acne to improve patients' well-being.

Prevalence, Intensity and Psychosocial Burden of Acne Itch: Two Different Cohorts Study

BACKGROUND

Chronic itch is a common symptom of inflammatory skin diseases. This study was undertaken to evaluate the presence and intensity of itching in two different cohorts of acne subjects. Additionally, the influence of itching on the psychosocial status of acne individuals was assessed.

METHODS

Consecutive acne patients seeking dermatological advice and university students diagnosed with acne during dermatological screening were considered. The clinical and psychological aspects of acne were assessed using a variety of instruments.

RESULTS

About 40% of acne subjects in both cohorts reported itching. The mean WI-NRS during the last 3 days in acne patients was 3.83 ± 2.31 points (mild itch) and was significantly more severe (p < 0.001) than in university students diagnosed with acne (2.09 ± 1.29 points). Itch intensity did not depend on the clinical severity of acne. In consecutive acne patients, itch intensity correlated with quality-of-life impairments (assessed using DLQI and CADI) and HADS scores. There was no correlation between itch intensity and stigmatization levels.

CONCLUSIONS

Itching seems to be a common phenomenon in acne sufferers. Acne itch significantly influences patients' well-being and should be considered in a holistic approach to acne patients.

Acne Vulgaris-Novel Treatment Options and Factors Affecting Therapy Adherence: A Narrative Review

Acne vulgaris is an extremely common skin condition, affecting a large population of adolescents, but at the same time, remaining a quite common issue in the group of adult patients. Its complex pathogenesis includes increased sebum secretion, impaired follicular keratinization, colonization of sebaceous glands with Cutibacterium acne bacteria, and the development of inflammation in pilosebaceous units. Although there are many methods of treatment available targeting the mechanisms mentioned above, a large percentage of patients remain undertreated or non-compliant with treatment. Ineffective treatment results in the formation of acne scars, which has a major impact on the well-being and quality of life of the patients. The aim of this publication was a review of available evidence on widely used and novel methods of topical and systemic treatment of acne, additionally including current literature-based analysis of factors affecting patients' compliance. The strengths and limitations of novel substances for treating acne were discussed. We conclude that an effective acne treatment remains a challenge. A better understanding of current treatment options and factors affecting patients' compliance could be a helpful tool in choosing a proper treatment option.