By Tarini Karnati, Parkway Central, Chesterfield, MO, USA
Summary: Acne is a disease that is extremely common among most adolescents. The rise of lesions and pimples, as well as scars and dark spots, leave a mark on one’s external appearance. This article aims to provide an insight on the mental effects along the journey of acne, ranging from the disease itself, to treatment, and all the way to the aftermath.
In a world that never seems to sleep, the first thing people notice about anyone and everyone is physical, external appearance. Everything around us moves so quickly, so we begin to judge things based on first glance, which tends to add a lot of pressure into one’s personal appearance. Society places this pressure because of not only stereotyping but also beauty standards. The implication of beauty standards on mental health is one that has, is, and will continue to exist. One of the most common diseases that affect 85% of adolescents (12-24 age group) is acne (Reese, 2018).
Acne is one of the most common skin disorders in teenagers and young adults. It is an inflammatory disease, where the sebum (oil that prevents drying the skin) and dead skin cells block hair follicles. All the blockage causes an inflammatory reaction consisting of swelling and redness, and the clogging creates lesions and pimples (NIAMS, 2020). There are many types of acne, but the similarity between all of the different types is that they leave indents, red or dark spots, and bumps on the skin. The accumulation of marks and spots on the skin is something that takes many, many years to recover from even after acne treatment. Generally, acne scars will fade away with time, but the scars left behind can be extremely frustrating.
Acne and scarring caused by it has a significant impact on the emotional well-being and self-esteem for many adolescents. Acne scarring affects 95% of people with acne and is formed through improper collagen production while lesions heal (Zhou et al., 2023). 250 adolescents between the ages of 13-25 with moderate to severe acne were surveyed, and the conclusion of the research paper was that acne has an “adverse effect” on the way people perceive themselves (Gudiya et al., 2022). Another study done through JAMA Network had their patients, which consisted of 60 individuals, write a letter to their disease. Then, the researchers made a chart about the letters, categorizing them by physical, psychological, and emotional effects as well as numerous other factors, all supporting the heavy burden acne and acne scars places on a person (Tan et al., 2022). With acne being a common prevalent disease amongst so many people, it’s necessary to take in consideration the psychological and social distress it leaves on those who are affected and provide support when needed.
Not only does acne and scarring have a significant effect on one’s mental health, but so does one of the most common and effective treatments for this disease. Isotretinoin has been a popularly controversial medication ever since its release in 1982 but that is because of its teratogenicity (abnormalities to an exposed fetus) and numerous other side effects. However, its ability to prevent acne and future appearances of pimples is remarkable. One side effect that has constantly been questioned is the neuromodulatory (alteration of neurotransmitters) effects of isotretinoin. Between 1982 and 2000, there have been 37 reported cases of suicide and 394 cases of depression after exposure to isotretinoin (Magin et al., 2005). However, many dermatologists question the link between depression and isotretinoin as there is a lot of inconsistency. According to a study done at Northwestern University, it was discovered that 3.77% of cases between 2001 and 2017 developed depression (Study: Isotretinoin, 2019). There is no clear reason for the supposed link between isotretinoin and the potential mental effects, but there have been numerous cases associated with depression. With isotretinoin, there is a vulnerability towards mood disorder and mental health which is why more research is necessary to clearly discover the relationship between these two variables.
Acne is a disease that a majority of people will experience at one point in their life. Despite the common nature of this disease, the social stigma that surrounds it makes it difficult to manage. The mental health aspect of acne and the treatment process as well as the aftermath is one that hasn’t been talked about enough, yet so many people experience it. We should strive to create a supportive environment that acknowledges the natural process of growing into your skin, metaphorically and literally.
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