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Acne May Blemish Teens' Emotional Lives, Too

By Randy Dotinga
HealthDay Reporter

THURSDAY, March 17 (HealthDay News) -- A new review confirms something that teens have always known: pimples, low self-esteem and depression often go hand-in-hand.

While it doesn't prove that blemishes actually cause emotional problems, the analysis of 16 studies suggests that teenage acne outbreaks do more than just boost Clearasil sales.

"Acne has a huge impact on people's lives," said review co-author Dr. Steven R. Feldman, a professor of dermatology at Wake Forest University School of Medicine. "It's something worth treating," he added, and not just because it can lead to permanent scarring.

Feldman said he launched his research at a time when there's a growing interest in how skin diseases might be linked to other conditions. People with psoriasis, for example, may have problems with heart disease, arthritis and mental issues.

Acne, of course, has long been known as a teenage scourge, although pimples can also affect older people. Feldman and his colleagues looked for research into the possible effects of acne on quality of life and mental health in adolescents. They determined that 16 studies were worthy of inclusion in their review; some of the studies included both teenagers and older people.

The review was published in the Dermatology Online Journal.

Overall, it says, the studies suggest that acne "can negatively affect quality of life, self-esteem and mood in adolescents." Acne is also linked to higher rates of anxiety, depression and suicidal thoughts.

In particular, one study found that 9 percent of teens with acne showed signs of depression, a rate that is three to four times higher than in the general population.

The cause-and-effect issue is a tricky one: the studies don't prove that acne directly causes these problems; it could conceivably be the other way around.

However, "we're not anticipating that depression causes acne," Feldman said, although he thinks stress could exacerbate the skin condition.

The good news is that acne is largely treatable, especially in severe cases. The drug Accutane (isotretinoin) remains available, despite its reputation for having serious side effects, including depression, if not monitored properly. Because of links to birth defects, the drug is also particularly hazardous for women who or pregnant or may become pregnant. "For those patients who take it, it will change their lives," said Dr. Robert S. Kirsner, chief of dermatology at University of Miami School of Medicine.

Those with less severe cases of acne, or those unwilling to take the drug, face a tougher battle, Kirsner said. In those cases, "you don't cure it. You treat it."

There are a variety of acne treatments other than pills, including injections that reduce inflammation and prescription and over-the-counter creams.

What to do? Review co-author Feldman advised acne sufferers to "go ahead and see your doctor to get it treated, a primary care doctor or a dermatologist, before there's scarring or psychological issues."

If you don't have insurance, many dermatologists will offer lower rates, and drug companies may be able to provide assistance too, he said.

More information

For more about acne, try the U.S. National Library of Medicine.

SOURCES: Steven R. Feldman, M.D., Ph.D., Wake Forest University School of Medicine, Winston-Salem, N.C.; Robert S. Kirsner, M.D., Ph.D., chief, dermatology, University of Miami School of Medicine; January 2011 Dermatology Online Journal

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