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How Emotions Affect Acne
You’ve been anticipating and maybe even dreading the “big day” for weeks. The nature of the event isn’t important;
it may be a first date, an important job interview, or your own birthday party or even your wedding day. You try to hide
behind hair or heavy make-up but you can’t ignore the face in the mirror. As a result your emotions affect acne
Sound familiar? For acne sufferers all over the world, these
scenarios are all too common. Even routine social interactions
such as a day at the office, a trip to the market can be a
nightmare of stress and self-loathing.
Yet, due to the “merely cosmetic” nature of acne vulgaris, these
very real emotions are widely dismissed as oversensitivity.
Clear-faced friends and co-workers say, “Really, it only looks
worse to you.”
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And they are probably right. But they are missing an important point: Acne is as much about how you feel as how
you look. Over the years, the research methods and medical treatments may have changed, but the answers to the
question “how does your acne make you feel?” have remained alarmingly constant: Ugly. Angry. Dirty. Depressed.
These answers are consistent across gender lines, age barriers and national borders.
What is Being Done when it Comes to How Emotions Affect Acne?
Every year, millions of dollars are devoted to the medical study and treatment of acne; millions more are spent on
the development and marketing of over-the-counter remedies.
Comparatively little energy, however, has been spent determining the psychological and social effects of the
condition. Consider the following statement:
There is no single condition which causes more psychic trauma, more maladjustment between parent and children,
more general insecurity and feelings of inferiority and greater sums of psychic suffering than does acne.
Made by Sulzberger and Zaidems in a 1948 article, this statement rings true even today. Despite acne’s limited
impact on overall patient health, several studies have concluded that it produces a similar degree of emotional
stress to skin conditions causing significant physical disability. The implications are fairly obvious: Acne hurts more
on the inside. So why is it so easy for people to dismiss these feelings as vanity?
The Problem with Measure Emotion
The difficulty lies not in validating acne’s negative affects, but in
quantifying them. For years, researchers have been struggling
to find an accurate means of measurement for this particular
kind of study.
Scientists use psychometrics to measure conditions of the mind,
but have yet to develop a scale for evaluating the psychological
effects of physical conditions such as acne. And the use of
psychometric scales for evaluating acne patients has been
Why? Emotional symptoms like depression, anger, low self-
esteem are influenced by an incredible number of variables. So
it’s difficult to know for sure whether one’s depression is caused
by acne alone. Or is it a combination of factors, ranging from
trouble in school to on-the-job stress? At the moment, the best way to understand the psychosocial effects of acne
seems surprisingly simple: Listen.
The Power of Patient Testimony Regarding How Emotions Affect Acne
Until science develops an accurate scale, the best way for us to learn about acne’s emotional effects is from the
patients themselves. The following passages are excerpted from verbatim quotes taken during a 1995 study in San
Francisco. In dramatic contrast with the psychometric questionnaires used in the past, patients were asked open-
ended questions and encouraged to answer at length.
It has been many years since I have looked in a mirror. I comb my hair using a silhouette on the wall to show the
outline of my head. I have not looked at myself in the eyes in years, and that is painful to not be able to do that, and
that is a direct result of acne.
When my acne got more severe, I began to really examine more things, become more aware of social norms, what
is acceptable, what is attractive. That is when I began to have lower self-esteem; it made me become more of an
introvert. It made me want to avoid certain occasions. Ask her out? Well, maybe not. She won’t be interested
because of how I look.
It’s associated with being dirty, and I hate that, because it’s not at all like that. I inherited it from my mother, and she
is always telling me that she had the exact same thing, and that it will go away. I am mad that I inherited it from her.
My dad makes me feel bad because he never had bad skin when he was younger, so he doesn’t understand.
My mother doesn’t know what she has done to hurt me. If I ate fatty foods, she would criticize. If I ate spicy food,
which Thai food is, they are all spicy, she would say that because I ate spicy food, that was why I had pimples. She
kept telling me how ugly my face was, and no one was going to marry me if I had bad-looking skin. And that really
I know I am so insecure in this way but if I go into a store, I won’t buy
candy, even if I really want it. I think in my mind that people are looking
at what I am buying, and thinking, ‘Oh, she eats junk. No wonder she
has so many zits on her face’.
From just this small sample, it is easy to see the wide-ranging
emotional impact of acne on those who suffer from it. These accounts
of family conflict, social withdrawal and deep private suffering are,
according to the patients, the direct result of their acne.
While it is hard to measure the impact of this condition, the message
within these testimonies is clear: Acne can cause profound
emotional suffering. Of course, if you live with acne, this isn’t news,
but it may be helpful to know you are not alone.
If you’d learn more about simple lifestyle changes that can have a
significant effect on your condition, check out my review of Acne No