Self-Injurious Behavior Might Be More Common in Adolescents With Acne

August 2, 2018

By Reuters Staff 

NEW YORK—Adolescents with acne are more likely to engage in self-injurious behavior than their clear-skinned peers, a small study from Turkey hints.

"The presence of high levels of psychiatric comorbidity, suicide probability, and self-injurious behavior in adolescents with acne in our study suggests that psychiatric evaluation should be included in acne treatment plans," Dr. Funda Ozyay Eroglu of Suleyman Demirel University, in Isparta, and colleagues conclude.

Adolescents with acne are more vulnerable to emotional and behavioral problems, but the relationship between acne and self-injurious behavior (SIB) has not been studied, the researchers note in the Journal of Cosmetic Dermatology, online July 11.

They assessed psychiatric comorbidities, SIB, suicide probability and related factors in 104 adolescents with acne and 102 controls matched by age and sex. In the affected group, 52.9% had mild, 32.7% moderate and 14.4% severe acne.

Overall, 37.5% of the adolescents with acne had at least one psychiatric diagnosis, versus 15.7% of the control group (P<0.001). The most common diagnoses included generalized anxiety disorder, post-traumatic stress disorder (PTSD), major depressive disorder and bulimia nervosa.

Acne quality of life score (AQLS) was significantly correlated with psychiatric comorbidity, with psychiatric diagnoses increasing as AQLS worsened.

Adolescents with acne who had a psychiatric diagnosis were significantly more likely to report low to moderate self-esteem than were adolescents with a psychiatric diagnosis in the control group (74.4% vs. 43.8%). They also had worse life satisfaction and loneliness scores.

In the case group, 41.3% reported SIB, compared to 20.6% of controls (P=0.001). "In our study, the most common type of SIB in the adolescents with acne vulgaris was preventing wound healing, followed by hair break, tucking and pinching behaviors, which suggested that SIB types observed in adolescents with acne vulgaris were mostly milder forms of SIB," the team writes.

Among the patients with acne who reported SIB, quality of life was significantly associated with hopelessness and hostility.

Seven study participants had been exposed to sexual abuse, all of whom were in the acne group; six of these individuals had clinically significant PTSD.

"Acne seen in adolescence, the period of life during which the ability to cope with stress is relatively lower, may play a role in the development of psychiatric comorbidities, which in turn reduces the quality of life and adversely affects the levels of self‐esteem/ loneliness/life satisfaction," Dr. Eroglu and colleagues write.

"Psychological assessment of adolescents with acne vulgaris is important for contributing to the detection of any potential covert sexual abuse," they add. "Our study demonstrates the importance of a multidisciplinary approach for acne treatment."


J Cosmet Dermatol 2018.

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