Acne and Psychodermatology

Abstract

Acne is a common skin disease: however, the psychosocial burden is often serious because it affects the faces of those during puberty and in young-adulthood. The quality of life (QOL) of acne patients, especially of female patients, is likely to be degraded due to the change in appearance. It is notable that even mild acne can significantly influence patient QOL, especially on the emotional plane. Acne has also been reported to be accompanied by depression and anxiety disorders. Psychosocial stress is one of the major exacerbating factors of adult acne. In such cases, acne is regarded as a psychosomatic skin disorder. The most frequent stressors among these cases are daily hassles, particularly interpersonal stress at work, which is a common stressor among young adults. In such cases, scratching behavior such as scratching, rubbing, and squeezing acne lesions may occur as a reaction to stress. This behavior is regarded as an inappropriate way of stress coping. Decreasing this scratch behavior as well as improving stress coping skills is necessary. A scratch diary, a self-monitoring of the situation in which scratching behavior occurs, is an effective tool for patients to recognize the correlation between their stress or negative feelings and scratching behavior. This helps patients find more effective and appropriate ways of dealing with stress. Patient self-care is the key to controlling acne; namely, practicing appropriate treatment behaviors, including adherence to medication, a good life style, reducing scratching behavior and so on. Dermatologists should support acne patients so that they exercise the expected self-care more successfully. The purpose of this article is to discuss the psychosocial aspects of acne in order to understand patients' problems more adequately. It also introduces a few simple approaches to acne treatment from a psychodermatology standpoint.