Acne stigma negatively impacts overall quality of life
Not only is self-perception of acne as a social stigma associated with higher levels of psychological distress, it is also linked to a lower overall quality of life, suggests a recent study.
“We know from previous research that many acne sufferers experience negative feelings about their condition, but we have never before been able to draw such a direct link between quality of life and perception of social stigma around acne,” said study principal investigator Dr Aisling O'Donnell of University of Limerick in Limerick, Ireland.
Among the 271 participants (mean age 21.6, 70.1 percent female) surveyed, perceived stigma of acne was significantly associated with higher levels of psychological distress (p<0.001), as indicated by depression and anxiety levels measured using HADS*. [PLoS One 2018;doi:10.1371/journal.pone.0205009]
Survey respondents with higher levels of perceived acne stigma also reported a greater impairment of health-related quality of life (HRQoL; p<0.001), as assessed using the 10-item modified Dermatology Life Quality Index (DLQI) which measures how acne affected six domains of their life including symptoms and feelings, personal relationships, daily activities, school/work, leisure, and treatments.
In particular, acne severity was found to correlate significantly with psychological distress and HRQoL, with greater severity predicting more distress and impairment in HRQoL.
Gender was another variable that correlated with HRQoL, with females reporting a greater impairment in quality of life than males.
Furthermore, female respondents with acne stigma also experienced more somatic symptoms (p<0.001) such as headaches, sleep disturbances, gastrointestinal problems, and respiratory infections as assessed in the 14-item Physical Health Questionnaire.
“The findings of this study echo previous research showing that individuals with visible physical distinctions, which are viewed negatively by society, can experience impaired psychological and physical well-being as a result,” said O'Donnell.
“This is important information for clinicians dealing with acne conditions. It’s also useful for those who are close to acne sufferers. The wider negative impacts some acne sufferers experience are very challenging and require sensitivity and support,” added study lead author, Jamie Davern, a PhD student at the University of Limerick.
“By developing a more complete understanding of the social factors affecting acne sufferers, it could be possible to improve the techniques for managing the diverse range of emotional and health consequences associated with the condition,” said the researchers.
The cross-sectional study surveyed 271 students and staff in a university who have experienced acne within the past two months. Their perceived stigma of acne was assessed using the adapted Day-to-Day Discrimination Scale. Respondents self-reported on measures of psychological well-being (by HADS), HRQoL (by DLQI), and somatic symptoms online. Majority of the acne condition was rated as mild (35.4 percent) or moderate (52.0 percent).
According to Davern, a lack of representation of acne in popular culture can add to the perceived stigma due to lack of awareness and understanding.
“Like many physical attributes that are stigmatized, acne is not well represented in popular culture, advertising or social media. This can lead people with acne to feel that they are ‘not normal’ and therefore negatively viewed by others,” he explained.
“Although skin conditions are commonly overlooked as mere cosmetic problems, the symptoms experienced by sufferers are often unpredictable, difficult to manage, and can have a considerable impact on self-esteem, body image and overall well-being,” said O'Donnell and Davern.