If you are or ever have suffered with acne, you know the devastating effect it can have on your confidence. And if you’ve been scarred by the experience—literally—the emotional toll can be even greater. Jerry Tan, M.D. knows all about it. He’s even researched it. The adjunct professor of dermatology at the University of Western Ontario and Acne Store advisory board member has co-authored two studies on the topic. The first examined how people perceived subjects shown both with and without acne; the second did much the same, but for acne scars. What both studies found is that both people with pimples and those left with lingering marks receive judgement from others—they’re even viewed as less successful. Here, Tan explains the significance of the psychological effects of acne and offers sound advice for facing the world chin-up, no matter what’s happening on your face. 

Q: What made you interested in looking at the psychological effects of acne and acne scars? 

A: Until now, the psychological effects of acne and scars had really only been understood through the eyes of the sufferer—their own self-perception. We know that they become extremely embarrassed and socially withdrawn and past research has told us that acne and acne scars can have a major impact on a person’s quality of life. [1] The psychosocial consequences can be more than just feeling down and anxious: These patients can demonstrate symptoms of depression, including increased thoughts of self-harm. What we didn't understand was how others perceived those with acne and scars. We wanted to see the impact.  

A: In a nutshell, what did you find? 

Q: The first study broke down the differences in what observers inferred from looking at images of people without acne versus those same faces digitized to have breakouts. Sadly, participants rated the people shown to be suffering from breakouts as less intelligent, less trustworthy, less happy, less healthy, and less popular. It really highlighted the issue of potential stigmatization and the possible negative attributes people associate with the acne and acne scars. 

Then we did a similar follow-up that had people judge images of faces without acne scars and, again, faces that had been digitally manipulated to have acne scarring. What that study showed was that when patients were shown with scars, people again thought they were considerably less attractive, less confident, less successful, less happy, and seen to be more likely to be insecure, shy, or withdrawn.  

Q: Some of the study participants had acne themselves—did that seem to play into their responses? 

A: Absolutely. Participants who either currently had or previously have had acne or scarring were much quicker to notice the skin first, as opposed to the hair, the eyes, or the lips. It may seem like they were quicker to judge, but I’d guess it was actually because those people were more sympathetic since they, too, have had those same troubles. They were more sensitive to it. 

 Q: You mentioned a connection between acne and scars and perceptions of success. Does that indicate that people think of acne as a personal failing? 

A: Sadly, I think so. One of the messages that came out of our studies was that all the observers in each of those groups—whether they had acne or not—thought that those with acne or scarring simply had to improve their skincare. I think that indicates they thought there was some sort of failing on the part of the person who had it.  

Q: What do you feel this told you about the psychological effects of acne and acne scars? 

A: I think both of these studies really underscore the importance of understanding the emotional burden of acne. And with scarring it's almost like a double whammy—acne is bad enough, but then they get scarring and their painful story continues.  

Q: How can this research help people with acne scars and depression? 

A: To me, the message is that if your acne or scars bother you—and it’s great if they don’t—it may help to express that. To vent. If someone who is bothered by acne doesn't get a chance to talk about it, they may become ashamed and become more socially withdrawn. Your dermatologist can certainly help clear up the acne and address the scarring, but if you're concerned about your feelings, it may also be a good idea to find a supportive psychologist or psychiatrist. I truly want to empower patients with hope: There have been a lot of advancements in recent years that mean we can help patients improve their skin more quickly and effectively. You don’t have to continue to look in the mirror and see acne or scars staring back at you. There is hope. There is help. 

References: 

[1]: https://pubmed.ncbi.nlm.nih.gov/9892952/