The Physical and Emotional Distress of Acne

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					The Physical and Emotional
     Distress of Acne

    By Kelly Ryder BS, PA-S
    Advisor: Bill Grimes, PA-C
         March 24, 2006
Due to the graphic nature of
the this presentation, viewer
    discretion is advised.
    What is Acne Vulgaris?

Who gets this disease?
                         Three types of Papules A, B, C
Components involved

                                 A pustule
What is bad about this disease?
 Noticeable lesions,
 redness, and
 Different types of scars

 Response to treatments
 Emotional distress
       Common Treatments
Avoidance of triggers
Balanced nutrition
Medicated creams,
lotions, soaps
Oral medications
Microderm abrasion
Laser Skin
        Accutane (Isotretinoin)
Powerful drug last resort
Vitamin A derivative
Severe birth defects in fetus
Liver Functions/elevated
Cracking and drying skin
and mm
Currently under a very tight
watch by FDA
Reported 260 patients depressed
and committed suicide
Before and After Treatments
What haven’t we covered about
How the patient
perceives themselves
Competitive society
where look is
Healthy skin seen in    Keys

supermodels, singers,
actors/actresses on
TV, billboards
Is Acne More Than Just Skin Deep?
     Many studies say
  2000 study of acne patients evaluating
  the relationship between acne and
  psychological well-being.
  31 patients with Acne Vulgaris to 25
  patients with healthy skin
  Results: acne patients suffered from a
  significantly lower self-esteem and had
  a higher rate of depression and trait
          Battle of the Sexes
2000 study
2,657 high school
Severity among
Anxiety and depression
Results: “adolescent girls
are more vulnerable than
boys to the negative
psychological effect of
    Is Acne and it’s emotional
effects only observed in the US?
 England study
 370 patients age 14-16
 Acne severity was assessed
 Emotional and behavior difficulties were determined
 Results: patients with acne were nearly twice as likely as
 those without acne to score in the abnormal/borderline
 range of the Strengths and Difficulty Questionnaire
 Interesting findings:
 Patients knowledge about the cause of acne was low (45%)
 *Less than a third of participants with definite acne had
 sought help from a doctor,”
     How Acne Affects People's
"There is no single disease which causes
  more psychic trauma, more
  maladjustment between parents and
  children, more general insecurity and
  feelings of inferiority and greater sums
  of psychic suffering than does acne
  vulgaris." --Sulzberger & Zaldems,
     Emotional distress of acne
Those who have acne for
many years, well into their 20’s
and 30’s often experience…
Social withdrawal
Decreased self-esteem
Reduced self-confidence
Poor body image
Feelings of depression
Higher rate of unemployment
Early intervention
Monitor treatments
Patient compliance
Routine mental health
Support groups
Supportive Psychotherapy
Anti-anxiety or depression
medications when seen fit
*in conjunction with
Stress management
  Talk To Your Patients
England study 2/3 didn’t know to seek
Impaired school or work function
Indications of depression or emotional
Affordable treatment
Advise a plan
Patient’s advocate
Is There a Brighter
Future for Potential
  Acne Sufferers?
 Oct 25, 2004-- German scientists
 With this discovery, Dr. Holger
 Brüggemann aims to, “see if we can
 block its enzymes that degrade tissues,
 and also block enzymes that interact
 with the immune system".
 Vaccinations may be in the future
Were you paying attention
     Quiz question 1.
      Name a very powerful medication that
      is used to treat acne as a last resort.
Quiz question 2.
 Name some severe potential side effects of
 this drug.
      Quiz question 3.
        What are some effects acne can have
        on a patients’ emotional status.
Aktan, S., Ozmen, E. Anxiety, depression, and nature of acne vulgaris in
adolescents. International Journal of Dermatology, Volume 39, Number 5, May
2000, pp. 354-357.
AcneNet. The Social Impact of Acne.
ArriveNet Editorials. Could Decoding Genes Spell the End for Acne?
Psychology today. A Care-Giver’s Companion.;_ylt=AttOJ3xz_rc2SVK6uoep84S3Gb4F
Sayer, K., Ugurad, I., Kural, Y., Acar, B. The Psychometric Assessment of Acne
Vulgaris Patients. Dermatology and Psychosomatics 2000;1:62-65.
Wolff, Klaus., Johnson, Richard Allen., Fitzpatrick’s Color Atlas & Synopsis of
Clinical Dermatology, fifth edition. p. XXV-XXVII.
Support group websites: