The Psychosocial Impact of Acne and Rosacea*

Acne and rosacea cause significant psychological distress and impairment of psychosocial functioning for many patients. Feelings of embarrassment lead many individuals to withdraw from social situations, and reports of depression and body image problems are common. Most studies, although not all, have found that patients with acne report higher rates of emotional and psychological problems than similar individuals without acne. In addition, self-rated quality of life is worse when acne is accompanied by more severe psychological distress. Rosacea is triggered by foods, alcohol, hot beverages, and also may be exacerbated by psychological stress. Depression and anxiety also appear to be especially common among patients with rosacea. Some reports have suggested that patients who are treated with oral isotretinoin may have relatively high rates of depression or suicide, although other studies have failed to identify a clear relationship between isotretinoin use and depressive symptoms. It is possible that the psychological benefits of improvement in severe acne with isotretinoin offset the potential for an increased risk of depression. Several authors have suggested specific recommendations to improve the management of the psychosocial impact of acne and rosacea. Patient education about the psychological impact of these disorders and the appropriate use of prescription medications is especially important. Referral to a mental health specialist who is experienced in the management of chronic illness is often helpful for patients with acne or rosacea. (Adv Stud Nurs. 2005;3(7):239-243)