In Healing Adult Acne, by Richard G. Fried, MD, he has a chapter entitled “The Psychological Effects of Acne.” He discusses five psychological disorders commonly associated with acne. He is both a dermatologist and clinical psychologist.
1. Acne Excoriee
In acne excoriee , acne sufferers will “pick, scratch, or dig at their lesions.” This will lead to “open sores or scabs” and the sufferer will develop scarring. However, Fried cautions that it is not helpful telling these people, “Just stop with the picking already!” They can’t stop. In fact, the condition often persists even after the acne has been successfully treated. Picking at the skin is a compulsive behavior for them. And the more worried or frustrated they are, the more they tend to pick.
Having another activity to replace the picking can be helpful. Squeezing stress balls, playing with worry beads, etc are recommended. But if this does not adequately address the problem, medication may be necessary.
2. Obsessive Compulsive Disorder
This can be very similar to acne excoriee . People with this disorder mentally obsess about specific behaviors they feel they must perform. Skin picking can be one of those obsessive behaviors. For instance, when skin picking is involved, sufferers will experience anxiety because they cannot stop thinking about picking at their skin. Only the picking of the skin will temporarily relieve their anxiety .
The doctor recommends both medication and psychotherapy to treat this disorder.
3. Body Dysmorphic Disorder
These people obsess about their physical flaws. These flaws do not necessarily have to be real. But if you have a bad case of acne, I assume this just makes the disorder that much worse. Despite any attempts their loved ones might make to assure them that they look just fine, they still experience high anxiety over their appearances. This can be very debilitating, even to the point of sufferers being unable to work or socialize, because they spend hours in front of the mirror obsessing about all of their perceived flaws.
Doctor Recommendation: A combination of medication and psychotherapy.
4. and 5. Depression and Anxiety
Fried cites studies stating that depression and anxiety rates are higher in acne sufferers than in people with other conditions. He includes cancer in that list of other conditions. I found this astonishing. Of all the dermatological conditions, having acne was most associated with suicidal thoughts. I would have thought terminal skin cancer would top the list. But it was acne.
The doctor recommends a number of coping techniques and medications to treat the depression and anxiety if psychological distress is severe.