Severe acne linked to suicidal thoughts in teenagers

By Dr. Ananya Mandal, MDSep 16 2010

According to a new study on Norwegian youth, compared to clear-skinned peers, teens who have bad acne are more than twice as likely to have mental health problems and are at greater risk of having suicidal thoughts. Normally most teenagers have pimples. The case gets worse only for some. Dr. Jerry Tan, a dermatologist at the University of Western Ontario, in Canada said a bad skin can be psychologically devastating at “a critical point in human development where self-image and confidence [are] being established.” Dr. Tan who was not involved in the study also added, “There are hidden consequences to acne -- particularly severe acne.”

Researchers are not yet sure whether the mental health problems are due to acne or isotretinoin, and other acne treatments may have played a role as the exact treatments of these teenagers are not known. Isotretinoin, the active ingredient in brand-name drugs such as Accutane and Claravis, has been linked to depression, suicide, and suicidal thoughts in the past.

According to Dr. Jon A. Halvorsen, lead author from of the University of Oslo, in Norway, “There has been a lot of controversy about this, especially in the U.S…But depression and suicidal [thoughts] in acne reflects the burden of acne, rather than being a side effect of isotretinoin.”

The study was funded by the Norwegian Institute of Public Health and published in the Journal of Investigative Dermatology. 3,775 teens aged 18 or 19 were included. Fourteen percent of the teens reported having “a lot” or “very much” acne. Of this “very much” group nearly 25% said they had had thoughts of suicide, compared with 11 percent of the study participants overall. In addition, the teens with bad acne were 52 percent more likely to have low attachment to friends. They were also more likely to do poorly in school, and were less likely to have had a boyfriend or girlfriend. Surprisingly this impact is more among boys than girls.

Dr. Tan says these results “are not surprising and agree with what I see in clinical practice…Those with more severe acne have greater psychological problems and social impairment.”