Parsing the Link Between Acne and Depression

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Teenagers with severe acne are two to three times more likely to suffer from depression than their clear-skinned peers, according to a new study in the Journal of Investigative Dermatology.

Jon Anders Halvorsen from Oslo University Hospital in Norway studied 3,775 men and women between the ages of 18 and 19. He found that the 528 participants who reported having “substantial” acne were more likely to be depressed and have suicidal thoughts.  Women with acne were twice as likely to contemplate suicide as women without, while men were three times as likely as their pimple-free peers.

But it’s not clear whether having bad skin makes teens depressed, or whether some other underlying condition links depression with acne. Considering that depression can cause poor self-esteem and sometimes even body dysmorphia, it’s also possible that depressed teens would self-report “substantial” acne more often than their peers. In other words, depression could fuel poor body image, which could cause a teenager to believe that his acne is worse than it is.

That said, about 10% to 20% of teens suffer from severe acne, so 14% does reflect the age group’s average.

Based on his findings, Halvorsen advocates for use of popular acne medications like Accutane, which was given a black-box warning by the FDA and has been linked to depression and behavioral problems. He says:

“There has been a lot of controversy regarding these drugs and that has made many dermatologists cautious about prescribing isotretinoin (Accutane). Our study is important because it provides an argument for not being so cautious.”

We say: not so fast. A well-respected 2008 study in the Journal of Clinical Psychiatry found a doubled risk for depression among teens who took the drug. And it seems tenuous at best to suggest that an acne medication does not cause depression, simply based on findings that associate the mood disorder with acne in teens. (The current study did not account for acne-drug use.)

More research is clearly needed to establish a link between these two conditions. In the meantime, if you have questions about acne treatment, ask an expert. The American Academy of Dermatologists offers a comprehensive database of specialists across the country.

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