Psychological sequelae of acne vulgaris: results of a qualitative study

Objective: To investigate the psychological sequelae of acne vulgaris. Design: Qualitative study using a grounded-theory approach. Setting: General practices and specialty dermatology practices in Newcastle, Australia. Participants: Patients with current acne recruited from the practices. Method: We used semistructured interviews and recorded participants' comments verbatim. Data analysis was cumulative and concurrent throughout the data-collection period. Coding and analysis was done in the inductive tradition. Main Findings: Interviews were conducted with 26 subjects who represented a range of ages and acne severity. Psychological morbidity was considerable. Though participants had mood and anxiety symptoms, these symptoms tended to be subsyndromal and evanescent. More prominent symptoms were embarrassment, impaired self-image, low self-esteem, self-consciousness, frustration, and anger. Some subjects thought that acne had affected their personalities permanently and adversely. Psychological sequelae were attributed to the effects of facial acne on appearance. Conclusion: The psychological effects of acne can be considerable. The psychological morbidity is complex and often does not conform to standard psychiatric disease criteria. Recognition and management of the psychological sequelae of acne by general practitioners is of considerable importance