The Physical and Emotional Distress of Acne

By Kelly Ryder BS, PA-S

Advisor: Bill Grimes, PA-C

March 24, 2006

Due to the graphic nature of the this presentation, viewer

discretion is advised.

What is Acne Vulgaris?

Who gets this disease?

Locations

Types

Components involved

Three types of Papules A, B, C

A pustule

What is bad about this disease?

Noticeable lesions, redness, and inflammation

Different types of scars

Response to treatments

Emotional distress

Common Treatments

Avoidance of triggersBalanced nutritionMedicated creams, lotions, soapsOral medicationsAccutane (isotretinoin)Microderm abrasionLaser Skin Rejuvenation

Accutane (Isotretinoin)

Powerful drug last resortVitamin A derivative Severe birth defects in fetusLiver Functions/elevated triglyceridesCracking and drying skin and mmCurrently under a very tight watch by FDA Reported 260 patients depressed and committed suicide

Before and After Treatments

What haven’t we covered about Acne?

How the patient perceives themselves

Competitive society where look is everything

Healthy skin seen in supermodels, singers, actors/actresses on TV, billboards

Alicia Keys

Is Acne More Than Just Skin Deep?Many studies say

2000 study of acne patients evaluating the relationship between acne and psychological well-being.31 patients with Acne Vulgaris to 25 patients with healthy skinResults: acne patients suffered from a significantly lower self-esteem and had a higher rate of depression and trait anxiety.

Battle of the Sexes

2000 study2,657 high school studentsSeverity among males/females Anxiety and depression Results: “adolescent girls are more vulnerable than boys to the negative psychological effect of acne”

Is Acne and it’s emotional effects only observed in the US?

England study370 patients age 14-16 Acne severity was assessed Emotional and behavior difficulties were determined Results: patients with acne were nearly twice as likely as those without acne to score in the abnormal/borderline range of the Strengths and Difficulty Questionnaire Interesting findings: Patients knowledge about the cause of acne was low (45%)*Less than a third of participants with definite acne had sought help from a doctor,”

How Acne Affects People's Lives

"There is no single disease which causes more psychic trauma, more maladjustment between parents and children, more general insecurity and feelings of inferiority and greater sums of psychic suffering than does acne vulgaris."  --Sulzberger & Zaldems, 1948 http://www.skincarephysicians.com/acnenet/socimpct.html

Emotional distress of acne Those who have acne for many

years, well into their 20’s and 30’s often experience…Social withdrawal Decreased self-esteem Reduced self-confidence Poor body image Embarrassment Feelings of depression Anger Preoccupation Frustration Higher rate of unemployment

TAKE HOME MESSAGEEarly interventionMonitor treatments Patient complianceRoutine mental health statusSupport groupsSupportive PsychotherapyAnti-anxiety or depression medications when seen fit *in conjunction with AccutaneStress management

Talk To Your PatientsEngland study 2/3 didn’t know to seek help

Impaired school or work function

Indications of depression or emotional distress

Affordable treatment

Advise a plan

Patient’s advocate

Is There a Brighter Future for Potential

Acne Sufferers?

Oct 25, 2004-- German scientists

With this discovery, Dr. Holger Brüggemann aims to, “see if we can block its enzymes that degrade tissues, and also block enzymes that interact with the immune system".

Vaccinations may be in the future

Were you paying attention Quiz question 1.

Name a very powerful medication that is used to treat acne as a last resort.

Quiz question 2. Name some severe potential side effects of this drug.

Quiz question 3.What are some effects acne can have on a patients’ emotional status.

ReferencesAktan, S., Ozmen, E. Anxiety, depression, and nature of acne vulgaris in adolescents. International Journal of Dermatology, Volume 39, Number 5, May 2000, pp. 354-357.AcneNet. The Social Impact of Acne. http://www.skincarephysicians.com/acnenet/socimpct.htmlArriveNet Editorials. Could Decoding Genes Spell the End for Acne? http://editorials.arrivenet.com/health/article.php/2555.htmlPsychology today. A Care-Giver’s Companion. http://health.yahoo.com/centers/stress/68;_ylt=AttOJ3xz_rc2SVK6uoep84S3Gb4FSayer, K., Ugurad, I., Kural, Y., Acar, B. The Psychometric Assessment of Acne Vulgaris Patients. Dermatology and Psychosomatics 2000;1:62-65.Wolff, Klaus., Johnson, Richard Allen., Fitzpatrick’s Color Atlas & Synopsis of Clinical Dermatology, fifth edition. p. XXV-XXVII.Support group websites:http://health.groups.yahoo.com/group/AcneSupport/http://asgic.proboards26.com/index.cgi?board=RealLifeSupporthttp://www.acne.org/messageboard/index.php?showforum=17

Kbryde2@uky.edu