The Effects of Acne on Self-esteem Among Adolescents
Adolescence is an important period for emotional and psychosocial development and considerable changes occur to self-consciousness. Low self-esteem in adolescence has been associated with delinquency, aggression, antisocial behavior, poor physical and emotional health, and lower economic success in adulthood compared to individuals with high self-esteem. This study focuses on how acne, a disease process that affects more than 85% of adolescents, impacts self-esteem in this patient population. We conducted a literature review for studies evaluating the impact of acne on adolescent self-esteem. Five studies that specifically focused on acne and self-esteem in the adolescent population were selected for complete review. All of the studies found a correlation between adolescent acne and low self-esteem and the majority of acne patients surveyed across all 5 studies reported dissatisfaction with their appearance and demonstrated more emotional disturbance than their peers without acne. Patient perception of disease severity was found to be the most important and universal indicator of low self-esteem. Acne treatment was associated with improvement in self-esteem. Early and aggressive treatment can have a positive impact on self-esteem in adolescents with acne, and it is important to consider a patient’s perception of his/her disease severity when selecting a treatment regimen. The high correlation between acne and psychosocial problems in adolescents indicates that it is imperative to assess patients for low self-esteem and depression prior to treatment.
Ref: Robin E. Schroeder, BS; Sebastian G. Kaplan, PhD; Steven R. Feldman, MD, PhD
- Acne (medically known as acne vulgaris) is perhaps the most common skin condition affecting people around the world.
- Acne affects people of all ages, though most commonly people in their teens, 20s, 30s, 40s, and sometimes unfortunately, even beyond.
WHO GETS ACNE & WHY
- Acne has few boundaries and occurs on the face, neck, upper arms, chest, back, and shoulders. While both males and females can get acne, research shows that outbreaks in males may be worse because they have more skin oils.
- Heredity also plays an important role-making some people more genetically predisposed to outbreaks than others. People with highly sensitive immune systems are also more likely to suffer from acne as they are more sensitive and susceptible to bacteria that are trapped in hair follicles.
- Other causes of acne include use of cosmetics containing oil, environmental pollutants, and drugs including androgens and barbiturates and humidity.
- According to the American Academy of Dermatology (AAD), acne is caused by the overproduction of androgens, hormones that are present in both males and females. Androgens most commonly increase during puberty, stimulating the sebaceous glands in the skin to enlarge and increase the production of sebum. This increase in oil production coupled with follicular debris composed of dead skin cells results in blockages in the sebaceous glands.
HOW DOES ACNE DEVELOP
- Acne is commonly described as an inflammatory skin condition.
- While PSUs are found all over the body, they most densely occur on the face, upper back, and chest. Sebaceous glands make an oily substance called sebum. Sebum normally empties onto the skin’s surface though the opening of the follicle, commonly called a “pore.” Keratinocytes line the follicle.
- Hair, sebum, and keratinocytes that fill the narrow follicle may produce a plug or blockage that prevents sebum from reaching the surface of the skin through the pore. The mixture of oil and cells create a perfect breeding ground for P. acnes bacteria that normally live on the skin to grow and multiply inside the clogged follicles.
- These bacteria produce chemicals and enzymes that cause inflammation. Redness, swelling, and tenderness commonly associated with acne lesions are characteristic skin responses to the presence of bacteria. When the wall of the plugged follicle breaks, their content comprising sebum, dead skin cells, and bacteria erupts into nearby skin-leading to what we commonly refer to as acne.
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