The psychological impact of acne appears to be greater in boys than in girls. The researchers aren’t sure why this is, although they say it could be because girls tend to treat their acne more aggressively than boys.
The findings “are not surprising and agree with what I see in clinical practice,” Dr. Tan says. “Those with more severe acne have greater psychological problems and social impairment.”
The study couldn’t prove that acne directly causes suicidal thinking and other mental health problems. As the researchers note, the link could run in the other direction: Psychological stress may make acne worse.
Nor does the study close the book on the purported link between isotretinoin and depression, Dr. Tan says, although he adds that the evidence for the link was not particularly compelling to begin with.
“While these results do not exonerate isotretinoin in causing depression, it does suggest that severe acne in and of itself is associated with suicidal [thoughts],” he says.
Suicidal thoughts sometimes lead to suicide attempts. Suicide currently ranks second (behind injuries) as the leading cause of death among adolescents in the industrialized world, according to background information in the study.