Acne diagnoses increases depression risk, says study

In the first year after being told by a doctor that they have acne, patients’ risk for a diagnosis of major depressive disorder spikes by more than 60 percent compared to the general population, a new study shows.

Dermatologists and other doctors treating acne should keep an eye on patients’ mood symptoms as well, and start treatment or make a psychological referral if depression is present, the authors write in British Journal of Dermatology.

“The idea for the current study came from another recently published study we did looking at the mental health effects of the acne drug isotretinoin (Accutane). Over the past few years, there have been numerous reports that isotretinoin (Accutane) has been linked to psychiatric disorders,” lead author Isabelle Vallerand told Reuters Health by email.

“Our recently published systematic review did not find an increased risk of psychiatric disorders among people treated with isotretinoin, but we wondered if acne itself may be contributing to mental illness,” said Vallerand, a researcher with the Community Health Sciences department of the Cumming School of Medicine at University of Calgary in Canada.

Acne, the most common skin condition in the U.S., includes whiteheads, blackheads, pimples, cysts and nodules that affect the face, shoulders, back, chest and upper arms. Past research has found that roughly two-thirds of acne patients are adults, not teenagers, and that depression is common, with about 10 percent of female acne patients also experiencing depression symptoms.

While it is intuitive that acne can have negative effects on mood, Vallerand said, the study team wanted to assess whether there was an increased risk of “true clinical depression.”

Using a large UK database of medical records, they analyzed information on patients ages 7 to 50 years, focusing on 134,437 people with a new acne diagnosis and 1,731,608 similar patients without acne.

After following both groups for up to 15 years, researchers found that among acne patients, the probability of developing major depressive disorder was 18.5 percent, while in the general population it was 12 percent. The risk was highest in the first year after a new acne diagnosis and then tapered off, the authors note.

 “We found that acne increased the risk of developing clinical depression by 63 percent in the first year following an acne diagnosis and that this risk remained elevated for five years after the initial acne diagnosis,” Vallerand said.

Overall, acne patients had 46 percent higher risk for major depression than the comparison group. Women outnumbered men among the acne patients, and women were also more likely to develop depression.

The authors did not have information about the severity of patients’ acne, but they speculate that more severe cases might lead to greater depression risk. Nor did they know what acne medications the patients were using, other than those on isotretinoin.

 “While it has been known for many years that people with acne might have a lower mood resulting from their skin, this is the first study to show conclusively that acne can be more than just a skin blemish, and can have a substantial impact on mental health in the form of clinical depression,” Vallerand said.

 “We believe that healthcare providers treating patients with acne should firstly be aware that acne is a risk factor for developing major depressive disorder and that they should encourage any of their patients with acne to feel comfortable raising any mental health concerns to their attention, as these should be taken seriously.”

Physicians treating patients with acne should also help to coordinate mental health interventions for their patients who develop depression, when needed, she added.