• Posted October 12, 2023

Women With Acne Bear Another Burden: Stigma

Adult acne can significantly change how women are perceived in social settings, a new study finds.

And where the acne is located on the face changes the onlooker's perception.

Researchers tracked eye movements of 245 study participants looking at pictures of women with clear skin or acne on different parts of their faces. Faces with acne were perceived as significantly less attractive, less trustworthy, less successful, less confident, less happy and less dominant.

Acne that was primarily located in the U-zone, which is around the jawline, mouth and chin, received the lowest scores for attractiveness and was considered the most visually disturbing.

“This study concerns simple questions: Who is more burdened by the disease? Which lesions need to go first? Whom should I treat more aggressively?” said lead author Dr. Marek Jankowski, an assistant professor of dermatology at the Nicolaus Copernicus University in Torun, Poland.

“What they're really trying to get at is where on the face acne is going to have the most impact on how someone perceives the acne, either self-perception or another person looking at the face,” added Dr. Christopher Bunick, an associate professor of dermatology at Yale School of Medicine. “The implication they're trying to make is that, if someone has more kind of mid-facial acne then maybe that's a little bit closer to the healthy skin and a little less bothersome. Whereas around the mouth and the forehead seem to be a little bit more problematic, which I thought was interesting.”

Bunick, who was not part of this study, recently conducted a separate study that found dermatology visits for acne were higher in adult female patients compared to adult males. So women, in particular, are concerned with how acne affects their appearance.

Dr. Raman Madan is a dermatologist at Northwell Health in New York. He was skeptical of the study's setup and whether looking at photos on a computer screen and tracking eye movements would be the same as looking at someone in person. But he has also found that women seem to come into his office more frequently than men to talk about acne.

“Women seem to be a lot more bothered by it than men,” Madan said. “Men will come to me for an unrelated issue and I ask if they want to have their acne treated and, if we address it, half the time they say, 'Oh no, I don't care. I've had this my whole life.' But the majority of time when it comes up with women, they are ready to talk about it. It's probably because they are more socially affected by it than men are.”

Indeed, yet another study out of Ireland found that, especially for girls and women who have acne, perceived social stigma diminishes quality of life. And, according to the American Academy of Dermatology Association, acne is the most common skin condition in the United States, affecting up to 50 million Americans annually. Adult acne is also increasing and affects up to 15 percent of women.

Acne can be caused by a variety of factors, including hormonal changes, diet, stress and genetics.

Fortunately, for people suffering with acne, there are treatment plans to address the issue, including oral spironolactone, a hormonal therapy, and oral isotretinoin.

While they aren't a magic bullet, said Bunick, they are worth trying.

“Are there perfect medicines out there? No,” he said. However, “we have a couple medicines that can deal well with adult female acne.”

For women considering oral isotretinoin, which used to be known as Accutane, it's important that they are not pregnant or trying to get pregnant.

The study was scheduled for presentation this week at a meeting of the European Academy of Dermatology and Venereology in Berlin, Germany. Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.

More information

For more on acne, visit the American Academy of Dermatology Association.

SOURCES: Marek Jankowski, MD, PhD, assistant professor, dermatology, Nicolaus Copernicus University, Torun, Poland; Christopher Bunick, MD, PhD, associate professor, dermatology program, translational biomedicine, Yale University Department of Dermatology; Raman Madan, MD, dermatologist, Northwell Health, Glen Cove, N.Y.; presentation, European Academy of Dermatology and Venereology, Oct. 11-14, 2023, Berlin, Germany