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For those who don’t struggle with acne, breakouts may seem like a superficial, cosmetic nuisance. But the truth is that living with acne is not that simple—acne is a complex skin condition, and it can actually be a much heavier burden than meets the eye.
Not only can acne be physically painful and create stubborn scars, but the emotional toll that comes along with it is much more than skin deep—in fact, studies show the condition can impact your mental health, particularly as it relates to trauma. Here, we’ll explain the research behind acne-related trauma and what experts have to say about it.
In 2020, the Journal of the American Academy of Dermatology published a systematic review of 42 studies on acne and the associated risk of depression and anxiety. This likely won’t come as a shock (especially to those who have experienced acne firsthand), but the study found a significant association between both acne and depression and acne and anxiety.
The takeaway? Because of this associated mental health risk, clinicians are encouraged to vigorously pursue acne treatment and consider psychiatric screenings or referrals for those going through acne treatment, as this condition is clearly more than skin deep.
Another 2016 study done on the psychological impact of acne shed light on what this looks like for those living with acne day to day. The results explained which aspects of participants’ lives were most impacted by this condition, and these were the results:
- 88% reported feelings of embarassment and self-conciousness.
- 75% reported intrapersonal relationship struggles.
- 68% reported acne affecting their social life.
- 57% reported a negative effect on their work or studies.
- 25% reported difficulty in sports related to their acne.
- 10% reported avoiding swimming or sports altogether because of their acne.
But it’s not just in the moment that we see these affects: having acne can fundamentlly change how you see yourself long-term. An older study done on acne-suffers found that some patients expressed that acne “had affected their personalities permanently and adversely.” Meaning not only did they experience negative emotions during the period of time in which they had acne breakouts, but those feeling reverberated throughout their lives—echoing that anxiety and embarrassment for years to come.
Through a dermatologists’ eyes.
Board-certified dermatologist Andrea Suarez, M.D., FAAD, sees patients struggling with acne every single day and attests: “There is definitely a large mental health burden that accompanies having acne,” she says.
One common emotional struggle Suarez hears from her patients is the constant feeling that they need to cover up their acne with makeup. She emphasizes that many of her acne patients, especially women, “would rather stay home all day than go through the headache of putting a full face of makeup on to go to the grocery store.”
And it’s not just facial acne that can influence this trauma response. “A lot of patients do feel that it impacts their interpersonal relationships, dating, their sex life, and [the latter] especially if they have body acne,” Suarez says.
Mental health professionals echo these experiences.
Clinical psychologist and author of Nervous Energy: Harness the Power of Your Anxiety, Chloe Carmichael, Ph.D., also helps us understand the psychology behind why acne can have such a negative effect on mental health.
Social anxiety, which Carmichael defines as “a hyperfocus upon thyself,” is a common and constant struggle for many people with acne. “When we feel most vulnerable (like on a date) that’s when our stress levels can be higher,” she says, and acne can exacerbate that stress.
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It’s in those high stress moments, Carmichael explains, that people often want to zero in on the other person. They want to listen to their date speak, but intrusive thoughts often take center stage. For example: Are they staring at my acne right now? I wonder if my makeup is holding up. I hope my acne doesn’t gross them out.
These obsessive patterns aren’t easy to navigate away from, either. Carmichael often tells her clients to think of a few things they can redirect their thoughts to when these intrusive thoughts crop up, in order to help soothe their anxiety and be more present—but, of course, it’s easier said than done.
Adult acne seems to be especially frustrating in the professional world, Carmichael reports. Her clients struggling with adult acne often say their main concern is not being taken seriously, because they feel like they appear younger than they actually are. “If you’re going to a job interview [with acne], you may feel that you are not projecting a seasoned and mature physical appearance,” Carmichael echoes.
What’s more, living every day with the overarching urge to cover up in order to be socially accepted (like the scenario Suarez mentioned up top) can become traumatizing over time. “It can create a false sense of identity for some people,” Carmichael says.
And to bring everything full circle, this emotional distress can lead to worsening physical symptoms as well. “There can become a vicious circle where in our high-stress moments, we will have an acne flare up, which in turn causes more stress,” Carmichael explains.
Because of this intense correlation between acne and mental health struggles, it’s imperative that we advocate for acne treatment to be more accessible and more comprehensive in order to support patients on a physical and emotional level.
Furthermore, changing the narrative on social media is key, particularly for younger generations that see photos of seemingly “flawless” skin every day. Suarez tells mbg she believes that those with significant media influence can help their followers by showing them unfiltered images, or even just being open about using filters in general. At the end of the day, anything helps.
And if you are dealing with trauma from acne, know that this is a real, research-backed phenomenon, even though it may seem quite subtle on the surface. As licensed psychotherapist and trauma specialist Britt Frank, MSW, LSCSW, once said on the mindbodygreen podcast: Anyone, no matter their lifestyle, can experience trauma, and the first step towards healing is honoring that you have it. “Start with, ‘No matter how awesome my life is, I have the right to feel pain and heal my trauma.’ I think that’s a good starting place,” she says. “You can’t heal what you don’t name.”
At the very least, allow this to serve as a reminder that nobody is alone when struggling with acne. “It creates a more real, more realistic space for skin,” Suarez says.
Studies have shown that acne has a significant correlation with depression and anxiety, and many different parts of life are impacted by this condition, not just the skin. And we’ve come a long way in terms of connecting the dots between mental health concerns and acne, but much work is still needed.
Considering we know that acne can cause intense emotional turmoil, we should encourage folks to seek professional help, not just to treat their skin—but also come up with coping mechanisms to deal the ways that acne can make people feel. In short: Don’t be afraid to ask for help, not just to clear up breakouts, but to address your feelings about the breakout.
Here at mindbodygreen, we’ve long preached that caring about your skin isn’t vanity—it matters and is important. And if your acne is leaving you feeling less than, it’s OK to voice that.
As we wrap up Acne Awareness Month, we should remember to keep this meaningful part of the conversation going, far beyond the month of June.