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 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.
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"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.
SOURCE: http://bit.ly/2HhVZBT British Journal of Dermatology, online
February 7, 2018.
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