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Adolescent patients with acne who had internalized stigma also had significantly lower quality of life, highlighting the need for holistic care.

Internalized stigma is strongly linked to reduced quality of life in patients with acne vulgaris, leading researchers to urge clinicians to adopt a holistic approach to management that includes stigma assessment and intervention. The findings were published in Healthcare.

“Research has shown that patients with acne and associated scarring frequently experience stigmatization, which can lead to impaired quality of life, social withdrawal, and body image disturbances. These factors may further increase the risk of developing depression and social anxiety,” said Mustafa Younis, PhD, and colleagues. “In this study, we aimed to evaluate the internalized stigma state of [acne vulgaris] and its relationship with quality of life and disease severity.”

Evaluating Acne Severity, Stigma, & QOL

The cross-sectional, observational study included 179 adolescents with acne vulgaris. The researchers assessed patients with the Internalized Stigma Scale (ISS), measured quality of life with the Acne Quality of Life Scale (AQLS) and the Dermatology Life Quality Index (DLQI), and evaluated acne severity with the Global Acne Grading System.

Mean ISS scores were significantly high, suggesting that many teens internalize negative perceptions about their appearance. Feelings of stigma were strongly associated with lower quality of life scores (AQLS, r=0.653; DLQI, r=0.487; both P<0.001) and modestly associated with increased acne severity (r=0.257; P=0.006).

Using linear regression analysis, the researchers identified the AQLS as a significant predictor of internalized stigma (β=0.521; P<0.001), suggesting that how patients perceived the social and emotional impact of their acne played a crucial role in how deeply they internalized stigma.

Toward Holistic Acne Management

The researchers noted that the study’s single-center design and lack of a control group limit the generalizability of their findings. However, several previous studies have linked internalized stigma to quality of life in patients with acne.

“Studies have demonstrated that individuals with acne frequently experience internalized stigma, which can lead to feelings of shame and worthlessness,” the researchers said. “Perceived stigma has also been shown to be a strong predictor of health-related quality of life, psychological distress, and somatic symptoms, significantly influencing overall well-being in those with acne.”

Given their findings, the researchers called for clinical practice to move toward more comprehensive management of acne vulgaris. They recommended that clinicians assess internalized stigma during routine evaluations and offer patients psychological support, counseling, and interventions as needed.

“The study calls for an urgent shift toward a holistic approach in acne management that not only targets the clinical aspects of the condition but also prioritizes the psychological well-being of patients,” Dr. Younis and colleagues concluded. “By addressing the psychological burden and stigma associated with [acne vulgaris], clinicians can improve patient outcomes and enhance overall disease management. This integrated approach will contribute to a better quality of life for patients and promote more effective and compassionate care.”