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The Physical and Emotional Distress of Acne
By Kelly Ryder BS, PA-S
Advisor: Bill Grimes, PA-C
March 24, 2006
Due to the graphic nature of the this presentation, viewer
discretion is advised.
What is Acne Vulgaris?
Who gets this disease?
Locations
Types
Components involved
Three types of Papules A, B, C
A pustule
What is bad about this disease?
Noticeable lesions, redness, and inflammation
Different types of scars
Response to treatments
Emotional distress
Common Treatments
Avoidance of triggersBalanced nutritionMedicated creams, lotions, soapsOral medicationsAccutane (isotretinoin)Microderm abrasionLaser Skin Rejuvenation
Accutane (Isotretinoin)
Powerful drug last resortVitamin A derivative Severe birth defects in fetusLiver Functions/elevated triglyceridesCracking and drying skin and mmCurrently under a very tight watch by FDA Reported 260 patients depressed and committed suicide
Before and After Treatments
What haven’t we covered about Acne?
How the patient perceives themselves
Competitive society where look is everything
Healthy skin seen in supermodels, singers, actors/actresses on TV, billboards
Alicia Keys
Is Acne More Than Just Skin Deep?Many studies say
2000 study of acne patients evaluating the relationship between acne and psychological well-being.31 patients with Acne Vulgaris to 25 patients with healthy skinResults: acne patients suffered from a significantly lower self-esteem and had a higher rate of depression and trait anxiety.
Battle of the Sexes
2000 study2,657 high school studentsSeverity among males/females Anxiety and depression Results: “adolescent girls are more vulnerable than boys to the negative psychological effect of acne”
Is Acne and it’s emotional effects only observed in the US?
England study370 patients age 14-16 Acne severity was assessed Emotional and behavior difficulties were determined Results: patients with acne were nearly twice as likely as those without acne to score in the abnormal/borderline range of the Strengths and Difficulty Questionnaire Interesting findings: Patients knowledge about the cause of acne was low (45%)*Less than a third of participants with definite acne had sought help from a doctor,”
How Acne Affects People's Lives
"There is no single disease which causes more psychic trauma, more maladjustment between parents and children, more general insecurity and feelings of inferiority and greater sums of psychic suffering than does acne vulgaris." --Sulzberger & Zaldems, 1948 http://www.skincarephysicians.com/acnenet/socimpct.html
Emotional distress of acne Those who have acne for many
years, well into their 20’s and 30’s often experience…Social withdrawal Decreased self-esteem Reduced self-confidence Poor body image Embarrassment Feelings of depression Anger Preoccupation Frustration Higher rate of unemployment
TAKE HOME MESSAGEEarly interventionMonitor treatments Patient complianceRoutine mental health statusSupport groupsSupportive PsychotherapyAnti-anxiety or depression medications when seen fit *in conjunction with AccutaneStress management
Talk To Your PatientsEngland study 2/3 didn’t know to seek help
Impaired school or work function
Indications of depression or emotional distress
Affordable treatment
Advise a plan
Patient’s advocate
Is There a Brighter Future for Potential
Acne Sufferers?
Oct 25, 2004-- German scientists
With this discovery, Dr. Holger Brüggemann aims to, “see if we can block its enzymes that degrade tissues, and also block enzymes that interact with the immune system".
Vaccinations may be in the future
Were you paying attention Quiz question 1.
Name a very powerful medication that is used to treat acne as a last resort.
Quiz question 2. Name some severe potential side effects of this drug.
Quiz question 3.What are some effects acne can have on a patients’ emotional status.
ReferencesAktan, S., Ozmen, E. Anxiety, depression, and nature of acne vulgaris in adolescents. International Journal of Dermatology, Volume 39, Number 5, May 2000, pp. 354-357.AcneNet. The Social Impact of Acne. http://www.skincarephysicians.com/acnenet/socimpct.htmlArriveNet Editorials. Could Decoding Genes Spell the End for Acne? http://editorials.arrivenet.com/health/article.php/2555.htmlPsychology today. A Care-Giver’s Companion. http://health.yahoo.com/centers/stress/68;_ylt=AttOJ3xz_rc2SVK6uoep84S3Gb4FSayer, K., Ugurad, I., Kural, Y., Acar, B. The Psychometric Assessment of Acne Vulgaris Patients. Dermatology and Psychosomatics 2000;1:62-65.Wolff, Klaus., Johnson, Richard Allen., Fitzpatrick’s Color Atlas & Synopsis of Clinical Dermatology, fifth edition. p. XXV-XXVII.Support group websites:http://health.groups.yahoo.com/group/AcneSupport/http://asgic.proboards26.com/index.cgi?board=RealLifeSupporthttp://www.acne.org/messageboard/index.php?showforum=17