Acne often makes patients feel unattractive, embarrassed, self-conscious, and uncomfortable in social situations. They tend to be more depressed than patients without acne. It has been shown that suicidal ideation is more prevalent in acne patients than in patients with other skin diseases. Emotional distress probably is an aggravating factor for acne. Under stress, our adrenal glands are stimulated to produce more hormones. One of these hormones (dehydroepiandrosterone) is well known to stimulate the skin’s sebaceous glands, and this can lead to aggravation of acne. So it could be in that way a bit of a vicious cycle if the acne itself were the cause of the stress, the stress then being a factor in aggravating the acne.
Cost would be one [reason patients don't seek care], particularly if a person has no insurance or if insurance is not sufficient to cover medication as well as a visit to a doctor’s office. Inertia or denial could be two other reasons. There is no question that if a young person, or a person of any age, comes to see a physician for a problem, that problem, no matter what it may be, is a serious problem. It needs to be addressed seriously. Certainly there is never a circumstance where a physician should trivialize a patient’s complaint.
Our mission is to treat the acne, and, once it is improved, the emotional conflict over it is also improved, usually dramatically.
