Psychiatric comorbidity and psycho-emotional status of patients with acne

Abstract

Acne is a very common skin disease that has a significant impact on the psycho-emotional status of patients. This disease affects various areas of patients’ lives, leading to problems in body image, socialization, and sexuality. The change in appearance and the psycho-emotional stress associated with the development of acne can also affect other aspects of  patients’ lives, including educational attainment, social activity, and a decline in academic performance and ability to work. Interpersonal problems in acne patients can occur not only with acquaintances and colleagues, but also within the family. The presence of  a  pronounced cosmetic defect, along with acute psycho-emotional problems, leads to a sharp decrease in quality of life, which is often exacerbated by comorbid psychiatric pathology: anxiety, depression, dysmorphophobia, self-injurious behavior, which certainly requires timely, effective and safe therapy for the underlying skin disease. Isotretinoin is an effective medication for the treatment of severe and treatment-resistant forms of acne. This drug has an  effect on all four pathophysiological factors of acne development. Isotretinoin reduces sebum production, regulates hyperkeratosis in the estuaries of sebaceous follicles, reduces the number of Propionibacterium acnes on the skin and is thought to have certain immunological and  anti-inflammatory effects. This is why the introduction of this drug into clinical practice has been recognized as an incredible triumph in the treatment of vulgar acne. However, the presence of  some undesirable side effects may limit its widespread use. In 1982, for example, the FDA issued a warning about the possible risk of depression and the occurrence of suicidal thoughts and attempts while using isotretinoin. However, this warning was not subsequently confirmed.