Acne and Depression



In some patients the distress of acne may result in depression. This must be recognised and managed.

Signs of depression include:
-loss of appetite
-lethargy
-mood disturbance
-behavioral problems
-wakefulness
-spontaneous crying
-feelings of unworthiness.



In teenagers depression may manifest as social withdrawal (retreat to the bedroom or avoidance of peers) or impaired school performance (lower grades or missed assignments). Worse still, severe depression from acne has resulted in attempted suicide and, unfortunately, successful suicide. Worrying statements include I don't want to wake up in the morning; I'd be better off dead; I'm worthless; You'd be better off without me. Parents, friends and school counsellors need to take heed when they start to hear these types of comments.
Rarely, depression can be associated with acne treatment, particularly isotretinoin. There is considerable doubt that the drug has caused the problem and it seems much more likely that it results from the acne and psychological disturbances described above.
Regardless of the cause, depression must be recognised and managed early. If you think you may be depressed, contact your dermatologist or family doctor urgently for advice.

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Psychological Effect of Acne 2



he psychological and social impacts of acne are a huge concern especially because it affects adolescents at a time they are developing their personalities. During this time, peer acceptance is very important to the teenager and unfortunately it has been found that physical appearance and attractiveness is highly linked with peer status.
In recent years, open discussions between patients and medical professionals have revealed the impact acne has on one's psyche. The following are some of the problems that patients with acne may face.
Self esteem and body image
Some embarrassed acne patients avoid eye contact.
Some acne sufferers grow their hair long to cover the face. Girls tend to wear heavy make-up to disguise the pimples, even though they know this sometimes aggravates the condition. Boys often comment, acne is not such a problem for girls because they can wear make-up.
Truncal acne can reduce participation in sport such as swimming or rugby because of the need to disrobe in public changing rooms.
Social withdrawal/relationship building
Acne, especially when it affects the face, provokes cruel taunts from other teenagers.
Some find it hard to form new relationships, especially with the opposite sex.
At a time when teenagers are learning to form relationships, those with acne may lack the self-confidence to go out and make these bonds. They become shy and even reclusive. The main concern is a fear of negative appraisal by others. in extreme cases a social phobia can develop.
Education/work
Some refuse to go school leading to poor academic performance and possibly future unemployment.
Some take sick days from work, risking their jobs or livelihood.
Acne may reduce career choices, ruling out occupations such as modelling that depend upon personal appearance.
Acne patients are less successful in job applications; their lack of confidence being as important as the potential employers' reaction to their spotty skin.
More people who have acne are unemployed than people who do not have acne are.
Many young adults with acne seek medical help as they enter the workforce, where they perceive that acne is unacceptable and that they should have grown out of it by now.
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Psychological Effect of Acne



Sometimes, acne can be more than just embarrassment. acne that broke out mostly around mouth and chin area were so painful that eating and smiling both caused pain. In addition to causing inconvenience and pain, acne can even be psychologically crippling. some of the more serious effects on acne sufferers, including behavioral problems, academic decline, social isolation, substance abuse, depression, even suicide. Teenagers are more vulnerable in this respect because both acne and depressive disorder have a peak incidence during adolescence.

Because acne is not a life-threatening disease, we won't get much sympathy when we complain aloud about it. Unfortunately for us, that's the way it is. It's human nature that we all care more about ourselves than others and, as a result, we are all guilty of not having enough understanding and sympathy of others' problems. A better understanding is always helpful and beneficial to all parties, acne or otherwise.

On the other hand, the reality is always a bit less unbearable than what we project it to be. People are never nearly as interested in our face as we are ourselves, or as we think they do. Realizing this may help reduce our agitation a bit. Of course, the final savior comes when our faces clear up. This will happen naturally to most acne sufferers, sooner or later.
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The Food Factor



Don’t eat that — you’ll get zits! We’ve all heard it; from parents, friends or even the family doctor. But the fact is, even after extensive study, scientists have not found a connection between diet and acne. Not chocolate. Not french fries. Not pizza.
According to the American Academy of Dermatology, “A healthy diet is important for improving raw materials for healthy skin,” but they also note that greasy or sugary foods do not cause acne.

Likewise, a study published in the Journal of the American Medical Association concurred, “Diet plays no role in acne treatment in most patients…even large amounts of certain foods have not clinically exacerbated acne.” Of course, that doesn’t mean you should make a habit of eating foods high in sugar or fat. The skin is the body’s largest organ, so what’s good for the rest of you will be good for your skin, too.


Acne Prevention & Diet - Nutrients for healthy skin. There are a number of nutrients found in everyday foods that are known to promote a healthy body — and therefore healthy skin. Get wise to these substances, and you’ll increase your chances of conquering your acne.


Acne Prevention & Diet - Vitamin A. Naturally occurring Vitamin A, or retinol, is found in fish oils, liver and dairy products. The Vitamin A produced by plants is known as Beta-carotene, and is found in yellow/orange fruits and vegetable such as carrots, yams, apricots and cantaloupe, as well as green vegetables like parsley, kale and spinach. Extremely high doses of Vitamin A are toxic, so don't overdo it.


Acne Prevention & Diet - Vitamin B-2. Stress has been known to aggravate existing cases of acne, and Vitamin B-2 is often helpful alleviating stress. Foods with a high concentration of B-2 include whole grains, fish, milk, eggs, meat and leafy green vegetables.
Acne Prevention & Diet - Vitamin B-3. Found in peanuts, eggs, avocados, liver and lean meats, Vitamin B-3 improves circulation, promoting healthy skin. It also reduces the cholesterol level in the blood and helps you metabolize protein, sugar & fat — increasing your energy through proper utilization of food.


Acne Prevention & Diet - Vitamin E. Vitamin E is found in almonds, peanuts, sunflower seeds, broccoli, wheat germ and vegetable oils. A powerful antioxidant, it protects your cells against the effects of free radicals, which are potentially damaging by-products of the body’s metabolism.


Acne Prevention & Diet - Zinc. Even in trace amounts, the antioxidant zinc is known to boost the immune system, improving overall health — which of course is reflected in the skin. Zinc can be found in eggs, whole grains, nuts and mushrooms.


Acne Prevention & Diet - Know your own triggers. Since acne is different for everyone, there may be certain foods that cause flare-ups in your skin. Clearly, these foods should be avoided. You may also want to check your vitamin supplements for their iodine content; while normal amounts of iodine have not been shown to affect skin, amounts greater than the RDA of 150 mcg may aggravate your acne.

Overall, use your common sense. Drink lots of water and eat a healthy, balanced diet — but don’t be afraid to indulge your cravings every now and then.
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TRICHLOROACETIC ACID (TCA)


TRICHLOROACETIC ACID (TCA) has a particularly long history as an effective agent for rendering histo­logic and clinical improvement to the skin and is par­ticularly safe when used as a superficial peel or in "combination peels" of medium depth for acne scars.Application of TCA to the skin causes precipitation of proteins and coagulative necrosis of cells in the epider­mis and necrosis of collagen in the papillary to upper reticular dermis.

  1. Over several days the necrotic layers slough and the skin reepithelializes from the adnexal structures that were spared from chemical damage.
  2. Dermal collagen remodeling after chemical peel may continue for several months.
  3. Many investigators have observed that the clinical effects of TCA were due to both a reorganization in dermal structural elements and an increase in dermal volume as a result of an increase in collagen content, glycosaminoglycan, and elastin.
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