Uncovering the emotional scars: Study reveals significant stigma associated with female adult acne

New research reveals that acne significantly influences how individuals are perceived in social settings. Faces with acne are seen as less attractive, trustworthy, confident, successful, dominant and happy, with adult female acne having the strongest negative effect.

This research, presented today at the European Academy of Dermatology and Venereology (EADV) Congress 2023, assessed the effect of different anatomical variants of acne on natural gaze patterns and social perception.

The researchers tracked the eye movements of 245 participants (mean age: 31.63 years; SD: 10.63) who viewed neutral and emotional faces of females with both clear skin and clinically relevant anatomical variants of acne (emotions included "happy," "angry" and "neutral"). Images were rated for acne-related visual disturbance while emotional faces were rated for valence intensity. Separately, a group of 205 online survey respondents (mean age: 35.08 years; SD: 11.48) were asked to rate the personality traits of the individuals depicted in the images.

The survey found that faces with acne were perceived as significantly less attractive (difference: 1.1593; 95% CI: 1.0191–1.2995), less trustworthy (difference: 0.3549; 95% CI: 0.2260–0.4838), less successful (difference: 0.6220; 95% CI: 0.4994–0.7445) less confident (difference: 0.9573; 95% CI: 0.7853–1.1293) and less dominant (difference: 0.9086; 95% CI: 0.7495–1.0675).

Notably, the results showed that adult female acne concentrated around the "U-zone" (around the jawline, mouth and chin) received the lowest scores for attractiveness and was considered the most visually disturbing. Happy faces with female adult acne were also rated as less happy than clear-skin faces.

Over the last decade, there has been a 10% increase in adult acne among women worldwide, which commonly affects the jawline and chin but can appear on any part of the face. In adults, this condition is known to have serious consequences, including a psychological impact, low self-esteem, social isolation and depression. While genetics represent the most prominent risk factor, other influences such as stress, hormones and diet can heighten an individual's risk of developing acne.

Multiple studies have previously shown how the perception of pejorative physical characteristics can lead to social distress, including social isolation, higher biologic stress and even poorer health. Appearance has been shown to play a role in job competitiveness and has been shown to determine whether an applicant is hired or not.

Discussing the study's findings, Dr. Marek Jankowski, the lead author of the study, states, "With over a decade of experience in the field, I've consistently seen that adult female acne leads to more social challenges compared to adolescent acne. The findings therefore reaffirm this. However, what was truly surprising was images depicting generalized acne, covering a larger area with more lesions, received more positive ratings than images featuring adult female acne occurring in the 'U-zone.'"

Dr. Jankowski underscores the implications of these findings, commenting, "Treatment needs to focus on improving the quality of life of patients, not just reducing the surface area impacted by the acne. Unfortunately, this is not currently a goal when treating acne, with therapeutic guidelines still advocating for certain treatment modalities based on the number of lesions, irrespective of their location. Unsurprisingly, acne severity scores do not correlate with quality-of-life scores in patients with acne."

"These results clearly emphasize the emotional and psychological burden experienced by individuals with acne," Dr. Jankowski adds.