The harmful effects of acne on social life, educational achievements, dating and work life is well proven. A new comprehensive review summarizes the current data on the psychosocial impact of acne. (Nguyen et al. Clinical, Cosmetic and Investigational Dermatology. October 2016.)
A study on 950 college students found that acne had a greater psychosocial impact on females when compared to males. 
Social phobia was diagnosed in 45.7% of high school patients with acne when compared to 18.4% of control subjects in a study by Bez et al. 
When surveyed, social bullying was perceived to be experienced by a significantly higher number of teenagers with acne. It was also shown that patients with acne had higher avoidance scores than controls and were more negatively affected in their occupational, social and family lives. 
Intrapsychic consequences (Such as self-consciousness) were found to be significantly increased in patients with acne. Alexis et al. 
A study on adult females with acne found that 71%–73% of patients experienced some degree of anxiety or depression. The majority of women (>75%) expressed annoyance, lowered confidence (In the majority of women, >75%), social withdrawal and bothersomeness. 
The likelihood of experiencing perceived stigma was three times higher for patients with acne. 
Tactual et al found that 21% of the adolescents with acne were affected in their school work and personal activities due to acne. Approximately 19% were affected in their hobbies and 19.2% were affected in their personal lives (Particularly in relationship building). In terms of hobbies, 14% of patients avoided swimming and other sports due to embarrassments. 
In another study of 160 acne patients, 13.3% stated that acne affected their school performance, while 21.1% said it affected their spousal relationship, 30% said it affected their marriage willingness and 17.2% said it affected their friendship relations. 
Acne-related depression can be improved dramatically by proper treatment. In one study, the mean anxiety score of people with acne before isotretinoin treatment was 8.9 out of 21, which is higher than that of the general population…denoting higher levels of anxiety. Approximately 26% of patients (Before treatment) qualified as clinical cases (A high score >11). After treatment with isotretinoin, only 3.5% of patients met this criterion, supporting the role that acne plays in the development of anxiety. 
Kubota et al distributed the Mental Health Inventory (MHI) or the Short Form-36 to Japanese adolescents. Students with acne were significantly more depressed than those without skin problems, and girls were more significantly affected than boys. The time span in which the patient was affected by acne also affected the MHI score, as patients with acne for >2 years had significantly lower MHI scores than those with acne for <6 months. 
There was no significant difference in the rate of depression or anxiety with regard to race (White/Caucasian vs Non-White/Caucasian)
- Shahzad N, et al. J Coll Physicians Surg Park. 2011;21(7):442–443.
- Bez Y et al. High social phobia frequency and related disability in patients with acne vulgaris. Eur J Dermatol. 2011;21(5):756–760.
- Ritvo E, et al. Psychosocial judgments and perceptions of adolescents with acne vulgaris: a blinded, controlled comparison of adult and peer evaluations. Biopsychosoc Med. 2011;5(1):11.
- Alexis A et al. Development of a new patient-reported outcome measure for facial acne: the Acne Symptom and Impact Scale (ASIS) J Drugs Dermatol. 2014;13(3):333–340.
- Callender VD, et al Racial differences in clinical characteristics, perceptions and behaviors, and psychosocial impact of adult female acne. J Am Acad Dermatol. 2014;7(7):19–31.
- Roosta N, et al. Skin disease and stigma in emerging adulthood: impact on healthy development. J Cutan Med Surg. 2010;14(6):285–290.
- Tasoula E, et al. The impact of acne vulgaris on quality of life and psychic health in young adolescents in Greece. Results of a population survey. An Bras Dermatol. 2012;87(6):862–869.
- Darwish MA, et al. Knowledge, beliefs, and psychosocial effect of acne vulgaris among Saudi acne patients. ISRN Dermatol. 2013;2013:929340.
- Marron SE, et al. Anxiety, depression, quality of life and patient satisfaction in acne patients treated with oral isotretinoin. Acta Derm Venereol. 2013;93(6):701–706.
- Kubota Y, et al. Community-based epidemiological study of psychosocial effects of acne in Japanese adolescents. J Dermatol. 2010;37(7):617–622.