Arecent video, posted by the BBC, focuses on the impact of acne on the everyday lives and sense of self-worth of affected individuals (BBC News, 2019). It follows Abigail Collins, who has had cystic acne since she was a child, who explains her condition and the way it has affected her throughout her life.
‘Spotty’, ‘not worthy’ and ‘ugly’ are the adjectives Abigail lists as examples of some of the comments she has received from strangers based on her appearance. She explains how she remembers being treated differently by others, and that some people didn't want to be seen out with her unless she was wearing make-up. Abigail explains that this is why she began to depend so heavily on make-up to ‘mask’ her appearance.
In the video, Abigail describes wanting to ‘shy away from everything’ and be away from people and in her own space. This highlights the extreme impact that skin conditions such as acne can have on a patient's wellbeing and quality of life. Several studies have highlighted the mental impact of acne in patients, with one suggesting that depression was found to be two to three times more prevalent in acne patients than in the general population, with a reported 8.8% of acne patients having clinical depression (Uhlenhake et al, 2010). Furthermore, in this study, 65.2% of the acne patient population was female, with twice as many reported to have depression as males (10.6% females compared with 5.3% of males) (Uhlenhake et al, 2010).
An article in this month's issue of Journal of Aesthetic Nursing, titled ‘Stigmatisation and social pressure in patients with skin conditions’, also focuses on this issue. In the article, Longhurst explains that skin conditions, such as psoriasis, rosacea and eczema, are associated with psychological comorbidities, including body dysmorphic disorder, depression, anxiety and suicidality. Those affected by these conditions report experiencing stigmatisation and social pressure, and one way in which they are affected is in their diet. The reationship between diet and skin conditions has a pathological basis, but Longhurst explains that this is made more complex by the increasing influence of social media in our lives. The information that patients find online is often not evidence-based and may lead to individuals manipulating their diets to treat and manage their skin conditions, for example, by avoiding certain foods when there is little evidence to support that this will help their condition.
In the video, Abigail describes her journey from hating her acne (and herself) to finally accepting it as something that is on her body. For Abigail, one big step in the move towards her accepting her acne is her Instagram account, on which she features pictures of herself, both with and without make-up, to help to document her journey. She summarises: ‘My acne does not define me. It may be on my face, but it's not a part of me’.