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The Physical and Emotional Distress of Acne

The Physical and Emotional Distress of Acne. By Kelly Ryder BS, PA-S Advisor: Bill Grimes, PA-C March 24, 2006. Due to the graphic nature of the this presentation, viewer discretion is advised. What is Acne Vulgaris?. Who gets this disease? Locations Types Components involved.

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The Physical and Emotional Distress of Acne

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  1. The Physical and Emotional Distress of Acne By Kelly Ryder BS, PA-S Advisor: Bill Grimes, PA-C March 24, 2006

  2. Due to the graphic nature of the this presentation, viewer discretion is advised.

  3. What is Acne Vulgaris? • Who gets this disease? • Locations • Types • Components involved Three types of Papules A, B, C A pustule

  4. What is bad about this disease? • Noticeable lesions, redness, and inflammation • Different types of scars • Response to treatments • Emotional distress

  5. Common Treatments • Avoidance of triggers • Balanced nutrition • Medicated creams, lotions, soaps • Oral medications • Accutane (isotretinoin) • Microderm abrasion • Laser Skin Rejuvenation

  6. Accutane (Isotretinoin) • Powerful drug last resort • Vitamin A derivative • Severe birth defects in fetus • Liver Functions/elevated triglycerides • Cracking and drying skin and mm • Currently under a very tight watch by FDA • Reported 260 patients depressed and committed suicide

  7. Before and After Treatments

  8. What haven’t we covered about Acne? • How the patient perceives themselves • Competitive society where look is everything • Healthy skin seen in supermodels, singers, actors/actresses on TV, billboards Alicia Keys

  9. Is Acne More Than Just Skin Deep? Many studies say • 2000 study of acne patients evaluating the relationship between acne and psychological well-being. • 31 patients with Acne Vulgaris to 25 patients with healthy skin • Results: acne patients suffered from a significantly lower self-esteem and had a higher rate of depression and trait anxiety.

  10. Battle of the Sexes • 2000 study • 2,657 high school students • Severity among males/females • Anxiety and depression • Results: “adolescent girls are more vulnerable than boys to the negative psychological effect of acne”

  11. Is Acne and it’s emotional effects only observed in the US? • England study • 370 patients age 14-16 • Acne severity was assessed • Emotional and behavior difficulties were determined • Results: patients with acne were nearly twice as likely as those without acne to score in the abnormal/borderline range of the Strengths and Difficulty Questionnaire • Interesting findings: Patients knowledge about the cause of acne was low (45%) *Less than a third of participants with definite acne had sought help from a doctor,”

  12. How Acne Affects People's Lives "There is no single disease which causes more psychic trauma, more maladjustment between parents and children, more general insecurity and feelings of inferiority and greater sums of psychic suffering than does acne vulgaris."  --Sulzberger & Zaldems, 1948 http://www.skincarephysicians.com/acnenet/socimpct.html

  13. Emotional distress of acne Those who have acne for many years, well into their 20’s and 30’s often experience… • Social withdrawal • Decreased self-esteem • Reduced self-confidence • Poor body image • Embarrassment • Feelings of depression • Anger • Preoccupation • Frustration • Higher rate of unemployment

  14. TAKE HOME MESSAGE • Early intervention • Monitor treatments • Patient compliance • Routine mental health status • Support groups • Supportive Psychotherapy • Anti-anxiety or depression medications when seen fit • *in conjunction with Accutane • Stress management

  15. Talk To Your Patients • England study 2/3 didn’t know to seek help • Impaired school or work function • Indications of depression or emotional distress • Affordable treatment • Advise a plan • Patient’s advocate

  16. Is There a Brighter Future for Potential Acne Sufferers? • Oct 25, 2004-- German scientists • With this discovery, Dr. Holger Brüggemann aims to, “see if we can block its enzymes that degrade tissues, and also block enzymes that interact with the immune system". • Vaccinations may be in the future

  17. Were you paying attention Quiz question 1. Name a very powerful medication that is used to treat acne as a last resort. Quiz question 2. Name some severe potential side effects of this drug. Quiz question 3. What are some effects acne can have on a patients’ emotional status.

  18. References • Aktan, S., Ozmen, E. Anxiety, depression, and nature of acne vulgaris in adolescents. International Journal of Dermatology, Volume 39, Number 5, May 2000, pp. 354-357. • AcneNet. The Social Impact of Acne. http://www.skincarephysicians.com/acnenet/socimpct.html • ArriveNet Editorials. Could Decoding Genes Spell the End for Acne? http://editorials.arrivenet.com/health/article.php/2555.html • Psychology today. A Care-Giver’s Companion. http://health.yahoo.com/centers/stress/68;_ylt=AttOJ3xz_rc2SVK6uoep84S3Gb4F • Sayer, K., Ugurad, I., Kural, Y., Acar, B. The Psychometric Assessment of Acne Vulgaris Patients. Dermatology and Psychosomatics 2000;1:62-65. • Wolff, Klaus., Johnson, Richard Allen., Fitzpatrick’s Color Atlas & Synopsis of Clinical Dermatology, fifth edition. p. XXV-XXVII. • Support group websites:http://health.groups.yahoo.com/group/AcneSupport/ http://asgic.proboards26.com/index.cgi?board=RealLifeSupport • http://www.acne.org/messageboard/index.php?showforum=17 Kbryde2@uky.edu

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