Can acne take a toll on your mental health? Experts say yes

Acne, when aggravated, can be more than just a skin concern, even affecting one’s mental health. We attempt to find out how 

A majority of the population in India today is cognisant of mental health issues.  More often than not, we associate mental health with something that is—or appears to be—a serious challenge in one’s life, such as a break-up, the loss of a loved one, or dealing with a dysfunctional family. Acne? One would think it stands no chance on this list. It would be rather unreasonable to think that something so commonplace could potentially lead to a mental health struggle. However, according to a survey, the prevalence of a psychological impact among individuals dealing with acne was as inflated as 85.5 per cent, making acne-related stress a legitimate concern. 

“Acne-shaming is a real thing. I have been bullied through passive comments disguised as ‘jokes’ or extreme remarks boiling my face down to ‘horrible’ without thinking of the consequences,” shares beauty content creator Aishwarya Waichal. A common skin concern, the predicament of acne can go deeper when it begins to affect one’s mental health. 

How acne impacts your mental health

Shattering self-confidence backdropped Prableen Kaur Bhomrah’s journey to being an acne-positive influencer on social media. “People often made insensitive comments like, ‘Why don’t you take care of your skin?’ or ‘You should try this remedy—it worked’ that made me question my worth and even kept me from attending social gatherings or getting photographed. It created a cycle of insecurity where I felt I had to ‘fix’ myself to be accepted. It wasn’t just about acne; it felt like an attack on my overall appearance and identity,” she shares. Tackling acne requires more than solving just the primary concern, considering acne’s psychological effects.

“Acne is more than a physical condition—it shapes how people perceive themselves and, therefore, interact with the world. It can make them feel self-conscious, leading to diminished confidence or social withdrawal. This is especially true for adolescents and young adults,” shares Mumbai-based celebrity dermatologist Dr Jaishree Sharad, spotlighting an overlooked link between acne and mental health. “I’ve seen patients who associate their acne with feelings of frustration or even depression, particularly if they’ve struggled with treatments that haven’t worked.” 

While a handful of forces in the beauty industry—skin-positive influencers, inclusive campaigns via brands, and informative content through certified dermatologists—are trying to destigmatise acne, the harsh reality is that a face with pimples and blemishes is a far cry from the archetype of conventional beauty standards. “The unpredictable nature of acne breakouts often gives rise to a loss of control over one’s appearance. Social media pressures further escalate feelings of inadequacy and isolation,” says board-certified dermatologist Dr Madhuri Agarwal. Not having ‘clear’ and ‘flawless’ skin can hit men as well. “While women may feel heightened pressure to meet beauty standards, men, on the other hand, find it harder to express distress due to societal norms around emotional stoicism, even though their experiences of shame and lowered confidence are equally valid,” cites Utkarsha Jagga, a counselling psychologist and founder of The Coping Central.

Waichal became extremely conscious of her acne-laden skin and wouldn’t feel comfortable leaving her house without stamping on some concealer or foundation. “If not make-up, I’d keep my hair over my face just to hide the pimples and, naturally, that worsened my skin. At the time, I was working at one of the biggest beauty retail companies, and was required to be on camera. As much as I loved it, comments on how my skin doesn’t fit the brand’s ‘criteria’ made me avoid that as well. And, if I ever clicked pictures, I would use Photoshop to make my skin look ‘flawless’,” she says. In many cases, the scars—both physical and emotional—outlive the condition, leaving behind long-term repercussions on self-confidence and mental health, adds Agarwal. 

Conversations around acne don’t discount its repercussions on one’s physical appearance, but the debilitating pain and discomfort seldom come to light. “When I started breaking out due to Lupus right after my marriage, I was not only mocked by relatives but leading a normal life also became very difficult,” begins Vibhuti Arora, a face yoga specialist and founder of House of Beauty India. “Going to work with dry, itchy, and bleeding skin was very difficult; I remember running into the washroom and crying at work or even at parties. It was the lowest phase of my life.” 

According to Sharad, the pain associated with acne arises from various factors and is more common than you think.“Inflammatory responses in the skin result in swelling, redness, and heightened sensitivity. Sometimes, bacterial overgrowth intensifies the inflammation, making acne more severe and painful. Additionally, deep cysts that rupture internally can irritate surrounding tissue, amplifying the pain further,” explains the doctor.

Cystic acne and nodular acne are particularly painful, adds dermatologist Dr Manasi Shirolikar. “Cystic acne is the most stubborn and difficult to treat because over-the-counter products and treatments do not work on them. It requires medical and procedural intervention along with a personalised treatment plan prescribed by a dermatologist,” she highlights. Regular upkeep with ingestible medications, topical ointments, and in-clinic treatments can also take a toll on one’s mental health. 

Beyond acne acceptance: addressing its impact on mental health

The mortification around acne may have reduced; acne-prone skin has made it to billboards, magazines, and beauty campaigns and the awareness about treating acne has also risen. What remains unchanged is the trivialisation of acne as a potential cause of stress, anxiety, and depression. The American Academy of Dermatology reveals that psychoticism and depression are the “most common psychological symptoms requiring treatment due to disturbed daily activities,”spotlighting an explicit relationship between acne and mental health.

“Just because it’s a ‘common’ condition and isn’t life-threatening, it doesn’t mean the struggles aren’t valid,” expresses Kaur Bhomrah. “That one pimple on your forehead—which isn’t even that noticeable to others—becomes the core of your attention and you lose sight of what’s more important,” adds Waichal. While the ebb and flow of hormonal acne impacts most people at some point in life, for those dealing with longstanding, sore acne the upheaval multiplies. “Trivialising acne as an excuse for mental health concerns is harmful, as it invalidates the emotional distress it can cause, making individuals less likely to seek help,” warns Jagga. “This dismissal perpetuates the stigma that appearance-related struggles are superficial, while, in reality, untreated distress can lead to worsening mental health conditions such as depression or social anxiety.”

How to overcome acne-related anxiety and boost self-confidence 

Acne is rampantly prevalent in India—as of 2022, 72.3 per cent of adolescents and 27 per cent of adults have had to deal with it. These numbers make one thing clear: dealing with the mental ramifications of acne is paramount, and a key component of managing it holistically.

The first step? Stop looking down upon your acne. “The internet can be overwhelming and you could feel like you have to try every product that claims to get rid of acne overnight. Stop chasing marketing terms like ‘glass skin’. The motive of such marketing gimmicks is to exploit the insecurities of masses so they feel compelled to purchase their products. It’s just business,” shares Waichal. While restorative healing, yoga, eating right, and Pranayam helped Arora curtail her breakouts, and thereby the consequent mental dismay, educating herself about acne, accepting her skin type, and subscribing to a sustainable skincare regimen helped Kaur Bhomrah. 

Having an ally who not only normalises acne but also helps you boost your confidence can be uplifting. While Waichal found a support system in a colleague who redefined beauty standards for her, Shirolikar shares anecdotes of her struggles with acne when she speaks to her patients, especially tweens and teenagers susceptible to skin dysmorphia.

Dr Archana Singhal, a counsellor and founder of The Mindwell Counsel, informs that the coping mechanisms vary across age groups. “For teenagers, peer acceptance and identity are key, so encouraging open communication with trusted adults (parents or counsellors) can help reduce isolation. For young adults, focusing on personal development, seeking professional care for the acne itself, and exploring ways to challenge societal beauty standards for oneself are starting points. In the case of adult acne, which may be hormonally-driven or stress-related, coping mechanisms could include therapy, stress management techniques, mindfulness, and prioritising overall mental and physical health.” Adopting a comprehensive approach including therapy, medical cosmetic assistance, and nutrition, if need be, can aid with pacifying various stress points. “I work with my patients to develop a personalised treatment plan, outlining a clear, step-by-step approach to managing their acne based on their specific needs. For severe cases, I prescribe treatments like retinoids, antibiotics, and hormonal therapies that need medical supervision. I also make sure to set realistic expectations by discussing the timelines for treatment,” shares Sharad.

Finally, it is important to remember that you must not allow anyone’s opinion—whether that’s trivialising your struggles with acne or reducing your self-worth to acne—to eclipse what you’re going through. 

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