Acne Is Not a Trivial Disease! Psychosomatic Aspects in Routine Therapy

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Abstract
Patients with acne may develop psychological problems as a consequence of their condition – often independent of the severity of their skin condition. Emotional problems due to the disease should be taken seriously and included in the treatment plan. A purely dermatological therapy may not achieve its purpose. Even mild to moderate disease can be associated with significant depression and suicidal ideation, and psychologic change does not necessarily correlate with disease severity. Acne patients suffer particularly under social limitations and reduced quality of life. Psychic comorbidities in acne are probably greater than generally assumed. Attention should be paid to psychosomatic aspects especially if there is suspicion of depressive-anxious disorders, particularly with evidence of suicidal tendencies, body dysmorphic disorders, or also of disrupted compliance. Therefore, patients who report particularly high emotional distress or dysmorphic tendencies due to the disease should be treated adequately, if possible, by interdisciplinary therapy. The dermatologist must have some knowledge of the basics of psychotherapy and psychopharmacology, which sometimes must be coupled with systemic and topical treatments of acne in conjunction with socalled psychosomatic basic treatment.

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