Psychological high-risk factors for acne: A prospective and cohort study

The present study explored the role of psychological factors and sleep quality in acne. Participants were recruited to assess the occurrence of acne monthly, and depression, anxiety, and sleep status were evaluated using the patient health questionnaire-9, self-rating anxiety scale, and the pittsburgh sleep quality index. Generalized estimating equations compared the effects of different factors on the occurrence of acne. Depression and moderate sleep quality were significantly related to acne (P < 0.05). Meanwhile, depression and sleep quality (moderate and poor) were significantly associated with inflammatory acne (P < 0.05). In conclusion, depression and sleep problems may be involved in the pathogenesis of acne, especially inflammatory acne. We recommend paying more attention to depression and sleep quality in patients to prevent acne.
- Wolkenstein P, Machovcová A, Szepietowski JC, et al., 2018, Acne prevalence and associations with lifestyle: A cross-sectional online survey of adolescents/young adults in 7 European countries. J Eur Acad Dermatol Venereol, 32: 298–306. https://doi.org/10.1111/jdv.14475
- Chen J, Wang L, Hong H, et al., 2014, Detection and analysis of substance P in serum of patients with acne vulgaris. Chin J Dermatovenereol Integr Tradit West Med, 13: 360–362.
- Fang X, Wang W, Jin C, et al., 2014, Sleep quality and related factors in 136 cases of alopecia areata. Chin J Dermatovenereol, 28: 274–275.
- Huang X, Liu Y, Liao J, et al., 2013, Serum level of substance P and related factors in patients with primary insomnia. Chin J Nerv Mental Dis, 39: 65–69.
- Liao L, Yang H, Wang S, et al., 2019, A comparative study of plasma neuropeptide Y and substance P levels in patients with unipolar and bipolar depressive disorders. J Clin Psychiatry, 29: 247–250.
- Chang H, Guo S, Cao Y, 2010, The research of anxiety and depression on acne patients. Chin J Dermatovenereol, 24: 369–370.
- Vallerand IA, Lewinson RT, Parsons LM, et al., 2018, Risk of depression among patients with acne in the U.K.: A population-based cohort study. Br J Dermatol, 178: e194–e195. https://doi.org/10.1111/bjd.16099
- Uhlenhake E, Yentzer BA, Feldman SR, 2010, Acne vulgaris and depression: A retrospective examination. J Cosmet Dermatol, 9: 59–63. https://doi.org/10.1111/j.1473-2165.2010.00478.x
- Ohayon MM, 2007, Epidemiology of depression and its treatment in the general population. J Psychiatr Res, 41: 207–213. https://doi.org/10.1016/j.jpsychires.2006.10.006
- Garg A, Chren MM, Sands LP, et al., 2001, Psychological stress perturbs epidermal permeability barrier homeostasis: Implications for the pathogenesis of stress-associated skin disorders. Arch Dermatol, 137: 53–59. https://doi.org/10.1001/archderm.137.1.53
- Choi EH, Brown BE, Crumrine D, et al., 2005, Mechanisms by which psychologic stress alters cutaneous permeability barrier homeostasis and stratum corneum integrity. J Invest Dermatol, 124: 587–595. https://doi.org/10.1111/j.0022-202X.2005.23589.x
- Duchaine CS, Brisson C, Talbot D, et al., 2021, Psychosocial stressors at work and inflammatory biomarkers: PROspective quebec study on work and health. Psychoneuroendocrinology 133: 105400. https://doi.org/10.1016/j.psyneuen.2021.105400
- Arck P, Handjiski B, Hagen E, et al., 2010, Is there a “gut-brain-skin axis”?. Exp Dermatol, 19: 401–405. https://doi.org/10.1111/j.1600-0625.2009.01060.x
- Wang S, Song W, Ouyang L, et al., 2020, Efficacy of psychological intervention combined with medicine in the treatment of the patients with papulopustular rosacea. Chin J Dermatovenereol, 34: 1023–1027.
- Mirdamadi Y, Thielitz A, Wiede A, et al., 2015, Insulin and insulin-like growth factor-1 can modulate the phosphoinositide-3-kinase/Akt/FoxO1 pathway in SZ95 sebocytes in vitro. Mol Cell Endocrinol, 415: 32–44. https://doi.org/10.1016/j.mce.2015.08.001
- Kayiran MA, Karadag AS, Jafferany M, 2020, Psychodermatology of acne: Dermatologist’s guide to inner side of acne and management approach. Dermatol Ther, 33: e14150. https://doi.org/10.1016/j.psyneuen.2021.105400