Depressive side effects which were thought to be caused by acne medications, such as Accutane and Claravis, may in fact be caused by the acne itself, say researchers in a new study published in the Journal of Investigative Dermatology. The writers suggest that fears that acne drugs may cause suicidal thoughts may have been overstated.
Young people with severe acne have considerably higher levels of depression and suicidal ideation compared to individuals with no acne or mild symptoms, the Norwegian investigators report.
Jon Anders Halvorsen, Oslo University Hospital, Norway, said:
There is a pretty strong and consistent association between acne and symptoms of depression or mental health problems.
A Canadian study in 2008 published in the Journal of Clinical Psychiatry suggested Accutane could increase the risk of depression.
Accutane, an acne medication made by Roche, is also available in generic form isotretinoin - Teva Pharmaceutical Industries, Mylan and Ranbaxy make and sell the generic version. Roche announced last year that it could cease selling Accutane because of generic competition.
The authors write that controversies regarding acne medications have discouraged many dermatologists (skin specialist doctors) from prescribing isotretinoin.
Our study is important because it provides an argument for not being so cautious.
In their study, involving 3,775 males and females aged 18 and 19 years, from Oslo, Norway, the investigators report:
- Twice as many females with severe acne reported having suicidal ideation compared to females with no acne or mild symptoms
- Three times as many males with severe acne reported having suicidal ideation compared to males with no acne or mild symptoms
- 14% of the respondents rated their acne as substantial
- 18 to 19 year olds with severe acne were 51% more likely to be virgin
- 18 to 19 year olds were more than twice as likely to have no close friends
Acne is frequently found in late adolescence and is associated with social and psychological problems. Adverse events including suicidal ideation and depression that have been associated with therapies for acne may reflect the burden of substantial acne rather than the effects of medication.
What is acne?Acne is a condition that involves the oil glands of the skin. It is not dangerous, but can leave skin scars. Your skin has pores (tiny holes) which connect to oil glands located under the skin. The glands are connected to the pores via follicles - small canals. Sebum, an oily liquid, is produced by these glands. The sebum carries dead skin cells through the follicles to the surface of your skin. A small hair grows through the follicle out of the skin. Pimples grow when these follicles get blocked.
In humans, when pimples appear they tend to do so on the patient's face, back, chest, shoulders and neck. Acne develops when follicles get blocked and infected.
Simply put - skin cells, sebum and hair can clump together into a plug, this plug gets infected with bacteria, resulting in a swelling. A pimple starts to develop when the plug begins to break down.
There are various types of pimples:
- Whiteheads - remain under the skin and are very small.
- Blackheads - clearly visible, they are black and appear on the surface of the skin. Remember that a blackhead is not caused by dirt. Scrubbing your face vigorously when you see blackheads will not help.
- Papules - visible on the surface of the skin. They are small bumps, usually pink.
- Pustules - clearly visible on the surface of the skin. They are red at their base and have pus at the top.
- Nobules - clearly visible on the surface of the skin. They are large, solid pimples. They are painful and are embedded deep in the skin.
- Cysts - clearly visible on the surface of the skin. They are painful, and are filled with pus. Cysts can easily cause scars.
"Suicidal Ideation, Mental Health Problems, and Social Impairment Are Increased in Adolescents with Acne: A Population-Based Study"
Jon A Halvorsen, Robert S Stern, Florence Dalgard, Magne Thoresen, Espen Bjertness and Lars Lien
Journal of Investigative Dermatology 16 September 2010; doi: 10.1038/jid.2010.264
Written by Christian Nordqvist