The effects of teenage acne on the individual’ psyche

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Adolescence, from the Latin word 'adolescere' means to grow up. Adolescence is the period of life where teenagers will undergo puberty, which is a 'transitional stage between childhood and adulthood that involves biological, cognitive, and socioemotional changes' (yan yan's adolescence). During puberty, teenagers experience a rapid physical growth and psychological changes due to a surge in hormone production. Examples of the effects on puberty on teenagers are development of facial and genital hair, development of breast in girls and changes in voice in boys. The development tasks of teenagers during puberty also include developing a sense of identity and self-worth, and hence, teenage acne has a high potential to cause adverse psychological and societal effects on teenagers (5). In this essay, the focus will be on the psychological and societal impact of teenage acne developed during puberty on teenager.

Acne vulgaris, also known as acne, pimple or zit, is very common in teenagers, over 90% of males and 80% of females will be affected by the age of 21 years [1](1). Teenage acne is a skin disorder results from the action of androgen, a male sex hormone released during puberty. Male sex hormone is not only found in men but also found in lesser amount in women. Therefore, both male and female teenagers have the tendency to suffer from teenage acne. The hormone causes the sebaceous gland on the skin to secrets sebum, an oily substance on skin. Sebum is then secreted onto the skin surface via the hair follicles opening. Mixture of oil and cells allows the growth of bacteria in the follicle openings. When the growth of bacteria happens, pore of skin will become clogged, inflammation may occur, and acne is developed. [2](web2) Teenage acne commonly appears on the face and the back, but it is also possible to have acne on the chest, arms, buttocks, groin and armpit area. Basically, acne can be formed at anywhere where there are the presence of hair follicles and sebaceous glands.

Apart from being the largest organ of the body, skin has long been recognised as the organ of expression and communication. Skin serves as the boundary between ourselves and the outside world [3](Sack, pg1). Skin can react to physiological stimuli such as rash caused by allergies and also react to psychological stimuli such as blushing when feel embarrassed [5](van moffaert pg1). Skin is like a mirror to reflects our soul. A healthy skin, like a healthy soul, 'is essential for individual physical and psychological well-being and self-confidence' [4](2). During adolescence, teenage tend to be more concern about their appearance and the judgment of their peers. As appearance and conformity are warmly valued by teenagers, therefore when a teenager suffers from acne, they may feel socially devalued and repelled by their peers.[6](web1). Due to the fact that adolescence is a point of increase in sensitivity, where they are exuberant and want to look the best. Therefore, even mild acne will produce significant psychosocial impact to a teenager.

Being in a society that emphasises greatly on appearance, teenage acne sufferers often feel uncomfortable and embarrassed (web 3). Generally, people will perceive that formation of acne is due to the lack of personal hygiene. Others tend to judge a person according to their physical appearance, this will cause harmful effects on a teenage acne sufferers' self-esteem. Teenagers with acne will have lower self-esteem as they have no confidence about themselves and constantly worry about their skin (4). As teenagers are more self-conscious about their appearance, they may felt guilty and shameful as they think that they are responsible for their skin conditions. Teenagers may have a tough time socialising normally, and have trouble making eye contact as they feel ashamed of their appearance. Hence, teenagers may withdraw themselves from the society as they do not want to be judged or to be commented on their skin conditions. An example of social withdrawal is a teenage girl may be so self-conscious of her appearance that she refused to be in the family pictures during a reunion outing. (web1)

A study was conducted on teenagers in New Zealand to 'examine the association between acne and depressive symptoms, anxiety and suicidal behaviours'. The study shows that teenagers presenting with teenage acne are at increased risk of depression, anxiety and suicide attempts.(5) Further studies show that formation of acne and mental health are interrelated. Stress, depression and anxiety could increase the severity of acne. Acne condition of patient having depression improves after treatment.(5) On the other hand, acne could lead to depression and anxiety on teenagers. This is due to the negative self image, lower self-esteem and social withdrawal of teenage acne sufferers. However, it was found that girls had higher level of anxiety and depression than boys(6). This can explain that the effects of acne on the body image may be more important for teenage girls, and teenage girls are more vulnerable to the negative psychological effects of acne.(6) All these negative psychological effects may exert too much pressure on teenagers and leads to suicidal attempts when teenagers failed to seek treatment to cope with it.

Besides psychological impact, acne also causes societal effects on teenagers. Teenage acne sufferers find themselves hard to make new friends because of their own view on their skin's appearance, as they believed that most people will judge others according to their physical appearances. Moreover, lower self-esteem and being embarrassed with their skin conditions also making it hard for teenagers to make new friends. At late adolescence, teenagers tend look for or to be involved in intimate relationships. However, physical appearances are often linked to sexual attractiveness. Therefore, teenage acne sufferers will find themselves ugly and not attractive enough. As a result, teenage acne sufferers will have decrease in confidence around opposite sex. Other than the emotional effects of teenagers, teenage acne sufferers may be bullied and teased by their peers in school (4). They may be called insulting names such as 'bumpy face' and 'walking human zits' by others. Because of all these bullying that happened in school, teenage ace sufferers may refused to attend school as they does not enjoy school and hated it when being bullied by others. Therefore, acne will affect teenagers' education as they will be skipping school very often to avoid being bullied.

As acne may also presence on teenagers' body other than on the face. Teenagers may not want to participate in sports as they would feel vulnerable because they have to expose their face or their upper body where acne is presence (web 4). Sports that required them to expose some portion of body such as gym class and swimming would be a problem for teenage acne sufferers. (web1) The look they get from their peers in school makes teenagers feel so socially insecure that some of them will fake injuries to avoid going to gym class. (web 4) Teenage girls may use cosmetics such as foundations and concealer to cover up their acne problem, at the same time, gives them a slight increase in self-confidence. Even though cosmetics may spread and worsen their acne conditions, teenage girls will still prefer to use cosmetics to veil their acne when they are in contact with others or doing sports due to their low self-esteem. On the other hand, teenage boys may feel at a disadvantage compared to teenage girls as boys have no ways to conceal their acne problem. Therefore, acne will have a bigger impact on teenage boys compared to teenage girls as they are lack of the aid of cosmetics to increase their self-confidence and self-esteem.

There are some tips to prevent and control acne. Do not over wash or use harsh scrubs on skin as acne is not caused by dirt. Too much cleaning can leave skin dry and irritated, which then triggers glands to produce more sebum that will increase the formation of acne. Besides, use oil-free or non-comedogenic products on face as these products will not clog the pores on skin. Lastly, do not squeeze or pick acne. Squeezing and picking acne can drive acne bacteria deeper into skin and leads to more inflammations as well as permanent scarring on skin (web2).

The cruelest truth about acne is that the more you think and worry about it, the more outbreaks of acne occurs. (web5) The pursuit for flawless skin will be really exhausting for teenagers and may cause them to lose interest in their studies. Parents play an important role in supporting teenagers when they are suffering from the psychosocial effects caused by teenage acne. If parents are not supportive enough, it will be very difficult for teenagers to overcome the emotional difficulties they are facing. Parents should be thoughtful and should not blame their children for the outbreaks of acne, saying that it is their daily diet and activities that is causing their acne. Besides supporting teenagers emotionally, parents can give support by taking teenagers to a dermatologist as dermatologist can help to reduce the outbreaks of acne which will then give some peace of mind to teenagers. Besides dermatologist, a psychologist or a counsellor is helpful to counsel teenagers with psychological problems and relieve them from stress and tensions. Apart from relieving stress, they are able to help teenagers to build up their self-esteem and face the world with more confidence.

Generally, teenagers suffer from acne have higher sense of awareness with their bodies and appearances. This causes them to have difficulties to comply with the social standards and hence causes them to be under tremendous pressure. This pressure will leads to psychosocial effects in teenagers such as depression, a decreased sense of body image and self-esteem, sexual and relationship difficulties, and a general reduction in quality of life. (pg 6) However, teenagers should understand that having flawless skin is not a crucial thing in life and real beauty should actually come from within (web6). Therefore, teenagers should focus on living life to the fullest instead of being too concern about their appearances.