Updated December 29, 2014.
Acne is a complex problem, and one that affects more than just the skin. Many skin professionals believe our emotions have a direct impact on our skin problems. Conversely, our skin problems can also affect our emotions.
Many people say their skin problems get worse whenever they’re in emotional upheaval. Have you ever wondered why? I did, so I interviewed a board-certified dermatologist who is also a psychologist.
Richard Fried, M.D., Ph.D, knows skin. As a psychologist, he also knows how skin problems can deeply affect us emotionally.
The clinical director of Yardley Dermatology Associates, Dr. Fried is chatty, frank, and has unique insights on both the physical and the emotional impact skin problems can cause. Dr. Fried explains the link between skin and emotion, the differences in teens and adults with acne, and tells us how the face of acne is changing.
Dr. Fried, you’re a board-certified dermatologist and a clinical psychologist. On the surface, those are two very dissimilar specialties. Can you tell me how they relate?
Dr. Fried: You know at first blush, no pun intended, they are seemingly very dissimilar. But due to the things that I’ve found, as I was in psych first, was that many, many people coming into my practice had skin problems like psoriasis, eczema, rosacea, chronic hives, and acne.
They would regularly tell me that, first of all, living with it was very stressful and depressing. Second of all, they would tell me that when they were miserable and depressed, or stressed, their skin got worse. So there was a two-way street — the conditions made them miserable, and being miserable made their conditions more miserable.
I gradually began to think: Wouldn’t it be fascinating to have the tools to take care of the medical aspects of the skin problems and try to incorporate some of the psychological tools that can help them as well?
How has the prevalence of acne changed over the past few years?
Dr. Fried: The data is reasonably clear that there is a dramatic increase in acne [in people] of all ages.
There’s no question that the actual incidence is increasing. Now what the exact number is, is very debatable. Some [say] as small as 15%, some show as high as 30%.
There are a very significant number of adult females who are presenting with acne. And there’s three main groups. [The first is] people who had acne through teenage years and it just wont quit. I refer to [that] as the forever, unyielding acne.
The second group is the group of people who had adolescent acne, outgrew it, and now it’s come back again.
The third group are the virgin acne players who just had great skin all through adolescence, never really had any problems with acne, and here they are — at 20, 22, 25, 30, 35, — presenting with acne for the first time.
So we’re seeing more acne, more stubborn acne, in an age group we didn’t used to see that much of it.
Are there differences in the way teens react to acne compared to adults, emotionally speaking?
Dr. Fried: As a group, if we want to take a broad brush stroke, adolescents have less patience for something they don’t like to get better. They can be more impatient than adults.
The adolescent, after several days of waiting for an OTC product or prescription product to work, [will] get totally frustrated, go and grab another product, or go to the mirror and pick their face. Whereas, statistically, the adult says, “Now, I did a little reading and I know it’s two to three weeks before any product, even the best product kicks in, and even though I’m unhappy about it and frustrated, I’m going to hang in there a little bit longer.”
So, adolescents tend to need more immediate results. Adolescents sometimes tend to need a little bit more support or hand-holding, and reinforce to them that I do think I see a little improvement.
But then there’s just individual differences. There’s some individuals who are just better or worse at waiting for gratification.
Read the entire interview with Dr. Richard Fried:
Part 1: The Mind-Skin Connection