LITERATURE STUDY 

2.6 THE SOCIAL IMPACT OF ACNE

According to Girman, Hartmaier, Thiboutot, Johnson, Barber, DeMuro-Mercon and Waldstreicher (1996:488), acne is associated with severe social inhibition and anxiety, especially concerning social events like meeting new people or interacting with the opposite sex (or same sex if gay). 

According to Murray and Rhodes (2005:200) acne has a detrimental effect on romantic relationships. Acne sufferers typically have low self-esteem and therefore feel that they do not deserve the attention of clear-skinned, desirable others. Acne also negatively affects existing relationships: when one partner suddenly develops acne, the fear of rejection often precipitates the end of a long-term relationship. 

It seems possible that sufferers reduce their contact with others chiefly as a way of protecting the self-image. Research has shown that acne patients limit the number of times they look in a mirror for the same reason. Such behaviour indicates desperate, but often futile attempts to protect and salvage a positive sense of self in spite of the highly visible and unsightly effects of acne (Kellet & Gawkrodger 1999:19). 

Acne sufferers’ perceived sense of exposure and the visibility of the skin disorder, also significantly influence sufferer’s social and psychological functioning. A study conducted by Papadopoulos et al. (2000:436) found that facial acne sufferers showed poorer self-esteem and body image evaluation than trunkal acne individuals. While self-esteem refers primarily to an individual’s evaluation of him/herself, body image is related more to the way we think others perceive us. This explains the difference between the two groups – as trunkal acne can be concealed by clothing sufferers are generally not subject to the negative and stigmatizing reactions of others. 

Certain personality traits can also exacerbate the adverse social impact of acne. Kreji-Manwarring et al. (2006:122) found that acne sufferers with high social sensitivity were more likely to have poorer social outcomes and quality of life. Social sensitivity can be described as one’s heightened concern for other people’s judgements of and reactions to one. Therefore sufferers who are high in trait social sensitivity will be more concerned about how others view them and might therefore suffer greater psychosocial consequences. 

In a study done by Murray and Rhodes (2005:197), participants reported that they often felt that both people known and unknown to them would stare at their acne. Similar results were obtained in a study by Jowett and Ryan (1985) as quoted in Papadopoulos et al. (2000:432). Participants reported that people in social situations and in the workplace were unable to avoid their gaze becoming drawn to the acne, making them (the participants) feel extremely uncomfortable and embarrassed. According to Murray and Rhodes (2005:197) the acne sufferers in their study also perceived the public as avoiding physical contact with them, as if their acne was somehow contagious. 

Although most acne sufferers are highly sensitive and extremely embarrassed about their skin condition, some researchers have found that the impact of acne may be even greater on women than it is on men (Kellet & Gawkrodger 1999:280). This is supported by a study done by Hsu (1990) in Hanstock and O’Mahony (2002:1318) that found that physical attractiveness seem to be more important to women than men as women rely more on social experiences and appraisal to define their self-concept. It is likely that the gender differences found in these studies are related to wider social and cultural forces in Western society that places great emphasis on women’s appearance. However, it is important to remember that regardless of gender, greater acne severity is associated with greater negative social impact (Kreji-Manwarring et al. 2006:128). 

All the aforementioned factors contribute to creating a feeling of being unfavourably evaluated or shunned by society. This has important social consequences as the sufferers either try to remain unnoticed, blend into the background, or completely withdraws from social interaction.