For the first time ever, the National Institute for Health and Care Excellence (Nice) has recommended mental health support for people severely affected by their acne.

The final guidance, the first by Nice to address the common skin condition, offers recommendations on therapies such as antibiotics and oral contraceptives (for women) and advises clinicians to consider referrals to mental health services, in particular for those with a history of severe depression or anxiety, body dysmorphic disorder, suicidal ideation and self-harm.

Pretty much all of us suffer from acne vulgaris at some point in our lives. Ranging from mild to severe, the spots occur when excess sebum and dead skin cells block our hair follicles. While it is usually limited to some facial pimples in our teenage years, a small fraction continue to have the condition past the age of 35.

Sometimes tied to genetics, acne can cause a person to experience psychological distress and in some cases, this can be a part of, or contribute to, a mental health disorder. While previous research has linked severe acne to suicidal behaviour. The acne treatment, isotretinoin (branded Roaccutane) has also been associated with reports of psychiatric disorders.

Both current acne vulgaris and scarring can have a psychological and social impact on people, potentially causing anxiety or depression and can also exacerbate pre-existing mental health conditions, the guidance report said.

Dr Tanya Bleiker, president of the British Association of Dermatologists, said: “This can be a challenging condition for people affected and for their families, carers and those treating them. Many long-term illnesses are linked to mental health problems like anxiety and depression.

“Acne has a particular effect on appearance, so in addition to depression and anxiety can be damaging to self-image, leading to isolation and sometimes to severe mental health disorders. This is often at times in life when people may feel vulnerable for many reasons.

“The severity of the acne is not always linked to the severity of the mental health impact so it is important that there is a better understanding that even mild acne can have severe effects on emotional wellbeing.”

The guidance comes at a time when some people are embracing the idea of acne positivity, from the occasional spot to full-blown cystic acne. The movement follows recent campaigns to celebrate our skin in all its glory – from vitiligo to freckles and stretch marks – but also as a dose of reality for those who still believe that acne is a problem for the unwashed and unhealthy.

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