The Impact of Acne, Atopic Dermatitis, Skin Toxicities and Scars on Quality of Life and the Importance of a Holistic Treatment Approach

Abstract

Skin conditions such as acne, atopic dermatitis, skin toxicity from oncology treatment, and scars are among the most common health conditions and negatively impact quality of life (QoL). Yet the physician perception of this impact often varies greatly from the patient perception. This is important because patient illness perception is closely linked with seeking help and treatment adherence behaviors. The objective of this review is to better understand the impact of these four highly prevalent skin conditions on QoL including their health-related economic factors to improve treatment outcomes. The literature search included literature published on QoL with acne, atopic dermatitis, scars (from any cause) and skin toxicities on PubMed between 2015 and 2020. We found that patients with skin conditions have a much higher frequency of altered QoL and psychological distress than those without. Also, skin conditions negatively impact self-image and can cause feelings of isolation, loneliness, lower self-esteem, and lower body satisfaction. Additionally, physical discomfort adds to the psychological distress. These physical and psychological impacts are an enormous financial burden on patients, their families and society. We found evidence that holistic treatment including treating the skin condition itself, providing wider peer and psychological support as well as shared decision-making, therapeutic patient education and dermatologist involvement improves outcomes. Holistic history-taking, checklists, or the use of more formal QoL scoring tools can be incorporated into routine consultations to better assess patient well-being and provide clinicians with important information for adapting treatment to individual patient requirements. In conclusion, this review highlights the overall impact of skin conditions (including psychological and QoL impacts) and the importance of providing holistic care to optimize treatment outcomes. A comprehensive QoL screening tool would be useful to help provide patient-centered treatment.

Combined Effect of Microneedling and Platelet-Rich Plasma for the Treatment of Acne Scars: A Meta-Analysis

“…The most common sequela of acne is acne scars, which could be formed in about 50% of people with acne, most commonly in highly visible areas such as faces and cheeks ( 5 ). Atrophic acne scars are the most common type of acne scars, which significantly affect the beauty of the patients and also impair the quality of life for some patients ( 6 , 7 ). The pathogenesis of atrophic acne scars is complicated, which mainly involves the degradation of inflammatory mediators, collagen fibers, and subcutaneous fat, ultimately leading to the change of subcutaneous collagen deposition ( 8 , 9 ).…”

Therapeutic potential of adipose tissue‐derivatives in modern dermatology

“…Acne is a common disorder arising during adolescence and causing great psychosocial stress. 82,83 Acne is characterized by comedones, pustules and papules often associated with scars after resolution. Its pathogenesis is multifactorial, involving critical factors with interrelated mechanisms: excessive sebum production, abnormal keratinization of the follicular infundibulum, colonization by the bacterium Propionibacterium acnes in the pilosebaceous unit and inflammation related to both innate and adaptive mechanisms.…”

“…Acne is a common disorder arising during adolescence and causing great psychosocial stress 82,83 . Acne is characterized by comedones, pustules and papules often associated with scars after resolution.…”

The Impact of Acne Vulgaris on the Quality of Life in Teen Patients

“…Skin conditions negatively impact self-image and can cause feelings of isolation and loneliness. Additionally, physical discomfort adds to psychological distress (Dreno et al, 2021). AV has a significant psychological impact and comorbidity even though it is a frequent and nonthreatening life condition (Stamu-O'Brien et al, 2021).…”

“…Alanazi et al (2018) mentioned that AV had a significant impact on quality of life in 14.50% of cases among allfemale secondary school students in 3 randomly selected schools in Saudi Arabia. From the literature search included literature published about quality of life with acne, atopic dermatitis, scars (from any cause), and skin toxicities on PubMed between 2015 and 2020, patients with skin conditions have a much higher frequency of altered quality of life and psychological distress than those without (Alanazi et al, 2018;Dreno et al, 2021;Hosthota et al, 2016;Kang et al, 2019;Tasoula et al, 2012).…”