Abstract
Alexithymia seems to be more common among patients with skin diseases. However, studies on acne patients are very limited. We conducted this study to evaluate alexithymia in adolescents with acne. In our cross-sectional study, 730 high school students (mean age: 17.05 ± 1.18 years) were recruited. The Toronto Alexithymia Scale (TAS-20) was used to measure alexithymia, the Dermatology Life Quality Index (DLQI) was employed to study quality of life (QoL), and the 6-item Stigmatization Scale (6ISS) was used to evaluate the level of stigmatization in acne subjects. Alexithymia was found in 31% of adolescents, with similar prevalence among those with and without acne (31.3% and 30.1%, respectively). The mean scoring on the TAS-20 in patients with acne (53.1 ± 12.8 points) was not significantly different from that of the non-acne group (53.5 ± 11.9 points). However, significant correlations between TAS-20 scores and QoL assessments (r = 0.332, p < 0.001) as well as stigmatization level (r = 0.284, p < 0.001) were found. These correlations were also significant for the domains of alexithymia described as difficulty in identifying feelings (DIF) and difficulty in describing feelings (DDF), but not for externally oriented thinking (EOT). The findings clearly showed that acne does not predispose to alexithymia; however, alexithymia in acne subjects is related to impaired QoL and stigmatization.
Highlights
Acne is the most common skin problem in adolescents and young adults [1,2]
The prevalence of alexithymia in the acne group was 31.3% and was not significantly different from the group of students without acne (30.1%). Taking into consideration both alexithymic and intermediate alexithymic subjects, there was no significant difference between students with and without acne (55.0% and 59.0%, respectively) (Table 1)
We found a significant relationship between alexithymia and stigmatization level in the whole acne group (r = 0.284, p < 0.001; Figure 3)
Summary
It was clearly shown that acne patients are at an increased risk for the development of psychological comorbidities [3]. Acne patients frequently present with depressive symptoms and anxiety reactions [3,4]. They were documented to have difficulties in emotion regulation [5]. It is not surprising that the quality of life (QoL) of acne patients is markedly decreased [6–8]. Alexithymia is considered a personality trait characterized by a decreased ability to identify and verbally express emotions, a limited imaginative capacity, and externally oriented thinking [11,12]. The prevalence of alexithymia in the general population was assessed as 10–13% [14–16]; it seems to be much more common in patients suffering from various disorders [17–19], including dermatological disorders [16,20–23]. The studies on alexithymia in acne patients are limited [15,24,25]
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