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Acne is a diabolically cruel thing: somehow it strikes your most visible feature just at the age when you become most vulnerable, to a gaze. Not surprisingly, acne is often accompanied by serious depression among teenagers. In fact, a 1999 study found that kids with acne bad enough to prompt a trip to the dermatologist reported having emotional and social problems as severe as those reported by patients with disabling diabetes and epilepsy.
Other studies have shown similar reactions to bad cases of acne. And so an international team of researchers — including scientists from Harvard Medical School in Boston and University Medical College in Tibet — decided the acne — depression question needed further investigation. The team’s intriguing new paper, published this week in the open-access journal BMC Public Health, not only confirms that acne goes hand in hand with depression and anxiety but further suggests that teens’mental distress may in fact be worsening the condition of their skin.
Led by Jon Halvorsen, a dermatologist at the University of Oslo in Norway, the researchers launched their study in 2004, inviting every 18 and 19-year-old who was finishing high school in Oslo to answer some questions about zits and other things. Of the 3,659 students invited, 90% participated, along with 467 other 18 and 19-year-old who were not graduating. The teenagers completed questionnaires about the severity of their acne as well as how much anxiety and depression they were experiencing, what they usually ate and whether they smoked and drank. Separately, the researchers collected socioeconomic data on the teens from the country’s central information-gathering agency, Statistics Norway.
The results show that the level of mental distress kids reported was strongly associated with how much acne they said they had, independent of other factors like diet or lifestyle. Roughly 19% of all kids who reported symptoms of anxiety and depression said they had acne, compared to only 12% of those who reported no mental distress. Among boys, those with depression and anxiety were 68% more likely to report acne than their happier peers; among girls, those with mental distress were twice as likely as those without to report acne.
The study found, for the first time, a linear relationship between mood and pimples: the worse the mental-illness symptoms, the worse the acne. It’s possible that the association simply means that kids who feel depressed are more likely to report they have bad acne, even if they don’t — but previous studies have shown that dermatologists independently agree with teens’ self-reports of acne severity about 75% of the time. Some of the depressed and anxious kids in the Norwegian study may have exaggerated their acne, but in a sample as large as this one, it’s unlikely that most did.
So how could mental-health problems actually exacerbate acne? One theory is that people with mental distress eat more junk food. The teenagers with acne says that overindulging in chocolate and potato chips — which can make greasy fingers and, consequently, greasy faces — spawns pimples. This is mostly myth, according to the study’s findings, although they offered a bit of support for the notion that diet plays a role. Girls in the study who consumed few vegetables tended to have more zits than girls who ate lots of greens. But diet was entirely irrelevant for boys.
The authors also discount other lifestyle factors. The Norwegian adolescents who said they regularly use alcohol and cigarettes were no more likely to report acne than those who were abstemious. Only mental distress was strongly correlated with acne in both boys and girls.
But that still doesn’t answer the question of what mechanism might be at work. The authors offer a few hypotheses. For instance, stress may somehow stimulate the growth of nerve fibers near sebaceous glands, which in turn contributes to the increased production of sebum — the fatty substance that combines with cell debris and dead skin cells to form those familiar blackheads and pustules. That theory is unproved, but previous research on the effects of depression and acne drugs suggests the authors may be onto something: we know, for example, that antidepressants can improve acne. We also know that a widely used drug that treats acne, Accutane(isotretinoin), has been associated with an increase in depression, although no causal link has been established.
The new study has some obvious shortcomings, particularly that it relies entirely on self — reports from a self — selected group of respondents. Much more rigorous research needs to be conducted to understand the relationship between mental illness and pimples — as well as the root cause of bad cases of acne. But in the meantime, drug companies might want to start working on a miracle cream.
粉刺总是让人感觉糟透了:不知为什么,它总是在你最不愿意引人注目的年龄侵袭你最引人注意的部份。毫不奇怪,在青少年中,粉刺的生长通常伴有严重的抑郁症。实际上,1991年的一项研究发现,长了粉刺且严重到不得不去看皮肤科医生的孩子报告其有情感上和社交上的问题,其严重程度等同于患有使人丧失某些能力的糖尿病和癫痫病的病人在这方面的问题。
其它的一些研究也显示了对严重粉刺病例的类似的反应。于是,一个国际研究团队——包括来自波士顿哈佛医学院和西藏大学医学院的科学家——决定对粉刺与抑郁的关系问题进行进一步调查研究。一篇极具吸引力的论文于本周发表在开放性获取期刊《BMC公共健康》上,它不仅证实青春痘与抑郁和焦虑密切相关,而且进一步表明,实际上青少年的精神压抑会使其皮肤状况变得更糟。
2004年,以挪威奥斯陆大学皮肤学家乔恩·霍尔沃森为首的研究人员开始进行研究,他们邀请奥斯陆所有18-19岁的即将毕业的高中生回答一些有关青春痘及其它事情的问题。被邀请的3659名学生中的90%和不在毕业年级的467名18-19岁的学生一起参加了问卷调查。他们完成的问卷内容包括自己所患青春痘的严重程度、经受了多大的焦虑和抑郁,通常吃些什么以及是否吸烟喝酒等。研究人员从挪威统计局国家信息收集中心机构搜集了这些青少年各自的社会经济资料。
研究结果显示,孩子们报告的精神压抑程度与他们所说长粉刺的量密切相关,但与其它因素如饮食和生活方式几乎没有关系。那些报告说没有精神压抑的孩子中只有12%长了青春痘,与此相比,约19%的有焦虑和抑郁症状的孩子说他们长了青春痘。在男孩子中,抑郁和焦虑的孩子比那些更快乐的同龄人长青春痘的可能性高68%;在女孩子中,有精神压抑的孩子患青春痘的可能是没有精神压抑的孩子的两倍。
该研究首次发现情绪和粉刺之间的线性关系:心理疾病症状越严重,粉刺的状况就会越糟糕。这种关联可能仅仅意味着,那些感到抑郁的孩子更有可能说自己长有糟糕的粉刺,即使他们并没有--然而,先前的研究表明,皮肤学家各自认可当时约75%的青少年粉刺严重程度的自我报告。在挪威进行的研究中,有抑郁和焦虑症的孩子当中的一些或许夸大了他们的粉刺状况,但在像这次这么大规模的抽样调查中,不可能大多数人夸大其粉刺状况。
那么心理健康问题实际上是如何恶化粉刺状况呢?一种推测认为,精神苦闷的人吃的垃圾食品更多。那些脸上长粉刺的青少年说,过度食用巧克力和薯片引发了粉刺,因为这些食物使手指变得油腻,随后使得脸也变得油腻。尽管这些发现为饮食发挥作用这一观点提供了些许支撑,但就从研究结果来看,大体上这是一个没有事实根据的理论。参与该研究的几乎不吃蔬菜的女孩比吃大量蔬菜的女孩往往长出更多的粉刺。不过,对男孩子来说,粉刺跟饮食完全毫无关系。
该报告的作者们还对其他生活方式因素持怀疑态度。那些说自己经常抽烟喝酒的挪威青少年同那些生活有节制的孩子们报告粉刺的可能性是一样的。无论男孩女孩,只有精神苦闷才与粉刺密切关联。
但这依然没有回答这个问题:什么机制在起作用?该报告的撰写者们提出了一些假设。例如,压力也许以某种方式刺激皮脂腺附近神经纤维的生长,这反过来促进了皮脂的增长——皮脂是将细胞碎片和死皮肤细胞化合以形成那些我们熟悉的黑头粉刺和脓包的脂肪物质。尽管这种假设尚未证实,但先前对治疗抑郁症和粉刺药物效果的研究表明,这些作者们或许发现了某些东西:例如,我们知道了抗抑郁药物可以改善粉刺症状。我们也知道,尽管还没有确立因果联系,阿克唐丸(异维甲酸),一种广泛用于治疗粉刺的药物,与抑郁症例的增加相关联。
该项新研究存在着明显的缺陷,尤其是其完全依赖于自愿参加的应答者的自我报告。要了解心理疾病和粉刺之间的关系以及造成严重粉刺病例根本原因,还需要进行更缜密的研究。但与此同时,制药公司或许打算开始研究一种神奇的去痘霜了。
Other studies have shown similar reactions to bad cases of acne. And so an international team of researchers — including scientists from Harvard Medical School in Boston and University Medical College in Tibet — decided the acne — depression question needed further investigation. The team’s intriguing new paper, published this week in the open-access journal BMC Public Health, not only confirms that acne goes hand in hand with depression and anxiety but further suggests that teens’mental distress may in fact be worsening the condition of their skin.
Led by Jon Halvorsen, a dermatologist at the University of Oslo in Norway, the researchers launched their study in 2004, inviting every 18 and 19-year-old who was finishing high school in Oslo to answer some questions about zits and other things. Of the 3,659 students invited, 90% participated, along with 467 other 18 and 19-year-old who were not graduating. The teenagers completed questionnaires about the severity of their acne as well as how much anxiety and depression they were experiencing, what they usually ate and whether they smoked and drank. Separately, the researchers collected socioeconomic data on the teens from the country’s central information-gathering agency, Statistics Norway.
The results show that the level of mental distress kids reported was strongly associated with how much acne they said they had, independent of other factors like diet or lifestyle. Roughly 19% of all kids who reported symptoms of anxiety and depression said they had acne, compared to only 12% of those who reported no mental distress. Among boys, those with depression and anxiety were 68% more likely to report acne than their happier peers; among girls, those with mental distress were twice as likely as those without to report acne.
The study found, for the first time, a linear relationship between mood and pimples: the worse the mental-illness symptoms, the worse the acne. It’s possible that the association simply means that kids who feel depressed are more likely to report they have bad acne, even if they don’t — but previous studies have shown that dermatologists independently agree with teens’ self-reports of acne severity about 75% of the time. Some of the depressed and anxious kids in the Norwegian study may have exaggerated their acne, but in a sample as large as this one, it’s unlikely that most did.
So how could mental-health problems actually exacerbate acne? One theory is that people with mental distress eat more junk food. The teenagers with acne says that overindulging in chocolate and potato chips — which can make greasy fingers and, consequently, greasy faces — spawns pimples. This is mostly myth, according to the study’s findings, although they offered a bit of support for the notion that diet plays a role. Girls in the study who consumed few vegetables tended to have more zits than girls who ate lots of greens. But diet was entirely irrelevant for boys.
The authors also discount other lifestyle factors. The Norwegian adolescents who said they regularly use alcohol and cigarettes were no more likely to report acne than those who were abstemious. Only mental distress was strongly correlated with acne in both boys and girls.
But that still doesn’t answer the question of what mechanism might be at work. The authors offer a few hypotheses. For instance, stress may somehow stimulate the growth of nerve fibers near sebaceous glands, which in turn contributes to the increased production of sebum — the fatty substance that combines with cell debris and dead skin cells to form those familiar blackheads and pustules. That theory is unproved, but previous research on the effects of depression and acne drugs suggests the authors may be onto something: we know, for example, that antidepressants can improve acne. We also know that a widely used drug that treats acne, Accutane(isotretinoin), has been associated with an increase in depression, although no causal link has been established.
The new study has some obvious shortcomings, particularly that it relies entirely on self — reports from a self — selected group of respondents. Much more rigorous research needs to be conducted to understand the relationship between mental illness and pimples — as well as the root cause of bad cases of acne. But in the meantime, drug companies might want to start working on a miracle cream.
粉刺总是让人感觉糟透了:不知为什么,它总是在你最不愿意引人注目的年龄侵袭你最引人注意的部份。毫不奇怪,在青少年中,粉刺的生长通常伴有严重的抑郁症。实际上,1991年的一项研究发现,长了粉刺且严重到不得不去看皮肤科医生的孩子报告其有情感上和社交上的问题,其严重程度等同于患有使人丧失某些能力的糖尿病和癫痫病的病人在这方面的问题。
其它的一些研究也显示了对严重粉刺病例的类似的反应。于是,一个国际研究团队——包括来自波士顿哈佛医学院和西藏大学医学院的科学家——决定对粉刺与抑郁的关系问题进行进一步调查研究。一篇极具吸引力的论文于本周发表在开放性获取期刊《BMC公共健康》上,它不仅证实青春痘与抑郁和焦虑密切相关,而且进一步表明,实际上青少年的精神压抑会使其皮肤状况变得更糟。
2004年,以挪威奥斯陆大学皮肤学家乔恩·霍尔沃森为首的研究人员开始进行研究,他们邀请奥斯陆所有18-19岁的即将毕业的高中生回答一些有关青春痘及其它事情的问题。被邀请的3659名学生中的90%和不在毕业年级的467名18-19岁的学生一起参加了问卷调查。他们完成的问卷内容包括自己所患青春痘的严重程度、经受了多大的焦虑和抑郁,通常吃些什么以及是否吸烟喝酒等。研究人员从挪威统计局国家信息收集中心机构搜集了这些青少年各自的社会经济资料。
研究结果显示,孩子们报告的精神压抑程度与他们所说长粉刺的量密切相关,但与其它因素如饮食和生活方式几乎没有关系。那些报告说没有精神压抑的孩子中只有12%长了青春痘,与此相比,约19%的有焦虑和抑郁症状的孩子说他们长了青春痘。在男孩子中,抑郁和焦虑的孩子比那些更快乐的同龄人长青春痘的可能性高68%;在女孩子中,有精神压抑的孩子患青春痘的可能是没有精神压抑的孩子的两倍。
该研究首次发现情绪和粉刺之间的线性关系:心理疾病症状越严重,粉刺的状况就会越糟糕。这种关联可能仅仅意味着,那些感到抑郁的孩子更有可能说自己长有糟糕的粉刺,即使他们并没有--然而,先前的研究表明,皮肤学家各自认可当时约75%的青少年粉刺严重程度的自我报告。在挪威进行的研究中,有抑郁和焦虑症的孩子当中的一些或许夸大了他们的粉刺状况,但在像这次这么大规模的抽样调查中,不可能大多数人夸大其粉刺状况。
那么心理健康问题实际上是如何恶化粉刺状况呢?一种推测认为,精神苦闷的人吃的垃圾食品更多。那些脸上长粉刺的青少年说,过度食用巧克力和薯片引发了粉刺,因为这些食物使手指变得油腻,随后使得脸也变得油腻。尽管这些发现为饮食发挥作用这一观点提供了些许支撑,但就从研究结果来看,大体上这是一个没有事实根据的理论。参与该研究的几乎不吃蔬菜的女孩比吃大量蔬菜的女孩往往长出更多的粉刺。不过,对男孩子来说,粉刺跟饮食完全毫无关系。
该报告的作者们还对其他生活方式因素持怀疑态度。那些说自己经常抽烟喝酒的挪威青少年同那些生活有节制的孩子们报告粉刺的可能性是一样的。无论男孩女孩,只有精神苦闷才与粉刺密切关联。
但这依然没有回答这个问题:什么机制在起作用?该报告的撰写者们提出了一些假设。例如,压力也许以某种方式刺激皮脂腺附近神经纤维的生长,这反过来促进了皮脂的增长——皮脂是将细胞碎片和死皮肤细胞化合以形成那些我们熟悉的黑头粉刺和脓包的脂肪物质。尽管这种假设尚未证实,但先前对治疗抑郁症和粉刺药物效果的研究表明,这些作者们或许发现了某些东西:例如,我们知道了抗抑郁药物可以改善粉刺症状。我们也知道,尽管还没有确立因果联系,阿克唐丸(异维甲酸),一种广泛用于治疗粉刺的药物,与抑郁症例的增加相关联。
该项新研究存在着明显的缺陷,尤其是其完全依赖于自愿参加的应答者的自我报告。要了解心理疾病和粉刺之间的关系以及造成严重粉刺病例根本原因,还需要进行更缜密的研究。但与此同时,制药公司或许打算开始研究一种神奇的去痘霜了。