Acne -- not acne medication -- is probably responsible for the mental health problems of sufferers, study says

One of the problems that doomed the acne drug Accutane was a widespread perception that – along with other problems, like birth defects and inflammatory bowel disease – it made patients more prone to depression and suicide. As my colleague Shari Roan reported in a story last year explaining why drug maker Roche Holding pulled Accutane from the market:

“The drug has been publicly and emotionally linked to an increased risk of depression, including suicides, and some families of suicide victims have pressed the Food and Drug Administration for its removal – among them Rep. Bart Stupak (D-Mich.), whose teenage son committed suicide after taking Accutane.”

But the link between Accutane and mental health problems is debatable, with studies producing conflicting results.

The latest study to address the matter was published online Thursday in the Journal of Investigative Dermatology. An international group of researchers collected questionnaires from 3,775 Norweigian teens (most of then 18 or 19) and looked for an association between acne severity and mental health.

Overall, they found that 11% of the Oslo teens experienced episodes of suicidal ideation. But those who reported having “substantial” acne were 80% more likely to report suicidal ideation compared to teens with clearer complexions. In fact, the researchers found that the worse one’s acne, the more likely they were to contemplate suicide.

Severe acne was also linked with other psychological deficits, including not thriving at school and having fewer attachments to friends. Those problems have also been linked to depression. Here’s how the researchers put it:

“Acne almost certainly causes embarrassment, stigma, shame, guilt, and low self-esteem, which are likely to cause psychosocial problems. Acne may cause depression, which then results in impaired social functioning and suicidal ideation.”

Bottom line: It is probably unfair to blame Accutane for depression in teens instead of the severe acne that led them to seek Accutane prescriptions in the first place.

-- Karen Kaplan