The Psychosocial Implications of Acne Vulgaris: A Push Towards Integrative Care

Abstract

Background: Acne vulgaris is one of the most common dermatologic conditions, affecting up to 85% of adolescents and many adults. While the physical manifestations are well-recognized, acne is strongly associated with psychosocial comorbidities such as depression, anxiety, low self-esteem, and suicidal ideation. Despite this, routine psychosocial screening is rarely incorporated into acne management, leaving a gap in holistic, patient-centered care. Purpose: The purpose of this quality improvement (QI) project was to increase provider awareness of the psychosocial burden of acne vulgaris and evaluate the impact of a brief educational intervention on provider knowledge, confidence, and intention to implement routine mental health screening in this population. Additionally, recommendations for psychiatric referrals and options for adjunctive therapies are presented. Methods: Guided by the Model for Improvement, the intervention consisted of a 15-minute in-person educational session delivered at a private outpatient primary care clinic. Three clinic staff members participated in the education session. A pre-intervention survey assessed baseline knowledge and practices, while a post-intervention survey evaluated perceived effectiveness of the education, appropriateness of screening tools, workflow feasibility, and intent to implement screening. Likert-scale items were analyzed using descriptive statistics, and open-ended responses were analyzed thematically. Results: Quantitative findings demonstrated improvements across all domains, with participants reporting higher confidence in identifying psychological comorbidities (pre-M = 4.00, post-M = 5.00), increased recognition of actionable strategies, and unanimous intent to implement screening. Qualitative analysis revealed three themes: value of validated screening tools, interest in expanding screening to all adolescents, and workflow and time barriers to sustainability. Conclusions: The educational intervention effectively increased provider knowledge, confidence, and willingness to integrate psychosocial screening into acne care. Findings support the feasibility of embedding validated tools and referral pathways into practice, with system-level adjustments needed for sustainability. This project underscores the importance of holistic, integrative care that addresses both the physical and psychosocial dimensions of acne vulgaris.