I would question whether the chicken or the egg came first. Acne is a result of stress which is, of course, part of what causes depression.
2
This is only logical.
Teenage need for acceptance and affiliation. Intense focus on appearance, even for the most humble among us.
Acne - or any appearance altering condition, I would guess.
1
Well, Social Anxiety Disorder is also associated with acne, and with depression.
This is a chicken and egg story - we don't yet know what causes what.
2
This article neglects to explain that researchers believe both acne and depression are linked to systemic inflammation — a biological process possibly related to an autoimmune disease.
2
My son didn’t have acne in junior high school. But he was severely bullied which indeed led to depression.
But please please please don’t waste time on a study to test if bullying leads to depression in teens. Us parents already know that it does.
Acne leads to social rejection and worse in the high school years. I am so sorry for every teen who has had to endure this unfair and cruel treatment. But why do we need studies to tell us the sad truth we already know?
6
Wow an unseemly skin condition could make somebody feel down? Thanks science!
8
I can not believe it took a "new study," obviously costing substantial time and money by British dermatologist, to conclude that acne causes depression---sometimes very severe and tragic depression. What? None of these dermatologist never had acne themselves and experienced what goes on in life? None of them ever talked with any of their patients one on one?
There is a comment below from a person named Colenso. I suggest that if any of the dermatologist behind this so-called study did not already know that Colenso's experience is typical, they should not be practicing medicine.
9
Are you kidding me? How do people still not know that correlation is not causation? Acne is *associated* with depression because *both* are associated with wacky hormones. That doesn't mean acne causes depression.
6
“People with acne were more likely to be female, younger, nonsmokers and of higher socioeconomic status. They were also less likely to use alcohol or be obese.”
^This aptly describes me. I am a female of 23 years who doesn’t smoke, drink, nor eat junk food. Everyday at work, coworkers applaud me for my healthy lunches & snacks. Yet, I suffer from acne. I changed my diet during my teen years (~17 years; when I first started breaking out) because I thought my acne was caused by junk I ate. However, now I’ve learned it’s not my diet... really unfair, God!
4
I eat healthy and no smoking or drinking. I got acne when I stopped all those bad habits. Now I spend 8 times what I used to on organic silicone free everything to keep it away, for the most part.
2
Maybe try getting rid of silicone (dimethicone, and anything that ends in -cone or -xane. It’s most likely in everything you put in your face. After ten years I found that that was what was the cause
1
Maybe the problem isn't with acne but with our societal and cultural standards surrounding beauty and focusing on outward appearance...
6
Which one is easier to fix? I'll take the Accutane.
2
My daughter suffered for several years with acne. We tried everything--oral and topical antibiotics and all of the various prescription and OTC treatments, and nothing seemed to help. So we tried it--nothing I mean. Washing your face with cold water and nothing else; and guess what? It helped. Dramatically.
We are learning more and more that bacteria are our friends--at least most of them are--and that our bodies cultivate those that are beneficial. When we disrupt them with various soaps and treatments, problems can arise.
I'm not saying it will work for everyone, but my daughter was at a point where it couldn't realistically get worse. "Nothing" was worth a try. It takes only two or three weeks to know if it's helping.
3
Yeah all those drying things can end up forcing your skin to make more oil. I use honey and milk and a bunch of other stuff found in my kitchen, and colloidal silver. No more chemicals.
1
Yep - at a certain point I started watching and listening to my skin. Even the mildest “cleansers” like Cetaphil made my face feel dry and tight, but since they were recommended by dermatologists and marketed as gentle, it never occurred to me that they could be exacerbating my acne. One day, a few years ago, I had an epiphany and just stopped everything. My acne didn’t disappear, but it got significantly better and my skin feels much healthier. I’m less oily and don’t need to shower every single day. Honestly, I stopped using soap on my body too other than a few key areas. I still feel and smell clean. I’m both grateful to have found something that works and resentful for the onslaught of misinformation and false claims and the years of ineffective dermatologists. I wish I would have had the guts to try this in my teens or twenties.
1
How can the association be unclear? Especially in the past 15 years, with an everyday increased visibility that people have to endure with the onset of digital and social media. The risk of depression when you get acne does wane - short, you get more used to it or find ways to hide/cover up. It takes time to do this, esp when you don't know what the cause is. That first year dealing with it changes your self-reflection completely.
4
I'm 65 when I was 12-16 a friend in my neighborhood had the severest case of acne id ever seen . He never received treatment and committed suicide shortly later . Enough said tragically .
3
Accutane!
It can save lives in the right cases.
With careful monthly medical monitoring, Accutane can be transformative for the lives of young people suffering from terrible cystic acne.
It helped my best friend, and it also transformed the appearance in the life of my son.
1
As a 15 year old kid I was told that acne was nature's way to stop me from talking to girls but made me focus on homework instead. That disaster was then further extended with the comment that young boys at age 20 had a strange face, neither young nor grown up. I did pass all my exams but until age 22 had no idea on how to charm a young lady.
1
I'm not sure why this is confusing. Having noticeable acne makes it harder to get a date. In high school it often leads to people being mocked and ostracized, and even in college it can have a reducing effect on one's social life.
When people around you aren't being judged for their appearance, and you are, through no fault of your own, it's depressing. Being unable to get into a romantic relationship for years is also depressing.
Of course, not everybody with acne will experience this, but enough will that it'd make them more likely to experience clinical depression. So I don't think this is a biological link, I think it's sociological.
4
Depression in adult acne is the main cause for acne not the other way around. Dermatologists should be asking their clients about life changing events insteads of selling their service and creams for their own greed.
2
"The reason for the association is unclear." Is this a joke? I can recall vividly the struggles of classmates and the cruelty they endured. At least one is an alcoholic.
13
One does not wish to sound over dramatic but acne destroyed my life. The acne led to the constant, relentless bullying and to the constant, relentless mockery and humiliation. This then led to the next step in my physical, mental and spiritual disintegration. And so on. I tried to console myself that I was Job, being tested by God. Alas, it brought no solace. It made me boil against the world. I have never healed, never recovered. I never can. I never will.
9
Colenso, I'm so very sorry for what you had to go through. I hope you find the peace and happiness you deserve. Take care.
9
I hear you. I hope you can find some peace, but I know the emotional scars can be worse than the physical ones. I will say that I struggled for a long time and am now married to a beautiful, caring woman who could not care less what my skin looks like. For what it’s worth. Good luck.
2
I remember reading a book review, I think here in the NYT about a man who was a depressed teenager with acne. His wealthy parents spent lots of money on psychiatrists, but his uncle finally took him to the dermatologist. Treating the acne lifted his depression.
Why the wealthy parents didn't think of treating the acne, I'll never understand.
8
So glad to see this link between the 2 in the NYTimes!
I'm 27 and have suffered through adult acne and depression for the past 2-3 years. Looking back it was unclear what started first: my depression or my acne.
I have basically changed most aspects of my life to get them both under control.
After a ton of herbal tea treatments, daily yoga, eliminating all harmful chemicals from my skincare routine, eliminating corn & chocolate & dairy & sugar, seed cycling, liver-cleansing supplements, starting to actually sleep again, and oh yeah-- LEAVING New York and an unfulfilling job, I'm happy to say my acne and depression are under control. Going all natural is the best thing I've ever done for my skin, body, and mind. I hope others suffering from these conditions can find relief in these remedies as well!
6
This article is pretty "light", but it hits close to home since I've suffered from acne since I was 12 or 13 (now 34) and it has had a dramatic impact on my mental health and well-being. I have a million theories on acne's causes and impacts - I think many people who suffer from it do, and it can easily become an all-consuming obsession. As for the link with depression, how about this: when I am broken out, I avoid face-to-face social contact. Lack of social contact leads to depression. Now that I'm married and have a kid, I'm never completely isolated. But when I was younger, and my skin was worse, I said "no" to a lot of social opportunities and suffered for it. Just a thought!
6
I have had the same problem well into my 30s and tried topical EVERYTHING. I finally read a study on microdosing via Accutane. Taking very small doses of Accutane - 10-20 mg daily, no more - for an extended six month period minimized the side effects and was documented to be as effective as the regular dose.
Now I get a pimple maybe once a month, usually less. It's been a great relief to feel 'normal'. I know no one really is, but there is so much weight on presenting yourself that way to the world outwardly.
See: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094720/
I had severe cystic acne on and off from the time I was 12 until I was 50, and it was no picnic. Over the course of those years, I spent tens of thousands of dollars on drugs (antibiotics, accutane), camouflaging makeup, doctor's visits, two surgical dermabrasions to get rid of the scars and three facelifts to tighten the excess skin caused by the destruction of the underlying dermal layer. Today, I'm in my 60s and my skin looks good, but it was a horror story for many years.
6
"People with acne were more likely to be female, younger, ...." No surprise here, Society in general holds the bar MUCH higher for young women to look a certain way than it does for young men. It's not "acceptable" for women when LOOKS are the sad defining factor for too many young people. No wonder depression might set in when your face starts breaking out and you feel like everyone is staring at you but not for the "right" reasons.
1
Chronic inflammation is related to many disorders, including heart disease & gum disease, one study found that eczema is related to developing Alzheimer's. So I am not surprised at this finding linking acne to depression, but I suspect the depression is caused by the overt appearance of sores on a teen's face and the resulting reactions of one's peers. If the depression was of a biological cause, it would not disappear after 5 yrs, which would be about the same amount of time it takes for a teen to get thru the worst of the teen years and the accompanying self-image negativity from having facial sores/scars. Being a teen is not easy.
1
This just in, people who are depressed have a higher chance of being depressed.
5
Lets face it; zits are depressing.
3
Two young males in our family have acne. What they have in common that differs from other family members is a poor diet with a lot of processed junk food and sugar. This diet could have something to do with acne and depression.
That is one of the true statements in the messages: no question that foods with a high glycemic index play a major part in the pathogenesis of acne.
1
There are dermatologists who don’t care about acne. If you go to a dermatologist who doesn’t care about treating your acne, get up and walk out.
5
One of my sons had very severe cystic acne. Tetracycline didn't touch it. Then, because of a broken bone that got infected where a plate had been used to hold the ends together, he spent several days in the hospital on an antibiotic administered by IV drip. Every day when I went to visit him I saw that the acne was clearing up on his face and on his back. It never came back. It was over! Now every time I see a teenager with severe acne I wonder why we don't just CURE it and save them all that heartache and scarring.
10
wow the coincidence of a broken bone really helped him how fortunate i was treated with accutane twice and is really cleaned up my skin in my early 30s i would still like to take it again i am in my 60s and i still have some deep acne blackheads that i know the accutane would help pop up but now i have two stents heart issues so i doubt anyone would prescribe if for me it is a real shame because that accutane really works for cystic acne but is causes birth defects so there is a lot of paperwork doctor has to fill out to get you a prescription so many times they give up it is too much work i would recommend to anyone accutane even if you are older to work on cysts and you can go to a plastic surgeon they do have treatments to diminish the acne scars left behind and yes i was depressed in high school when this all started
2
For this obvious fact they needed a study?
My god, any good clinical dermatologist knows this very well, and learns it well from the moment their training begins, and always keeps it in mind when treating such patients! Many (read: most) skin diseases carry with them a heavy psychological burden, with acne (especially the more severe varieties) at the apex for such. Next usually are psoriasis and eczema. The dermatologist who forgets this matter is putting a patient at real risk.
Disclaimer: I am a clinical professor of Dermatology at U. of Penn, and was in private solo practice for 40+ years.
29
Seriously- what alternative universe are these scientists in?
5
(Somewhat) interesting to know but the study was 15 years long and, "The reason for the association is unclear."??? It just seems really hard to believe that the study didn't answer a pretty basic question-were they not able to conclude that the depression was solely (or for the most part) due to those afflected, doubting their self-worth (either self-imposed or a result of being teased/bullied/ignored) OR is there some possible "biological" connection?
2
CORRELATION IS NOT CAUSATION. Thank you, New York Times for the sentence, "The reason for the association is unclear." The quotation at the end of the article, "It can have a substantial impact on overall mental health," seems careless in implying that one causes the other. When I was a teenager, I was depressed AND I had acne, but would I NOT have been depressed had I NOT had acne? The answer is not clear from this study.
4
My acne was so bad in college that I often would not go to classes for days. I'd spend hours trying to cover it up with skin colored make up until I'd look ridiculous and clownish (kind of like our president), and just not go out. I was always thrilled when the time would change and it would get dark earlier because I could hide in the night. One time I got pulled in the back room by store security for shoplifting because I had put some acne cover medicine in my pocket because I was too embarrassed to pay for it...I thought the cashier would look at what I was buying and then inspect my ravaged face. Acne is so awful. A drug called Accutane came out and I was put on that and it was a miracle for me. As I've aged the scars have largely faded. I beg any young person with this problem out there to just know...it will pass, don't be desperate and let it ruin you.
19
What about acne AND braces? And gangly limbs, bad haircuts, and the wrong zip code.
7
Well, DUH! Get called pizza-face a few times and have people avoid you just might give you low self-esteem. Did these researchers ever go to high school?
17
They actually needed a study for this? It is as obvious as a pimple on your face.
13
Skin problems such as acne are related to hormonal (mostly reproductive) imbalance and depression is also caused by imbalance in brain hormones. It is quite possible that both imbalances are caused by the malfunctioning of a particular endocrine process and acnes are the early warning of that malfunctioning.
3
The most interesting question about acne is the timing of its appearance:
Biologically, humans begin to mature sexually in their teens. And then acne kicks in to ruin any kind of sexual attraction.
How could such poor timing have evolved? Does acne force the evolution of a stronger sex drive--so strong it can overcome the repulsion of acne? Or is it simply proof that the universe is having a big laugh at our expense?
3
Maybe acne is Mother Nature's way of making sure that you love someone for themselves, despite their acne.
2
Reading these honest and heartbreaking stories, I want to cry. I had never experienced acne until my late thirties, which is apparently a common age for it to start. But it never got very bad. My husband had had some as a teen, but it was treatable with tetracycline). Our daughter, however, developed it as a teen, and we ended up getting her two courses of Accutane. That second course was something the doctors really didn't like to initiate, but that really clobbered it. Her skin is clear and beautiful. She had had acne on her back and chest too and wouldn't even wear a bathing suit or short-sleeved blouses. What a cruel, cunning, and emotionally devastating disease.
12
My acne finally cleared up when I stopped eating foods made with conventionally processed flour. I'd had it for decades. And, yes, it did make me feel better about my appearance.
2
Not sure why everyone assumes that the depression must automatically be the result of hating how you look with acne. Maybe acne makes you angry and sad, which are not the same as depression. Depression is a medical condition. Has anyone considered that the acne could be caused by a chemical or hormonal imbalance, which could ALSO cause depression?
3
You can take all the anti-depressants, mental health labels, and psychologists combined and still come up with "depression" if your acne does not go away.
3
I am grateful that this study has been done to legitimize the feelings I had for the majority of my youth. The results seem so incredibly obvious, but it's important to separate acne from all the other difficulties of being a teenager. From condescending "Have you just tried not touching your face?" to mean peers (and later coworkers), acne seemed like the inescapable evil of my life from age 13 through my mid-20s. Accutane changed my life. While it hasn't cleared everything up entirely, it's helped me feel good about my looks for the first time I can genuinely recall. I hope that drawing this line between acne and depression enlightens the dermatologists who laughed at me when I told them how hard it was to have acne, and no other teenagers suffer the shame and humiliation I did.
14
When I was in 8th grade around 55 years ago, there was a very handsome, tall, outgoing boy. All the girls really liked him. By 10th grade, he had developed severe cystic acne. He became a totally different person, totally withdrawn, few talked to him, and the cruel subjected him to some ridicule behind his back. The fact that I still remember this 55 years later is a testimonial to how dramatic and tragic the change was to his life. Insofar as I know, there were no effective treatments at that time for cases like his.
31
Sure there were. Tetracycline and other antibiotics were used.
Agree, only it can be worse for a woman. I took tetracycline for YEARS, did some good, but not much. Now in my 70's, still have the scars and I look at them every day. BTW - long term tetracycline gives your teeth a bluish tinge to boot. They say it had to have been taken during my mother's pregnancy, but she swears she did not take any medications.
5
Sorry, addendum - my acne finally cleared up when Accutane became available. For me, it was the miracle drug that tetracycline never was.
4
People have downplayed the significance of acne. When I was a teenager with cystic acne doctors would even laugh at my misery - "you'll grow out of it - don't worry!" I didn't grow out of it. It wasn't until I was in my late 20s and went to a dermatologist for a different issue that the doctor all-but insisted that I needed to try accutane. By then I had tried so many different pills, creams etc. that I was very skeptical and took a week after getting the medication to try it. It changed my life. I know it has side effects for some people, but for me it was the answer. I could finally leave the house without pancake makeup slathered on and a mirror to constantly reapply it (fooling no one). Having cystic acne was painful, humiliating and humbling every day. Of course it has an impact on mental health.
39
In other news, scientists discover plants need water...
23
Ha! Exactly! "Adults who were clear faced teenagers discovered the kid with acne felt self conscious and depressed". Fortunately, most teenagers don't judge people on a superficial level. (Actually, I think most don't. But,it's still hard to have acne)
1
Let's talk about acne and job interviews. During my college years I developed severe cystic acne. Nothing any dermatologist did helped. I turned toward very expensive cosmetic products and weekly facial, which I was fortunate enough to be able to afford. They worked. I really do believe that I would not have been hired by the real estate company, or the high-end art gallery where I worked for years, had I still been suffering with acne. Appearance matters. I am in my 60s and my face is still scarred. It was a horrific experience for a young woman.
25
It's not so great for a young man.
6
Cosmetics by law and definition cannot affect the skin - if they did they would then be labeled as drugs, and thus regulated. Facials do nothing for acne, but they do make the sufferer feel better.
1
She didn't say the cosmetics improved her acne- they were used to minimize its appearance.
1
I had bad acne as a teenager. It was bad for my confidence and overall well being. I had to take acutane and that killed the worst of it all though its not good for you at all. I would still do the same thing over again though.
8
My son has severe acne and I know that his confidence is down because of it. He has tried Accutane and although it stopped the severe growths in his body, his face has been salvaged, he still gets the occasional growth. We have done everything and went to every doctor. All this to say that not one method works and I have been reinforcing his other wonderful qualities and that is something that will go away at some point. But I will do this for my son again as well.
4
This may sound counter-intuitive, but coconut oil has excellent properties for clearing skin. It is anti-bacterial, anti-inflammatory and anti-fungal and promotes healing.
1
This is so naive it's laughable! How could I not have been "depressed" when acne almost destroyed my teen years? Maybe this article is making a distinction between "clinical" depression and just plain old misery, but it's still sounds like a big fat "duh" to me.
25
Yes and no...it is a bit but in many way it is a distinction without a real difference. Outside stresses often trigger MDD. Consider two people at identical risk for depression, one with acne and one without. The person with acne is very likely to experience more stress and more negative peer interactions triggering depression.
1
Finally a story about acne I could laugh at. The idiocy of not understanding intuitively the unbelievably obvious link here just boggles my mind. My teenager years were horrible.
I can’t help but concur with the reader who said it’s like discovering that people with broken legs limp.
22
In other news - the sky is blue and water is wet
19
I know when I was a teen, acne made life harder (and more depressing) for me. Yes, these results seem wildly intuitive, as so many people are writing in their comments.
I'm also someone who studies child development, so I'm often on the receiving end of comments like, "That was so obvious -- why bother studying it!?" There are a bunch of reasons why researchers explore questions that may seem obvious. First, sometimes we get surprising answers to questions that, on their surface, seem like no-brainers. Second, sometimes we get nuanced answers (e.g., some people are more vulnerable than others to a particular problem), and these types of results can be incredibly useful. Third, sometimes something needs to be demonstrated through research before funding or other types of next steps can be put in place to address an issue.
I, for one, am grateful to the types of researchers we read about in articles like these. In a political climate in which science is being attacked, we should be mindful of how we undercut researchers trying to do good work.
And, back to the subject of the article at hand, I hope that these results will spur more attention to the various ways that young people suffer without always getting the support they need.
16
I agree most most will say "duh, that's obvious", about this study.
Then as a parent, I have seen many friends blow off their kids bad acne as something they will grow out of and tell them they are making a mountain out of a hill.
Or they old "if they only like you for your looks you need better friends." - exactly what every kid wants to hear in such a situation.
3
I developed bad acne in my thirties. Prior to that I had had nearly perfect skin. I think irregular periods may have been to blame, but I also got it after having some health problems.
It was really bad — uncomfortable. I used to ice my face. One blemish became badly infected and I needed three rounds of oral antibiotics to treat it. I definitely didn’t feel like leaving the house, and it can be really hard to cope with. I felt so embarrassed if I didn’t wear make-up.
I eventually took accutane. I wish I had done it sooner. It’s a miracle drug!
Of course, it’s a serious drug and it has side effects. You also get worse before you get better, but I found it totally worth it.
10
No joke. It's good to somehow quantify it, I guess, but sure isn't new.
Those of us who suffered through it or, even at age 60, still do on occasion
can testify to weight that acne puts on your heart and soul.
6
This article provided some clarity for me. Last year, my girlfriend, 39 years old, developed severe acne. At first we thought it was an allergic reaction to a new sunblock, but it hasn't yet gone away. Over last year she's withdrawn more from social life. We've fought more than ever before and are going through a reevaluation of our relationship. Although there are many other factors involved for us, we've traced the change to this moment when the acne appeared. It feels silly to be so affected, but this article revealed that our situation is not so uncommon.
8
Hopefully, your girlfriend can see a good dermatologist. When severe acne develops all of a sudden at almost midlife, I would wonder if there's something else going on in the body. It wouldn't hurt to have it checked out, if she already hasn't done so, especially if it hasn't gone away. There might be something to treat it or at least be assured it's not connected to another health concern.
1
I had acne as a teenager but it has persisted well beyond that period. The condition became more severe in my early 20s to a point where I was prescribed isotretinoin. I paid for dermatologist visits & the regimen, which took about 7 months to complete, entirely out of pocket because no insurance would cover the treatment. It is a depressing and stressful condition to live with especially because people, however well-intentioned, will offer their advice on how to treat it which may include harmful & misguided assumptions about personal hygiene & lifestyle. The lesions have healed but now I have permanent atrophic scars on my face which I have come to accept. There are expensive resurfacing treatments that may or may not smooth out the scars to a significant level. It's a gamble I don't wish to partake in.
6
Did this study control for people whose acne had been brought under control in the months preceding the survey? If not, depression may have been even more clearly linked to acne.
Accutane, Accutane, Accutane! I cannot say enough about how wonderfully it works, especially where nothing else will. Everyone who is suffering with intractable acne should at least give it a try (under a doctor's supervision). You can always stop if you have a bad reaction.
A lot of the "scary" information out there about Accutane has been propagated by plaintiff-side trial attorneys who have a significant financial interest in convincing the general public that it is a dangerous medication.
9
No surprise here. Another example of a high IQ scientist with low EQ. Acne was part of a perfect storm for me as a young adolescent male. Family problems. Feeling disconnected from old elementary and junior high friends at a large California high school. It lead to almost crippling self-consciousness and only realized decades later it was depression. Inter-disciplinary research would benefit here, an epidemiologist perhaps comparing notes with a psychologist and social worker.
3
Commenters are indicating that acne causes the depression, but what if it's the hormones that cause the acne that also cause the depression? Seems like the hormonal imbalance that affects the skin may also affect mood.
12
This is news? No more surprising than to learn that people with leg injuries are likely to limp. Acne strikes at an age when youthful sufferers are struggling with social relationships and self identity. Would you expect them to be cheerful acne sufferers?
28
More and more I wonder if chronic, systemic inflammation isn't at the root of most diseases - including acne and depression. Over a lifetime landing most of us at an auto-immune disorder and/or cancer. Happy Monday!
14
I'm not surprised by this at all -- I fell under the exact same circumstances as the women mentioned in the study -- young, female, not obese, did not abuse alcohol and from a relatively affluent family. Acne was debilitating. I saw my face change from a beautiful one to one that continues to be scarred 28 years later. Appearing at the onset of one's sensitive teenage years, it's absolutely the worst condition for a young woman. There were days that I didn't want to leave the house, or hid my face with long hair. To say I was depressed the condition is an understatement.
Depressingly enough, our public healthcare system doesn't view acne scars to be treated, and the treatments that remain for them are largely ineffective. It truly is a condition that scars you for life.
37
Maybe if some people weren't so judgmental about acne, then people who have it wouldn't be so depressed. How can any of us survive (much less thrive) in such a shallow, superficial, self-absorbed society? It's amazing if anyone isn't deeply depressed these days.
16
Although Accutane can be incredibly effective, and it was for me (i'm 55), please do significant research if you are thinking of using it. There are a number of nasty side effects including depression. One friend who was given three courses of treatment with the drug, suffered severe liver problems.
Also, please make sure your skin condition is correctly diagnosed as acne. Recently, a physician friend after hearing me describe my acne, believe what I was really suffering from was a staph infection, which was likely caused by popping zits.
12
> suffered severe liver problems
Doctors should test triglycerides every month. Accutane can be perfectly safe and wonderfully effective.
5
The more my mother and I fought, the worse my acne got. In 1959 I was given birth control pills (Enovid), which helped a lot. But psychoanalysis in Chicago made the acne--and the depression--go away. The process took years. I was lucky to have insurance and a good teaching job that helped me afford it. 2 dermabrasions helped smooth my pitted face but left scars where the dermatologist erased pigment. I believe acne is a mental health issue as well as a physical problem.
17
Despite claims to the contrary, diet can make a difference. Chocolate and soda and alcoholic beverages make me break out, and have for decades. Drinking plenty of water improves the condition. But doctors are selling their services and pharmaceutical and cosmetic companies are selling their products, so you’re unlikely to get this information from them. I didn’t, and suffered unnecessarily through my teens and twenties until I figured it out for myself.
4
Diet may be the cause for some people, but it's certainly not the cause of all acne. It's great that changing your diet solved your acne, but for many people the root cause is a hormone imbalance, skin sensitivity, or something else entirely. Our bodies are complex and, as with most medical issues, you should avoid making sweeping generalizations.
16
So many of us probably suffered unnecessarily. I was fortunate that one round of tetracycline cleared up my "pizza face," but that didn't happen till the end of high school. And I've got no scars, that you can see. Ate whatever I pleased afterward, too, and it never came back. But it's not a simple thing, for sure, though I do believe the mind-body effect can be powerful.
1
The quote from the study’s author must out of context. Maybe she referred to magnitude of an element in the study. No reasonable person could be that clueless about the impact on self esteem during a critical period of one’s life that this condition has.
4
I was so depressed and agitated because of acne that my mother took me to see a dermatologist. This was an extraordinary step given that I was 1 of 8 children and we were not wealthy by any stretch. The doc put me on Tetracycline as a long term strategy. Just having the acne acknowledged and addressed did make a difference. Thanks mom.
22
I had severe, cystic acne when I was in my 20s. Fortunately, I was referred to a great dermatologist who prescribed tetracycline and performed acne surgery. It allowed me to avoid scarring and pitting.
In the intervening years, I sought therapy for depression and anxiety. I learned to value my own feelings and work to heal from trauma.
Today, I try to eat well, exercise and honor myself. My skin will never be perfect, but it has improved.
I recommend tackling the issue from all angles; finding triggers and treatments for individual situations.
And always remember: we are so very much more than our complexions. Anyone who does not value you beyond your looks is not worth spending a moment of your time or emotional energy on. As Maya Angelou says: When someone shows you who they really are, believe them the first time.
15
Acne is an awful experience. I had it my entire middle school, high school, and college years. Bought hundreds of drugstore products, burned my skin with chemicals... got pretty good at makeup during that time... never went out of the house without a full face of it. Everyone, and I mean EVERYONE told me that when I became an adult my acne would go away. They were completely wrong. I remember once during work one of my cysts surfaced and began draining - I had to take the next two days off because of the wound in my face. Finally when I started working and the embarrassment of walking into meetings with my cystic face became too much, I went to a dermatologist. I went on accutane and it changed my life (dry lips, dry skin, nothing crazy). I don't wear makeup anymore, family doesn't analyze my face and ask me if I've tried washing it, and people look me in the eye when speaking to me (the feeling of wandering eyes on your face is terrible). I highly recommend going to a derm if you are suffering from acne, I don't know why people don't sooner!
36
SM, I can totally relate to all of that. And people gave me so much advice on diet and stress management. And I tried it all. I blamed myself. I was even on tetracycline and it didn’t help. I am so glad there is Accutane.
I had things drain . . . I don’t even know how to describe it. You reach up and your face is wet — through the nicely applied make-up. Horrible.
4
I began getting acne by 12, and it was clear from then on I'd have bad skin for the rest of my days. I still suffered from acne all the way into my mid-30s, before I finally decided to go through a course of Isotretinoin (Accutane). It worked, and now nearly a decade later I've never suffered from acne again.
But the damage from bad skin will remain in my psyche forever. I have always dealt with depression. I have always dealt with low self esteem. I have always dealt with lack of confidence. All of which I believe is at least in part directly related to the horrible skin I saw in the mirror and was certain everyone else saw as well.
I have nothing but sympathy for those of us with this affliction.
34
Groan!
I'm going through that experience with my oldest son, right now. I can not express the emotional pain our family is going through. Is Acne the cause?
I don't know. He is under the care of a therapist. I will cite this article when we see her, today.
12
Take it very very seriously. Seek a really good dermatologist and be very cautious if they rec Acutane. It is effective and highly toxic to some people. Do not blow it off as teen angst. It could have lasting consequences.
2
Of course its depressing.
I've had acne since I was 8 years old and nothing, literally NOTHING, has worked. My mom spent years taking me to several different dermatologists in hopes of finding a solution. I've tried every single thing ranging from soaps to Accutane, regardless of the side effects.
Of course, its depressing. Acne isn't common at such a young age and as the years went by it became even harder. You see all these teenage girls with beautiful clear skin. The worse part wasn't that my skin wasn't smooth because makeup helped a little bit. What really gets to you is breaking out on your back and chest. Low-cut shirts were no longer cute and neither were opened back dresses and bathing suits.
Being continuously self-conscious about your skin does harm your self confidence. For most people, its temporary. Me? I was forced to learn to accept that this is something I must learn to live with.
50
When i eat gluten my face breaks out. Try going completely gluten free for 8 weeks and see if your condition improves. Dairy free too
2
I remember my social life changing at the time I started to get regular teen acne. Before I had acne, I was a class leader and quite popular. But after I got acne, the combination of my self-consciousness and embarrassment and the superficial physical judgments' of my peers made me more of a depressed loner. Multiple times when I couldn't get my covering makeup to hide my acne, I invented "illnesses" to skip school rather than having to face the awkward stares of my classmates. The event did probably lead me to develop more inner strength and perseverance, but it also depressed me for that teen and early 20s time period. Accutane was like a miracle.
40
several positive reports on Accutane here...however, I thought it was banned or recalled because of problems with side effects some years down the road...OK, just looked it up...it appears the drug was taken off the market by the company because of multiple lawsuits, but is still available in it's generic form...
7
Acne makes a person depressed - no kidding! We need studies to prove this?
I had a few pimples when I was a teenager, and made the mistake of covering my face with powder, resulting in my face looking like a ghost. I had zero guidance from the adults in my life. Add unwanted body hair to the acne. I was miserable from age 14 when my period started and the acne and body hair followed. The stress made everything worse. Puberty can be truly hellish for many.
I finally began to blossom when I was 21 and living on my own, the acne cleared up, I stopped wearing make up, my hair glowed. The unwanted body hair continued however and it was not until I had it removed at a dermatologist office when I was 42 that I finally felt free of it.
The meds that readers are recommending, such as Accutane are very scary. I would never want my daughter to use it though she suffers from acne and
unwanted body hair (must be genetic). She uses other treatments and methods and she can talk to me about it - I had no one to confide in.
16
All 3 of my kids went on accutane, along with my husband when he was in his forties! It was great for them all. There were side effects, although every kid was a little different. Middle son had sore joints, probably the worst ones. My daughter had to have a pregnancy test every month. It was honestly a great treatment, talk to your dermatologist about it. None of them have had any more acne since treatment.
6
Please let your daughter have Accutane. I wish my mother had. I would have been spared years of misery. It is safe under a doctor's supervision. If she has a bad reaction, she can stop and the drug will be completely flushed out of her body within a few days.
Plaintiff-side trial lawyers have done a really good job of demonizing Accutane. It's very sad how this has prevented huge numbers of people from being cured.
7
Wow...these researchers are great, aren't they? Having red spots which occasionally burst, releasing pus, all over your face can be depressing! Who would have thought?
5
Why at risk for depression? Because iin our ultra-superficial world we are all supposed to aspect an athlete, movie star or other "perfect-looking" pop star. I was called crater face in high school and went on in a very few years to model. So much for teen acne and its ravages.
7
I suffered from acne for literally decades. I tried everything, including 2 courses of Accutane, which helped but did not solve my problem. Years ago I read a book called, "The Good News About Women's Hormones" and asked my dermatologist to start me on spironolactone. This was the solution I had been searching for to control my hormonal acne. I have been essentially breakout free for over 10 years, and not being continuously anguished and preoccupied about my skin absolutely changed my life.
42
It's been used in many females by derms like me for decades!
2
Exact same story here -- I too went on two rounds of Accutane as a teenager. It helped overall but I still would have rounds of cystic acne on my face and back. I got tested by an endocrinologist and was found to have elevated androgen sensitivity -- that is, my androgen levels were normal but my cells were a lot more sensitive than a normal person. I too have been on spironolactone since my 20's and now into my 30's. (while typically used as a diuretic for high blood pressure, it also has an anti-androgen effect that can be taken advantage of at lower doses). I still get the random breakout here and there -- usually hormonal or stress related -- but my skin overall has been well-behaved, and over the past few years I've found myself increasingly willing to leave the house without foundation. That NEVER would have happened in my teens or early 20s.
I remember it being terrible to be a teenager with aggressive acne, but I think it would have been even worse to be a young adult with acne.
2
When I transformed from a pretty girl into someone increasingly hideous at at 13, my life was indeed never the same. There was no effective treatment when I was young (birth control pills, antibiotics, and dry ice treatments were all tried).
When I saw the beautiful skin of other young people, it felt to me that I was extremely flawed, no matter that I had a very loving and concerned family. To avoid stigma I spend hours applying make-up, and Iavoided overhead fluorescent lighting and sun.
This problem lasted into my 40's, although it abated somewhat before then. Somehow I did manage to marry someone wonderful, and I developed a fit body and intellect, but throughout it all I was experiencing painful self-consciousness. Thank goodness for old age.
This problem is not trivial in this kind of society, although surely it would be less painful in a culture less focused on youth and beauty. We do focus on the self-esteem issues relating to obesity in young people, so maybe we are making progress. I wonder how my development would have proceeded without that painful self-consciousness.
50
Acne does not present with an easy solution for a good portion of the affected population. Before Accutane came along, there were dietary restrictions, special soaps, daily antibiotics, cortisone injections which left bluish scars, and acidic lotions for nighttime. The only good thing that came out my teenage battle was a medical excuse slip to see the dermatologist during phys ed class. Not much of it worked. It greatly affected my self confidence during those years and on into my twenties. I didn't realize how scared emotionally I was until my boy friend at age 25 raised it. I could barely bring myself to discuss it.
Along came Accutane with its very annoying side effects but I persevered through it three times. The depression that came with Accutane was vexing. One dermatologist reminded my that the choice was depression from acne which would continue indefinitely or depression from Accutane which would end with treatment. I chose Accutane.
The emotional scars from 15 years of affliction affect how I think people perceive me even today.
So my advice to parents is to hit it hard with strong medications, cope with the side effects and put acne behind the child. Shortening the duration of the trauma is the best medicine despite the drawbacks of serious side effects.
Life long esteem issues, depression, and self-consciousness about appearance (scars) warrant aggressiveness..
57
Not so fast. My son developed schizophrenia a few months after he stopped taking Accutane. Coincidence? I have no idea.
Here's the warning:
Accutane can cause severe, life-threatening birth defects. Never use Accutane if you are pregnant.
Women of child-bearing potential must agree in writing to use two specific forms of birth control and have regular pregnancy tests before, during, and after taking isotretinoin.
Accutane is available only under a special program called iPLEDGE. It is dangerous to try and purchase Accutane on the Internet or from vendors outside of the United States.
Do not take vitamin supplements containing vitamin A while you are taking isotretinoin. Do not donate blood while taking Accutane and for at least 30 days after you stop taking it.
What apparently does clear up acne is high dose niacinimide or nicotinimide. (Dr. Abram Hoffer). Wish I had known.
4
I agree about the side effects of Accutane versus acne. And you're right - as a cystic acne sufferer for more than 16 years (until I took accutane) I think it definitely impacted how I see myself today and, strangely, how others perceive me, even today.
3
Vitamins do not cure acne - and can aggravate the condition. If such chemicals actually did what you claim, and were documented as a medical fact then, trust me, it would have become standard of care decades ago!
1
Good grief, someone actually paid for this study??? I never cease to be amazed.
JimF from Sewell
5
The good that can come from a study like this is it might be used to influence insurance companies to cover treating acne. Also, if you wonder if this isn't really a problem, I was once told by an insurance company that I was denied coverage for a private insurance policy because I had acne. And yep, my acne and its financial consequences did not do much for my mental health.
41
Glad the scientists could amaze you, Jim. I guess their work here is done, given that amazing the good grief right out of you is apparently all you got from this article.
1
So we need expensive/time-consuming studies "proving" the link between depression and acne so that the greedy insurance companies will suddenly realize the effects of acne are a real medical issue?The medical "health" system in this country is a joke.
1
I've had acne my entire life and I'm not 56. Good grief am I glad that I didn't know at 17 that it was never going to end. The only time my skin ever looked clear and healthy was when I lived in Hawaii in my 20s and early 30s; swam in the ocean and got too much sun every single day. It prematurely aged my skin and I now have to watch carefully for signs of skin cancer. But to tell you the truth, it was so awesome having clear, tanned skin--in Hawaii, in my young adult life--that I'm not sorry to pay the price now.
25
You really DO NOT want malignant melanoma, though I understand your emotions.
There were times in my life -- as a young teen or young adult woman -- when I would have literally sold my soul to Satan to have clear skin.
I am 62 today, and I still have adult acne. Long past the hormone thing, of course -- so it doesn't flare up regularly -- but it does react to weather and stress. Hot humid weather will cause awful breakouts.
I was told as a child of 9 that if I followed doctors orders religiously -- washed several times a day with harsh cleansers -- never touched my face -- never wore bangs -- never ate chocolate, cola drinks or coffee, nor chips, fried chicken, etc. -- that my skin would swiftly clear up. Then I was told "as soon as you are through puberty". Then I was told "when your periods are regular". Then I was told "when you are older, and sexually active" and then "when you are on the Pill". None of these things were remotely true, nor had the slightest effect on my skin.
I'm glad I didn't know it was a lifetime thing, or I might have utterly despaired. If you are not over acne at 56 or 62...frankly there is no hope. I will die with this.
9
I too am in your camp. My acne never cleared up even after accurate. At 60, I really don't get the inflamed pimples all that often but my face is full of white bumps that on a daily basis one could extract the junk all sufferers know too well. I've learned to live with it (no other choice) but it has unquestionably affected my life in negative ways. Like many, I waited for it to go away. It's not going to.
1
Or maybe the hormonal/endocrine difficulties that are responsible for acne are also affecting mood. Maybe vice versa.
Many antidepressants can cause acne in some people.
Several anti-acne medicines like Accutane, are linked to depression.
Perhaps treating the human body as though though it's some artifact with a variety of subsystems with limited interaction is just wrong.
10
If you've never suffered from severe acne, you have no idea how difficult it can be to live with in our appearance-obsessed society. I've had acne since I was 12. I was teased mercilessly for it in elementary school, since I started suffering from it earlier than most of my peers. My mother refused to take me to a dermatologist because she claimed I would "grow out of it." I am still waiting for that to happen (I'm 32 now). It has been a constant source of self-consciousness throughout adolescence and adulthood for me, and while I wouldn't say it was necessarily a trigger for depression, the constant low-grade anxiety it causes certainly wears on me and my self-esteem.
So ...while some of the factors you mention could certainly be contributors to the statistics, I don't think you can discount the mental and emotional effects of severe acne on a person's life.
41
Severe acne is also very painful.
15
This surprises? In the cutey-pie, appearances matter above all culture we live in it would be surprising if teenagers weren't prone to depression if they have acne. How about all of the bullying we hear about? Some self-conscious kid with bad skin might be a good target for a bully. A teenage boy with acne could feel the real sting of being ignored because his classmates buy into the lie that the advertisers have so successfully promulgated that physical appearance is all-important. Beauty's only skin deep.
19
Young people can be very unkind to those who look different.
43
Dermatologists who think they can treat cystic acne through accutane, antibiotics, creams, etc are just treating symptoms. The root cause is hormonal and a competent endocrinologist (at least where women are concerned) is the answer. In Europe, birth control pills such as Diane, or the medication Androcur used under a physician's guidance eliminate cystic acne. The FDA is so behind in this, like much of everything else. Yes, eliminating sugar, dairy, and wheat is also helpful but not a cure.
22
Hormone treatments (birth control pills) do not work for everyone either. Treatments need to be based on the individual ‘s specific type of acne.
14
Hormonal treatments don't always work. Most dermatologist don't start with the accutane, they go through the lesser levels first. As for dietary restrictions, well, I would need more double blind studies first.
3
The root cause is still not known -even after decades of research. Hormones clearly prepare the soil for the disease, and clearly influence it, but that's about what we know (actually we know a ton, but simplicity is nice in a missive like this)
1
As unbelievable as it sounds, depressing things result in depression. Study is slated to be expanded in the summer to determine whether losing an eye can lead to blindness.
105
Any teenager could have predicted this correlation.
110
This is one of those studies with results so obvious, you can't believe they bothered to study it. Nevertheless, let's hope that physicians will take adolescent acne more seriously and more proactively suggest treatment.
87
It could also be chicken or egg. Which came first?
6
We need oil to lubricate the skin and eyes, and we have little oil glands in the skin and eye lids for just this purpose. Sometimes things go wrong. Excess oil production may clog the glands which then become infected, also called a pimple or acne. The link between Acne, Probiotics and the gut-brain-skin axis is discussed by Whitney P Bowe and Alan C Logan in their article in Gut Pathology 2011. They say:"gut microbes, may ultimately influence the degree of acne by a systemic effect on inflammation, oxidative stress, glycemic control, tissue lipid levels, pathogenic bacteria, as well as levels of neuropeptides and mood-regulating neurotransmitters. .... there appears to be supportive evidence to suggest that gut microbes, and the integrity of the gastrointestinal tract itself, are contributing factors in the acne process." For more see my article on this topic: http://jeffreydachmd.com/pantothenic-acid-vitamin-b5-for-acne/
10
Thank you Dr. Dach for your up to date assessment. I'm just a health coach and and if you look at acne from a functional medicine approach, getting to the root cause all points to the integrity of the gut. There are many reasons why acne develops and the overuse of antibiotics is a huge contributor as it decimates all bacteria in the gut leading to major gut imbalance and gut impermeability, " iI appears that acne is a lot more than skin deep" is a major understatement.
2
Unclear? Could it perhaps be due to the fact that someone's previously unblushing and beautiful face is now covered in puss bubbles? With the likely result being that people react and treat you differently than before? It is well established that more attractive people get treated better by others, in particularly strangers. If they broke down the study I bet they would find a correlation with instances of depression being higher in people who were otherwise good looking who now found themselves covered in acne vs people with average to below average looks who now found themselves covered in acne. The later were less likely to notice any changes in behavior by the people around them.
68
It's not how others react to you. It's your reaction to your appearance in the mirror, each and every time you see your reflection.
3
Oh, yes... The countless hours in front of the mirror. "When is it going to stop...when is it going to stop...will it clear by tomorrow morning for school... " and on and on and on....
I suffered from moderate acne as a teenager; I recall being quite embarrassed and, retrospectively, likely was depressed for a period due to acne.
As an adult I have had rosacea and that also has been burden. I tried many things and was so pleased when a small dose of an antibiotic did the trick.
What we look like is important, I am glad that articles like this one on acne and depression are being written.
55
My rosacea is awful. Still working with the dermatologist to get it better. It was under control and then went through menopause. Nothing good came of that.
1
I had acne late into my 50s. No amount of scrubbing, cream applying and healthy diet had any effect. Today at 71 I have a pitted face to prove it. In Mexico I purchased a cream for burns called Raspisons at Pharmacia Similar.
Then, I noticed on the label that it was also an acne treatment. I tried it in small amounts and it really worked! I asked my dermatologist about it and she said that it could cause an allergy as it contains a sulfa drug. Using it sparingly, It has consistently worked almost instantly. OTC acne treatments do not work. I found a miracle. You would think that medical science could figure this out. Tons of money are spent on useless stuff that only teaches you that you are too dirty.
20
Have you ever strictly cut out dairy/gluten for more than a couple of weeks? This can alleviate both acne and cognitive/mental health conditions in those who cannot process these substances properly.
2
Cutting out gluten is only recommended for people diagnosed with celiac disease.
12
My acne, which began when I was about 12 years old, started to clear when I was 72 and disappeared altogether before the year was out. Two things: I was told that it would go away when I "got a little older," when I got more sun, when I had children, when I got more sleep, when I stopped eating chocolate and other things, when I ate more sauerkraut (in my family we even made our own sauerkraut), and when I hit menopause; also I always wondered how my life would have been different if I had not had to deal with an off putting face.
8
"The reason for the association [between acne and depression] is unclear."
Not to me. As someone who suffered from severe acne starting as a teenager, there is no lack of clarity about why I was depressed. Anyone, especially in their teens is extremely sensitive to her/his appearance. Also, severe acne is one painful and bloody infection after another on your face, chest and back. That's enough to depress anyone.
153
This amazing study on 130000 subjects (!) with Acne proves what we all know. Untreated Acne causes depression. 90% of people with Acne never see a Dermatologist. Acne treatment is broken. It’s about time to use mobile based image analysis and AI to make it more affordable, easy and effective. www.MDacne.com is a good example.
27
I cannot recommend Accutane highly enough. Our dermatologist, whose 3 daughters took Accutane, prescribed it for my son.
You have to jump through multiple hoops to fill the prescription (and there are more hoops for girls). My son's lips peeled badly until we got the prescription lip balm.
But the cystic acne on his back (we thought his football pads were irritating his skin, but the acne persisted after the season) and the less severe acne on his face literally disappeared and have never come back.
I think he took it for 4-6 months and was swimming, free of embarrassment, the next summer.
60
My husband, a Viet Nam vet, suffered from severe acne on his face and back since junior high school. His parents had sought treatment from several physicians, nothing helped. He's recounted instances of being ridiculed by other teens for his appearance. An Army physician in 1969 prescribed Accutane. The acne ceased, but the physical and yes some emotional scars remain. I mentioned this article to him and he was incredulous that the study authors were surprised at their findings.
66
Honeybee: it works well -- though with some serious side effects -- on cystic acne. Not all acne is cystic (red, inflamed, deep cysts).
I have the kind of acne that manifests as very large pores, very oily greasy skin (that resists every imaginable treatment, soap or cleanser) and constant blocked pores. There is no real treatment for this. I've consulted dozens of dermatologists, and tried almost every treatment.
Using Accutane means staying out of the sun -- and god forbid you get pregnant! it can cause birth defects! -- so if you use it, you need to be cautious. It is also can cause depression.
3
Accutane is a wonder drug. I regularly contemplated suicide in high school, and I believe the horrible acne I suffered from was a huge cause. I finally took Accutane as a senior. The acne disappeared - permanently (I'm now 38) - and so did the suicidal thoughts. It's incredibly nice not to look in the mirror and feel disgusting. Nowadays, I'd like to think I'd have the self-esteem to handle acne, but I didn't at 16.
having suffered from acne for my teenage years, of course having acne is depressing. what else would it be? BTW, as I aged I told my dermalotogist, acne and gray hair most unfair.
46
I was told at age 9 that my acne would resolve once I finished puberty. Then that it would clear up as I got older. Then that it would clear up once I got my period -- then "when your periods are regular" -- then when you are on birth control pills, or have sex, or get pregnant, etc. etc. etc. None of this was remotely true.
NO, it is horribly unfair to have acne as bad as a teenager, when you have gray hair and bifocals to read with!
5
It is known that the gut microbiota are responsible for the production of vitamins, neurotransmitters, and cytokines that influence mood through various pathways, including signaling the brain by way of the vagus nerve. Some of the microbiota also influence glycemic and lipid levels, which in turn influence the skin's microbiome. More recently, it has been shown that the health or dysbiosis of the skin's microbiome has a causal link to the presence or absence of acne.
This overall link between the gut microbiome, mood, and skin condition was suggested by John Stokes and Donald Pillsbury more than 75 years ago. In the past several years, enough of the pieces have come together to understand how it works. Now, the focus is turning to the role of diet, genetics, infections, and antibiotics in determining the progression of many diseases, syndromes, and psychiatric conditions that have been considered too complex to understand and explain.
27
Besides the obvious reasons for being depressed, if acne is caused by bacteria, it can also affect our mood, immune system and overall health. Better methods are needed for determining the cause of acne so we can treat it properly, instead of doctors randomly prescribing antibiotics or harsh medicine that causes serious side effects and may never help because it is not the right treatment. Some people simply need to eat healthier while others need to stop smoking and others need to get rid of underlying cause - bad bacteria in the gut and a boosted immune system. Each person needs specialized treatment, depending on the type/cause. Instead of throwing every pill at a problem, lets diagnose every possibly cause and use one treatment for that specific cause.
3