Depression in Acne Scars: Looking at morphological variables and association with depression.

BACKGROUND: Acne scars commonly occur in almost 95% adolescents having acne. Depression is noted in 13% to 19% of these adolescents which has a negative impact on treatment and overall outcome of acne scar. AIMS & OBJECTIVES: TO STUDY: the prevalence of depression & its association with acne scar severity, grading, duration & site of scarring. MATERIAL &METHODS: Around 81 patients above 18 years of age clinically diagnosed as having different grades of acne by dermatologists as per acne scar assessment scale and those who do not have any other co morbid skin or psychiatric condition were assessed for depression using Becks Depression Inventory and severity of acne scar using qualitative scarring grading system. RESULTS: The mean durations of acne was 6.03 ± 2.9 years, acne scar was 2.88 + 1.2 years. Nearly 93% of our sample had an equal preponderance of Grade 1 and Grade 2 acne scars, with Grade 3 scars in 5(6.17%) patients.37(45 % )patients had boxcar and rolling scars each, 2(2.4%) patients had ice pick scarring and hypertrophic scarring was seen in 5(6.1%) patients. Around 49(60.49%) patients had < 50 number of acne scars, 32(39.50 %) patients had >50 acne scars on their faces.24 (29.6%) patients also having other areas involved such as back, arms, chest and shoulders.31 (38.27%) patients had clinical depression with total mean BDI score of 16.8 + 9.7. 15(18.5%) and 7(8.6%) patients had moderate and severe depression respectively whereas 9(11.1%) patients had borderline clinical depression. A highly significant association of depression was seen with Grade 1 & Grade 2 acne scars but not with number of acne scars. CONCLUSIONS: There is a high prevalence of depression in patients of acne scarring which needs to be detected and treated. Liaison with psychiatrist would improve the outcome.