Objective: The purpose of this study was to determine the level of social anxiety in acne vulgaris patients and to examine its relationship to the sociodemographic and clinical characteristics of acne, as well as to depression, self-esteem, and negative automatic thoughts.

Method: The study included 83 acne vulgaris patients from the dermatology outpatient unit of a university hospital and 58 healthy controls. Sociodemographic and clinical questionnaires, and the Global Acne Grading System (GAGS), Hospital Anxiety and Depression Scale (HADS), Liebowitz Social Anxiety Scale (LSAS), Rosenberg Self-Esteem Scale (RSES), and Automatic Thoughts Scale (ATS) were administered to both groups.

Results: The degree of social anxiety, social avoidance/withdrawal, general anxiety, depression, and negative automatic thoughts were significantly higher, and self-esteem was significantly lower in the acne patients. Among the 83 patients, scoring above the scales' cut-off points was as follows: 25.6% on the LSAS, 32.9% on the LSAS-Anxiety Subscale, 27.7% on the LSAS-Avoidance Subscale, 36.1% on HADS, 30.1% on the HADS-Depression Subscale, and 50.6% on the HADS-Anxiety Subscale. Psychological symptoms were negatively correlated with age and level of education in the patient group; however no relationship was observed between the psychological symptoms, and gender, the severity of acne, or acne localization. The patients rated their symptoms more severely than did the clinicians; however, the subjective ratings of the patients were not correlated to their psychological symptoms.

Conclusion: Acne vulgaris must be considered as an illness with the potential to negatively affect the psychological and emotional functioning of patients; therefore, routine psychiatric evaluation and psychological support should be part of the routine acne treatment plan.