The survey found that faces with acne were perceived as significantly less attractive, less trustworthy, less successful, less confident, and less dominant.

Faces with acne are seen as less attractive, trustworthy, confident, successful, dominant and happy, and adult female acne has the strongest negative effect, according to research presented today at the European Academy of Dermatology and Venereology (EADV) Congress 2023 in Berlin.

The researchers tracked the eye movements of 245 participants (mean age: 31.63 years) who viewed neutral and emotional faces of females with both clear skin and clinically relevant anatomical variants of acne (emotions included ‘happy’, ‘angry’ and ‘neutral’).

Images were rated for acne-related visual disturbance while emotional faces were rated for valence intensity.  Separately, a group of 205 online survey respondents (mean age: 35.08 years) were asked to rate the personality traits of the individuals depicted in the images.

The survey found that faces with acne were perceived as significantly less attractive, less trustworthy, less successful, less confident, and less dominant.

Adult female acne concentrated around the ‘U-zone’ received the lowest scores for attractiveness and was considered the most visually disturbing. Happy faces with female adult acne were also rated as less happy than clear-skin face, the study showed. 

"With over a decade of experience in the field, I've consistently seen that adult female acne leads to more social challenges compared to adolescent acne,” says study author Dr Marek Jankowski, an assistant professor of dermatology at the Nicolaus Copernicus University in Torun, Poland.  “The findings therefore reaffirm this. However, what was truly surprising was images depicting generalized acne, covering a larger area with more lesions, received more positive ratings than images featuring adult female acne occurring in the ‘U-zone’."

Treatment needs to focus on improving the quality of life of patients, not just reducing the surface area impacted by the acne. “These results clearly emphasize the emotional and psychological burden experienced by individuals with acne,” Dr Jankowski adds.

“Unfortunately, this is not currently a goal when treating acne, with therapeutic guidelines still advocating for certain treatment modalities based on the number of lesions, irrespective of their location, and unsurprisingly, acne severity scores do not correlate with quality-of-life scores in patients with acne.”