New research presented this week at the 74th annual meeting of the American Academy of Dermatology (AAD) suggests that not only do people have plenty of misconceptions about acne, they also think quite negatively about its sufferers.

The study recruited 56 healthy volunteers to first view the images of eight different skin conditions (acne, psoriasis, and herpes included among them). They were then asked how the images made them feel and about the attitudes and perceptions they held towards each condition. Save for herpes, participants were most upset by the acne images (63 percent), with location, color, and open sores being the features of an image most likely to be upsetting. Fifty-five percent believed acne was at least partly caused by poor hygiene, 38 percent blamed diet, and 50 percent thought it was infectious in nature.

While there’s some research showing that dairy consumption and stress can be risk factors for acne — defined by the presence of inflamed hair follicles clogged by dead skin cells and oil — it’s generally accepted to be a near-universal health condition, especially among the young, and has nothing to do with poor hygiene. Similarly, though acne is associated with excessive build-up of the bacterium, Propionibacterium acnes, it can’t be transmitted to others. If anything, the severity of someone’s acne is largely influenced by their genes rather than any outside factors, which can also include hormones.

“Clearly there are a lot of misconceptions out there,” said lead author Dr. Alexa Kimball, a professor of dermatology at Harvard Medical School, in a statement. “People are making incorrect assumptions about acne, and it’s affecting their opinion of patients with this condition.”

Indeed, Kimball’s study also found 68 percent would find someone with acne unattractive as well as be ashamed to have it themselves. Forty-one percent would feel uncomfortable being in public with someone who has acne, and 44 percent would feel the same about touching them. For the saving grace, only 20 percent would flat out exclude someone with acne from a social event, while 14 percent would avoid hiring them. Over 80 percent of those polled expressed pity for acne sufferers, again the highest percentage of all the various skin conditions.

“I was surprised by these results,” said Dr. Kimball. “Since so many people have experienced acne, I thought they would have more empathy for patients with this condition.”

Though a small survey, Kimball’s findings do partially explain the commonly reported feelings of shame and embarrassment felt by many young acne sufferers, particularly those with more severe acne. Other research has found that for adults with acne, the more stigmatized they feel about it, the poorer quality of life they end up having.

“Acne is a very common condition, but it seems that many people don’t have a good understanding of it,” Dr. Kimball concluded. “The widespread misconceptions about acne may contribute to negative perceptions, which can affect patients’ quality of life and social interactions. Rather than attempting to manage the condition themselves based on those misconceptions, I encourage acne patients to visit a board-certified dermatologist, who can provide the best possible treatment.”

The most common evidence-based treatments for acne include antibiotics, oral contraceptives, and various topical creams, with the AAD issuing new guidelines last February that recommend most acne patients are given two or more treatments at the same time to best combat it. It’s estimated up to 50 million Americans are affected by acne every year, according to the AAD.

Source: Kimball A. Stigmatization of Acne. 74th annual meeting of the American Academy of Dermatology. 2016.