Dear Editor,
Acne is a visible skin disease 1 that affects self‐esteem, sense of pride and self‐worth in young patients. 2 Individuals with acne suffer from negative assumptions by the general population, 3 which fuel stigmatization. 4 We assessed acne's impact on the use of social media (SoMe) and dating apps, with a particular focus on patient photo activity.
Members of the France 3A (France Acné Adolescents & Adultes) association took part in an online survey from 01 March 2023 to 30 April 2023. Data included demographic data, acne diagnosis, permanent marks of acne, impact of acne, overall happiness, severity of acne assessed by Cardiff Acne Disability Index (CADI), use of SoMe and dating apps. No incentive has been given in exchange for participation. The study had been also advertised on SoMe by Eucerin France on April 28th and by seven SoMe influencers. Statistical analysis has been performed with IBM SPSS Statistics 25.
We received 2116 responses and analysed 1780 completed questionnaires. We focused only on women because of the overwhelming overrepresentation (n = 1734, 97.4%). Table 1 summarizes the main demographics and women's feelings about acne. Briefly, 37% were aged between 18 and 25 years and 49% between 26 and 35 years and 80% had a phototype 2 or 3. Acne had been diagnosed by a doctor in 56% of the cases; 37% were followed by a dermatologist and 52% by no one. Women rated at 6.33 ± 1.76 their level of happiness on a numeric scale from 0 to 10. The CADI score among women was of 5.44 ± 3.8 (equivalent to mild disability of the respondents). Women who acknowledged being embarrassed by their lesions or by their post‐acne marks (agree or totally agree), tended to be bothered by their skin, find their skin ugly, be jealous of friends with healthy skin, felt stigmatized and conversely did not have confidence in themselves nor reported loving their skin (Pearson's correlation test, p < 0.01 for all correlations).
TABLE 1.
Characteristics of the women respondents and impact of acne on quality of life.
| Women, n (%) | |
|---|---|
| Gender | 1734 (97.4) |
| Age (years) | |
| 18–25 | 645 (37) |
| 26–35 | 842 (49) |
| 36–50 | 232 (13) |
| 50+ | 15 (1) |
| Skin phototype | |
| 1 | 75 (4) |
| 2 | 683 (39) |
| 3 | 707 (41) |
| 4 | 201 (12) |
| 5 | 43 (2) |
| 6 | 25 (1) |
| Acne diagnosed by a doctor | |
| Yes | 888 (56) |
| No | 686 (44) |
| Acne treated by | |
| A dermatologist | 635 (37) |
| A GP | 418 (24) |
| A cosmetologist | 176 (10) |
| A pharmacist | 198 (11) |
| No one | 902 (52) |
| Post‐acne marks | |
| Yes | 1315 (92.2) |
| No | 111 (7.8) |
| I'm embarrassed by my acne lesions (papules, pustules) | |
| DNA at all | 24 (1.7) |
| DNA | 85 (6.0) |
| Neutral | 124 (8.7) |
| Agree/Totally agree | 1190 (83.6) |
| I'm embarrassed by my post‐acne marks/spots | |
| DNA at all | 37 (2.6) |
| DNA | 99 (6.9) |
| Neutral | 191 (13.2) |
| Agree/Totally agree | 1118 (77.4) |
| My marks reinforce the discomfort caused by my acne lesions | |
| DNA at all | 54 (3.8) |
| DNA | 139 (9.7) |
| Neutral | 274 (19.1) |
| Agree/Totally agree | 970 (67.5) |
| I'm bothered about my skin | |
| DNA at all | 15 (1.0) |
| DNA | 66 (4.5) |
| Neutral | 170 (11.7) |
| Agree/Totally agree | 1203 (82.7) |
| I love my skin, it's part of me | |
| DNA at all/DNA | 749 (52.0) |
| Neutral | 441 (30.6) |
| Agree | 191 (13.3) |
| Totally agree | 69 (4.8) |
| I find my skin ugly | |
| DNA at all | 79 (5.5) |
| DNA | 211 (14.7) |
| Neutral | 343 (23.8) |
| Agree/Totally agree | 817 (56.7) |
| I have confidence in myself, despite my acne and marks/spots | |
| DNA at all/DNA | 589 (40.7) |
| Neutral | 447 (30.9) |
| Agree | 328 (22.7) |
| Totally agree | 83 (5.7) |
| I'm jealous of my friends with healthy skin | |
| DNA at all | 89 (6.2) |
| DNA | 152 (10.6) |
| Neutral | 234 (16.3) |
| Agree/Totally agree | 965 (67.0) |
| I feel stigmatized because of my acne and acne marks or spots | |
| DNA at all | 169 (11.9) |
| DNA | 345 (24.3) |
| Neutral | 379 (26.7) |
| Agree/Totally agree | 526 (37.1) |
| My skin is unpredictable | |
| DNA at all | 15 (1.0) |
| DNA | 56 (3.8) |
| Neutral | 153 (10.5) |
| Agree/Totally agree | 1239 (84.7) |
| Are you happy? from 0 to 10 | |
| Mean ± SD | 6.33 ± 1.76 |
| CADI score | |
| Mean ± SD | 5.44 ± 3.8 |
Abbreviations: DNA, does not agree; GP, general practitioner; SD, standard deviation.
Almost 94% of the women had at least one SoMe account: Instagram (99.8%), Facebook (81%), Snapchat (58.6%), TikTok (31.8%) and Twitter (27.5%). 87.8% of the respondents had not taken any selfies within the past 7 days. In 61.8% of the cases, acne prevented them to take a selfie. More than half often or always used a filter before taking a selfie. Women seldom staged their acne on purpose when posting on SoMe (Table 2). Only 7.4% of the women in our sample were on a dating app, while 32% and 36% of the French women under 30 y and under 39 y were, respectively, on a dating app in 2022. 5 Almost 91% acknowledged that acne had an impact on their profile picture. Over a third (35.8%) thought that acne had an impact on ‘likes’/‘matching’ and almost 70% that acne had an impact on the meeting in real life. Half of those who were not on any dating apps considered that acne had an impact on site registration (Table 2). However, we found no correlation between CADI score with being on SoMe or using dating apps.
TABLE 2.
Use of social networks and dating sites.
| Women | |
|---|---|
| Social media | |
| Do you have one or more SoMe accounts? | |
| Yes | 1524 (93.7) |
| How many selfies have you posted in the past 7 days? | |
| 0 | 1338 (87.8) |
| 1–4 | 170 (11.2) |
| 5–10 | 9 (0.7) |
| >10 | 7 (0.5) |
| Before posting, do you use a filter to edit your selfie? | |
| Never | 41 (22.0) |
| Sometimes | 43 (23.1) |
| Often/Always | 102 (54.8) |
| Has acne prevented you from taking a selfie? | |
| Never | 15 (8.1) |
| Sometimes | 56 (30.1) |
| Often/Always | 115 (61.8) |
| Have you ever staged a selfie with your acne? | |
| Yes | 157 (9.7) |
| No | 1469 (90.3) |
| Have you featured your acne in a post (other than a selfie of your face)? | |
| Yes | 64 (3.9) |
| No | 1562 (96.1) |
| Dating app | |
| Are you currently registered on one or more dating sites or apps? | |
| Yes | 120 (7.4) |
| No | 1506 (92.6) |
| Your acne has an impact on the choice of photos on your profile | |
| DNA at all | 5 (4.2) |
| DNA | 1 (0.8) |
| Neutral | 5 (4.2) |
| Agree/Totally agree | 109 (90.8) |
| Your acne has an impact on the ‘matches’/’likes' you get on these sites | |
| DNA at all | 13 (10.8) |
| DNA | 15 (12.5) |
| Neutral | 49 (40.8) |
| Agree/Totally agree | 43 (35.8) |
| Your acne has an impact on a live date | |
| DNA at all | 4 (3.3) |
| DNA | 11 (9.2) |
| Neutral | 23 (19.2) |
| Agree/Totally agree | 82 (68.3) |
| If you are not on any dating sites or apps, acne had an impact on your decision? | |
| DNA at all | 348 (23.1) |
| DNA | 140 (9.3) |
| Neutral | 269 (17.9) |
| Agree/Totally agree | 747 (49.7) |
| If you are not on any dating sites or apps, acne severity had an impact on your decision? | |
| DNA at all | 369 (24.5) |
| DNA | 172 (11.4) |
| Neutral | 283 (18.8) |
| Agree/Totally agree | 680 (45.2) |
Abbreviations: DNA, does not agree; SoMe, social medias.
The well‐documented influence of acne on body image becomes particularly evident in the context of SoMe, where individuals seek validation through selfies, stories, and likes. This impact is especially pronounced among women. Their portrayal on SoMe is noticeably affected as they navigate self‐consciousness about their appearance. Many women with acne tend to refrain from taking selfies or resort to image modification using filters. They experience heightened pressures both in their online presentation on dating platforms and in the anticipation of face‐to‐face meetings. Appropriate support and proper management of adult women with acne promote greater self‐acceptance and improve QoL.
FUNDING INFORMATION
Beiersdorf SAS, Paris, France.
CONFLICT OF INTEREST STATEMENT
Nicolas Kluger has received honoraria/fee from Eucerin, Christelle Comte is a consultant for Eucerin. Jennifer Bedran, Laura Payraud, Adel Sammain and Julia Gallinger are all employees of Beiersdorf SAS. Charles Taieb and Christophe Beausillon declare no conflict of interest.
ACKNOWLEDGEMENTS
The authors wish to thank all the members of the France 3A association and all the respondents who took part in the study.
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
REFERENCES
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.