Acne and self-esteem: How skin outbreaks affect social media use and relationships

acne and self esteem

A new survey of young Australians has revealed how acne is affecting their self-esteem and social media habits. Young people with severe acne are highly likely to edit photos of themselves and choose not to upload their photos onto social media.

They were also more likely to experience difficulties meeting new people or finding a partner, said Dr Rhiannon Russell, a resident medical officer at The Wollongong Hospital, who led the study.

Acne affects 90% of adolescents and previous research has shown that acne can negatively affect confidence, self-esteem and body image. This survey, however, is one of the first to examine the impact of acne on relationships and social media use among young people

How acne affects relationships

Acne can have a huge impact on confidence and self-esteem, and that was reflected in the survey responses. 

Dr Russell asked young people aged 18-26 who were living with acne if they found it hard to meet a partner. The more severe the acne, the harder it became, she said. 

“For people with severe acne, 50% of those respondents said they find it difficult to go out in public, and 67% of them said it was hard to meet new people”.

More than 80% of people with severe acne said they had significant difficulty engaging with their gender of interest. For people with mild acne, only a third said they had difficulty meeting new people or finding a partner. 

“People with severe acne found it very difficult to meet a partner because of their acne, whereas it wasn’t really a limitation for people with mild acne.

Less than 50% of people with fluctuating acne said they had trouble meeting someone, Dr Russell said. Among people with fluctuating acne, 70% said they also had difficulty continuing engagement with their gender of interest.

How acne changes social media behaviour

Dr Russell said social media could be a minefield for young people challenged by body image issues, and for young people with acne this was particularly difficult. 

“We found that individuals’ social media use and behaviour changed depending on the severity of their acne and skin breakouts.”

Behaviour changes between severe and mild acne

For young people with severe acne, 100% chose not to include a photo of themselves on social media when their acne was visible. 

“But interestingly, even in the mild acne group, 59% of them said they still wouldn’t include a picture, even though their perception of their acne was mild,” Dr Russell said.  

“If a photo of them was uploaded many would choose to delete or untag those photos. This was the case in more than 50% of circumstances for people with mild acne, and once again 100% of people with severe acne would do this altering behaviour. 

“We found that behaviours altered significantly in people with mild to severe acne, and in most of the cases people with severe acne would significantly alter their behaviour in some way.”

People with fluctuating acne edit the most

More than 75% of young people with moderate and severe acne altered, cropped or edited photos of themselves before sharing them on social media. 

Perhaps surprisingly, people with fluctuating acne were the most likely to edit photos, with 92% altering, cropping or editing photos of themselves. 

“For someone with fluctuating acne, they have days when they feel they look good and things are going well, but then they have days when they don’t, but they prefer to look like when their acne is well controlled. 

Young people stick with social media, but many avoid photos

Dr Russell said despite clear concerns about their appearance, most young people with acne would still choose to stay on social media. 

However, many said they often avoided having their photo taken. Among people with severe acne, 66% avoided photos all the time, compared to 40% of people with mild acne.

Young people need psychological support

While younger people are all too aware of the pervasiveness of social media, clinicians often don’t realise how much it influences body image and self-esteem, Dr Russell said.

“When dermatologists and GPs see young adolescent patients, it’s important to acknowledge that their acne may be really upsetting.” 

It would help patients if clinicians acknowledged how social media affects people with challenging skin conditions, she said. 

“It can also be helpful to talk about social media, and that the photos we see on social media aren’t necessarily what people look like in real life.”

Having examples of photos that aren’t airbrushed or altered and comparing them to photos that are airbrushed can be helpful to young people, she said. 

“Educate people from a young age that what you see on social media isn’t always necessarily true.” 

Young people need more than just the medical management of their acne, Dr Russell said.

Clinicians can also use questionnaires to find out how much acne is affecting their patients’ emotional wellbeing, Dr Russell said. That’s particularly important for people with severe acne, she said. 

“Use a multidisciplinary approach to treating acne, including psychological support, rather than just treating the physical symptoms.”

As social media becomes more of a presence in the lives of young people, its effect on self-image and self-esteem will become even more pervasive, she said. 

“Social media plays such a significant role in many people’s lives and influences their behaviours, such as what they’re looking at, what they want to wear and what they want to be.” 

Speak to your doctor for help with acne

If you’ve been avoiding people because of your skin, or worried or concerned about acne or some other skin condition, then talk to your GP. 

And if you’re not seeing a dermatologist already, ask your GP for a referral so your acne can be assessed and treated. There are plenty of treatments available that can improve your skin and help manage your acne. 

If your skin is getting you down, you can also contact Beyond Blue on 1300 22 4636 or Lifeline on 13 11 44 – they’re both open every day, 24/7.

Read more:

Maskne: 6 steps to managing mask-related breakouts
How gut health affects our skin
Survey reveals the financial cost of self-treating acne
Uncovering back acne


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The All About Acne team – the authors of this site – are a group of medically-trained skin experts from across Australia who have an interest in acne management. Our experienced team of leading dermatologists guarantees the information on this website is independent and based on the highest quality research available.

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