Acne vulgaris and risk of depression and anxiety: A meta-analytic review

Background Several studies have shown an association of acne vulgaris with depression and anxiety, but a quantitative review has not yet been conducted. Objective We sought to conduct a systematic review and meta-analysis that elucidates the association of acne vulgaris with depression and anxiety. Methods A systematic review and meta-analysis of literature published before October 1, 2019 from the PubMed, PsycINFO, MEDLINE, and Cochrane databases was conducted. We used a metaanalytic approach to perform a random effects analysis comparing individuals with and without acne. Subgroup analyses between studies included age, study setting, and geographic region. Results Forty-two studies were included. We found a significant association of acne vulgaris with depression (r = 0.22 [95% confidence interval 0.17-0.26, P  Limitations Inconsistency between publications regarding acne and outcome ascertainment, data reporting, and studies with no control group posed considerable barriers to synthesizing all available published literature. Conclusions Because of an increased risk for depression and anxiety, clinicians should pursue aggressive treatment of acne and consider psychiatric screening or referrals.