Anatomical variants of acne differ in their impact on social perception

Abstract Background Acne negatively affects quality of life, however quality‐of‐life scores poorly correlate with disease severity scores. Previous research demonstrated existence of facial areas in which skin lesions have greater impact on gaze patterns. Therefore, we hypothesized that anatomical variants of acne may be perceived differently. Objectives The aim was to investigate effect of anatomical variants of acne on natural gaze patterns and resulting impact on social perception of acne patients. Methods We tracked eye movements of participants viewing neutral and emotional faces with acne. Images were rated for acne‐related visual disturbance, and emotional faces were rated for valence intensity. Respondents of an online survey were asked to rate their perception of pictured individuals' personality traits. Results All faces with acne were perceived as less attractive and received poorer personality judgements with mid‐facial acne presenting smallest deviation from healthy faces. T‐zone and mixed acne exhibited the least significant difference in respondents gaze behaviour pattern from each other. In addition, there was no significant difference in respondents' grading of acne visual disturbance or ratings for attractiveness, success and trustworthiness. U‐zone adult female acne was rated as the most visually disturbing and received the lowest scores for attractiveness. Happy faces with adult female acne were rated as less happy compared to other acne variants and clear‐skin faces. Conclusions Anatomic variants of acne have a distinct impact on gaze patterns and social perception. Adult female acne has the strongest negative effect on recognition of positive emotions in affected individuals, attractiveness ratings and forming social impressions. If perioral acne lesions are absent, frontal lesions determine impact of acne on social perception irrespective of the presence of mid‐facial lesions. This perceptive hierarchy should be taken into consideration while deciding treatment goals in acne patients, prioritizing achieving remission in perioral and frontal area.