# Internalized Stigma in Acne Vulgaris Patients and Relationship with Quality of Life, Disease Severity

## TL;DR

This study shows that acne vulgaris in adolescents is linked to high internalized stigma, which worsens quality of life and disease severity.

## Contribution

The study identifies a strong relationship between internalized stigma and quality of life in acne vulgaris patients.

## Key findings

- High internalized stigma scores were found in acne vulgaris patients.
- Stigma was strongly correlated with lower quality of life and higher disease severity.
- The AQLS was a significant predictor of internalized stigma.

## Abstract

Background/Objectives: Acne vulgaris (AV), a common dermatological condition in adolescence, has been widely recognized not only for its physical impact but also for its significant psychological and social consequences, particularly the internalization of stigma. This study specifically aimed to evaluate the state of internalized stigma in adolescents with AV and its relationship with quality of life and disease severity. Additionally, we sought to identify and assess the factors associated with internalized stigma. Methods: A total of 179 patients with AV were included in this cross-sectional observational study. We employed a convenience sampling strategy. The Internalized Stigma Scale (ISS) was used to assess patients’ stigma. The Acne Quality of Life Scale (AQLS) and the Dermatology Life Quality Index (DLQI) were used to assess patients’ quality of life. The Global Acne Grading System (GAGS) was used to assess disease severity. Results: Cronbach’s alpha coefficient for the ISS was determined to be 0.79. In our study, the mean total ISS scores for patients with AV were notably high. The ISS was significantly positively correlated with the AQLS score (r = 0.653, p < 0.001), DLQI score (r = 0.487, p < 0.001), and GAGS score (r = 0.257, p = 0.006). Linear regression analysis was performed to predict the ISS variable. Accordingly, the AQLS positively and significantly predicts (β = 0.521, p < 0.001). Conclusions: AVs often experience high levels of stigma. Internalized stigma is strongly associated with reduced quality of life and increased disease severity. Moreover, the AQLS significantly affects stigma.