Teens with severe acne are more likely than others to have mental health problems and thoughts of suicide, and it may not be due to the acne medications they take, as previous research has suggested, according to a new study.

A questionnaire-based study of 3,775 18- and 19-year-olds in Norway found that girls with severe acne were more than twice as likely as other girls to have thoughts of suicide, and boys with severe acne were three times as likely as other boys to have those thoughts.

"These kids have double the risk of having mental problems ," said study researcher Jon Halvorsen, professor of dermatology at the University of Oslo. "There is under-treatment of acne in teens, and this shows it's important not to delay seeking treatment."

The study was different from others that have examined the mental health of teens with acne, Halvorsen said, because this questionnaire was given to teens in the general population, whereas most previous work included only teens who were under a doctor's care for their acne. Because teens with severe acne are often untreated, it was necessary to look at a sample of teens from the general population.

It has been claimed that the side-effects of some acne medications include increased risk of depression or thoughts of suicide, Halvorsen said. This study, while not providing a test of any medications, seems to indicate that depression and thoughts of suicide are much higher among teens with severe acne, so the acne itself may be the root of the problem, not the drugs, he said.

"This is an argument against the claim that treatment for acne might cause suicide ideation or depression," Halvorsen said.

The finding that boys with severe acne had an even higher likelihood than girls to have depression or suicidal thoughts, compared to their respective peers, may indicate that teen girls in general more commonly experience mental health problems than boys do, Halvorsen said.

But the finding could also be due to the fact that the study included older teens, and because girls enter puberty earlier than boys, they tend to encounter acne at earlier ages. By age 18 or 19, many girls may already be through the worst of it.

The study also found that teens with severe acne were more likely to suffer from difficulties at school and in their social relationships than other teens. They were more likely to report feeling that they were not as close to their friends as they perceived their peers to be, that they were not in a romantic relationship, and that they were not doing well in school.

"Health care systems and schools should be aware of this problem," Halvorsen said. Teens with acne should be encouraged to seek treatment, he added.

The study was funded by the University of Oslo, the Norwegian Institute for Public Health and the Regional Centre for Child and Adolescent Health, Eastern and Southern Norway. It was published online today (Sept. 16) in the Journal of Investigative Dermatology.Marijuana Use by Teens Isn't a 'Gateway' to Later Drug Use