Background: Acne is a very common and disfiguring disease that more or less severely affects the majority of adolescents and, to some extent, also adults. The importance of emotional stress in the onset or worsening particularly of skin diseases has long been a subject of study and debate, and it has been shown that stress stimuli may lead to behavioral changes and biological modifications within the muscular, neurovegetative and psychoneuroendocrinal as well as the immune system. The aim of this study was to investigate whether acne may have psychosomatic genesis and may be based on stress, personality, mood, and the activation of the hypothalamic-pituitaryadrenocortical axis. Patients and Methods: In order to establish whether stress is a causal factor or only a consequence of the disease, four tests were used to reveal the presence and possible influence of specific stressing events as a concomitant primary or secondary cause of onset or progression. The study population consisted of 33 patients (29 women and 4 men, with a mean age of 27.87 ± 7.3 (range 19–47) years). Results: Paykel’s scale of stressing events showed that the majority of the patient group (67%) reported a relationship between the onset of acne and the occurrence of a stressing event. This was particularly true for recent stressing events, mainly those associated with emotional life (30%) and education (37%). The Minnesota Multiphasic Personality Inventory (MMPI) provided an average personality profile highlighting the fact that acne particularly develops in people with depressed (depression scale mean score 75.41 ± 15.59) and conformist (masculinity/femininity scale mean score 42.23 ± 15.53) personality traits. Zung’s test indicated that the mood of the subjects was partly depressed (63.6%), and finally the Questionario per la Tipizzazione della Aggressivita (QTA) revealed a tendency to aggressiveness (particularly resentment and irritability) within the sample.

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