Depressive side effects which were thought to be caused by acne medications, such as Accutane and Claravis, may in fact be caused by the acne itself, say researchers in a new study published in the Journal of Investigative Dermatology. The writers suggest that fears that acne drugs may cause suicidal thoughts may have been overstated.

Young people with severe acne have considerably higher levels of depression and suicidal ideation compared to individuals with no acne or mild symptoms, the Norwegian investigators report.

Jon Anders Halvorsen, Oslo University Hospital, Norway, said:

There is a pretty strong and consistent association between acne and symptoms of depression or mental health problems.

A Canadian study in 2008 published in the Journal of Clinical Psychiatry suggested Accutane could increase the risk of depression.

Accutane, an acne medication made by Roche, is also available in generic form isotretinoin - Teva Pharmaceutical Industries, Mylan and Ranbaxy make and sell the generic version. Roche announced last year that it could cease selling Accutane because of generic competition.

The authors write that controversies regarding acne medications have discouraged many dermatologists (skin specialist doctors) from prescribing isotretinoin.

Halvorsen said:

Our study is important because it provides an argument for not being so cautious.

In their study, involving 3,775 males and females aged 18 and 19 years, from Oslo, Norway, the investigators report:

• Twice as many females with severe acne reported having suicidal ideation compared to females with no acne or mild symptoms
• Three times as many males with severe acne reported having suicidal ideation compared to males with no acne or mild symptoms
• 14% of the respondents rated their acne as substantial
• 18 to 19 year olds with severe acne were 51% more likely to be virgin
• 18 to 19 year olds were more than twice as likely to have no close friends

The researchers concluded:

Acne is frequently found in late adolescence and is associated with social and psychological problems. Adverse events including suicidal ideation and depression that have been associated with therapies for acne may reflect the burden of substantial acne rather than the effects of medication.