No teen wants to have acne, but those who do may find comfort in research that suggests the dreaded rite of passage is linked to some very good outcomes in life.
The recent study, titled “Do Pimples Pay? Acne, Human Capital, and the Labor Market,” found having acne in adolescence was associated with achieving higher grades in high school English, math, social studies and science, and an overall higher high school GPA.
It was also positively associated with completing a college degree, with all of the associations stronger for women than men. The study also found some evidence teen girls who had acne went on to earn more money than their peers with clear skin.
Famous faces who have dealt with acne include Cameron Diaz, Emma Stone, Salma Hayek and Lorde.
"I used to have horrible acne... I didn't want to leave my house," Diaz wrote in "The Body Book." "I was miserable."
Neither of the study authors had major problems with acne as teenagers, they said, but they became interested in the topic as a way to figure out how people’s physical appearance affects their economic success.
They focused on acne because it’s a well-defined medical condition that’s “less subjective” than general physical attractiveness, they noted.
“We were surprised at how persistent the relationship between acne and grades was,” Erik Nesson, an associate professor of economics at Ball State University, told TODAY.
The findings “may bring hope and consolation to teenagers suffering from acne,” added co-author Hugo Mialon, associate professor of economics at Emory University.
“Since having acne is also strongly associated with depression and suicidal (thoughts) among teenagers, widespread knowledge of long-term benefits associated with having had acne has the potential to reduce teen suicides.”
Focus on intellectual pursuits
The research was based on data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), which included a nationally representative sample of thousands of junior high and high school students in the U.S. during the 1994-95 school year. They were surveyed about their well-being and then followed into their 20s and 30s.
The initial survey included questions about their skin, self-esteem, social life and grades. Follow-up surveys asked whether they went on to college and how much money they earned.
When the authors crunched the numbers, almost half of the students reported having skin problems as adolescents. Indeed, acne is the most common skin condition in the U.S. with up to 50 million Americans suffering from it at any one time — most of them teens or young adults, according to the American Academy of Dermatology.
The adolescents who had acne reported lower levels of self-esteem and social acceptance. They were less likely to be active in sports, but more likely to be in non-sports clubs.
Having skin problems was related to “statistically significant” increases in grades and overall GPA, and later strongly related to getting at least a bachelor’s degree, the study found. It was also linked to higher earnings for women.
Why might that be? The authors suggest having acne leads teens to be less social and to focus more on studying and other “intellectual pursuits” rather than sports. That leads to an academic boost and then a long-term payoff when they enter the workplace.
“Acne, the shock to physical appearance during adolescence, largely wears off by the time that we measure earnings,” Nesson said.
Acne can be 'disabling'
Experts had mixed reactions to the research.
Jennifer Hartstein, a child and family psychologist in New York, agreed acne can make adolescents very self-conscious, which impacts their self-esteem and can cause some to withdraw and put their energy into studying.
“It doesn’t mean that they don’t have friends or aren’t social, it just may mean that when they have a flare-up, they tend to isolate more,” she said.
“Not all people with acne have the same kinds of self-consciousness about it. Many can recognize that this is a part of development and a result of hormones shifting.”
Suggesting a teen with acne will focus more on studying than social activities is a “giant leap” and underestimates the impact acne can have on a person's life, added Dr. Adam Friedman, professor and interim chair of dermatology at the George Washington University School of Medicine and Health Sciences.
“It is well known that acne, as a visible and deforming chronic inflammatory disease, does lead to social ostracism among many age ranges,” he said.
“I would argue that this state of being does not facilitate a strong drive to perform in school or career; rather, it can be equally disabling in all facets of life.”
Acne can last through adulthood, so it's important to manage it, Friedman said. That includes using a topical retinoid even when the acne is clear. For women, he recommended taking ongoing oral medications like birth control and spironolactone.
Isotretinoin, sold under brand names such as Accutane, can be a "cure" for a good percentage of acne suffers, Friedman said, though it’s not right for everyone.