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Clin Exp Dermatol. 2019 Jan 31. doi: 10.1111/ced.13919. [Epub ahead of print]

The mental health burden in acne vulgaris and rosacea: an analysis of the US National Inpatient Sample.

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Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Departments of Dermatology, Preventative Medicine, and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.



Little is known about the mental health (MH) hospitalization among patients with acne and rosacea.


To determine the MH disorders and cost burden associated with acne and rosacea.


Data were examined from the 2002-2012 US National Inpatient Sample, comprising a sample of ~20% of all US paediatric and adult hospitalizations (n = 87 053 155 admissions).


A diagnosis of ≥ 1 MH disorder was much more common among all inpatients with vs. those without a diagnosis of acne (43.7% vs. 20.0%, respectively) and rosacea (35.1% vs. 20.0%, respectively). In multivariable logistic regression models controlling for sex, age, race/ethnicity and insurance status, acne (adjusted OR = 13.02; 95% CI 11.75-14.42) and rosacea (adjusted OR = 1.70; 95% CI 1.56-1.95) were associated with significantly higher odds of a primary admission for an MH disorder (13 and 8, respectively, of 15 MH disorders examined). Both acne and rosacea were associated with higher risk of mood, anxiety, impulse control and personality disorders, and with > $2 million of excess mean annual costs of hospitalization for MH disorders in the USA.


In this study, inpatients with acne or rosacea had increased odds of comorbid MH disorders. In particular, there was an increased number of hospital admissions secondary to a primary MH disorder with coexistent acne/rosacea. MH comorbidities were associated with considerable excess costs among inpatients with acne or rosacea.


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