A novel cognitive stress management technique for acne vulgaris: a short report of a pilot experimental study

Int J Dermatol. 2019 Feb;58(2):218-220. doi: 10.1111/ijd.14227. Epub 2018 Sep 19.


Background: Acne vulgaris (AV) is one of the most common disorders treated by dermatologists and other healthcare providers. Stress is a well-attested contributor to AV pathogenesis. However, to our knowledge, stress management has not yet been performed in AV patients. In this 8-week experimental study, we primarily examined the effectiveness of a novel method, dubbed Pythagorean Self-Awareness Intervention (PSAI) in AV.

Methods: This is a two-armed 1 : 1 randomized non-blind experimental study. The total sample was comprised of 15 female patients in the intervention group (mean age 27.2 ± 6.6) and 15 female patients in the control group (mean age 29.1 ± 6.9), all women. Measurements included clinical stage of AV, acne-related quality of life, perceived stress, and positive and negative affect assessed by validated self-administered tools.

Results: Fourteen (93.3%) patients in the intervention group and four (26.7%) patients in the control group showed improvement of the acne stage (relative risk: 3.5, 95% CI 1.5-8.2, P = 0.001). Significant improvements remained after adjusting for age and baseline acne stage. Large to moderate significant effects were observed for perceived stress and negative affect. There were no dropouts and side effects in the PSAI group, whereas compliance reached 100%.

Conclusions: Pythagorean Self-Awareness Intervention is a feasible and possibly effective stress management method for AV. Future larger and longer randomized controlled studies are strongly encouraged.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acne Vulgaris / etiology*
  • Adult
  • Cognitive Behavioral Therapy / methods*
  • Female
  • Humans
  • Pilot Projects
  • Quality of Life
  • Severity of Illness Index
  • Stress, Psychological / complications*
  • Stress, Psychological / therapy*
  • Young Adult