A study of 280 acne outpatients treated at Vietnam’s National Hospital of Dermatology and Venereology in Hanoi found that 69 patients, or 24.6%, met criteria for at least one phobic anxiety disorder.
The findings, based on patients seen between December 2025 and June 2026, point to a substantial level of reported fear or avoidance among this specialist-hospital sample. They do not show that acne caused the anxiety disorders, because the study measured patients at one point in time.
Social phobia made up most cases
Social phobia was identified in 64 patients, representing 22.9% of the full sample and 92.8% of those who had a phobic disorder. Specific phobia was diagnosed in 26 patients, while one patient had agoraphobia.
Twenty-two of the 69 patients had two types of phobic disorder. No patient had all three types recorded in the study.
The participants had an average age of 21.3 years, and 68.6% were women. More than half had severe acne, 57.9% had scarring, and 62.1% were taking isotretinoin at the time of the study.
Scarring and treatment response showed associations
After statistical adjustment, acne scarring was associated with higher odds of having a phobic disorder. The adjusted odds ratio was 2.29, with a 95% confidence interval of 1.04 to 5.05.
A difficult treatment response had a stronger reported association: patients with poor treatment response had an adjusted odds ratio of 5.06, with a 95% confidence interval of 2.20 to 11.62.
Before adjustment, 36.6% of patients with poor treatment response had a phobic disorder, compared with 8.4% of those whose acne had improved markedly. Severe acne showed a similar unadjusted pattern: 30.8% of patients with severe acne had a phobic disorder, compared with 18.2% of those with milder acne.
However, severe acne was not clearly associated with phobic disorders after adjustment. Its adjusted odds ratio was 1.54, with a 95% confidence interval of 0.72 to 3.29.
How the study assessed patients
A psychiatrist interviewed each patient face to face and applied ICD-10 criteria. Questionnaire scores alone did not determine whether someone was classified as having a disorder.
The researchers reported that patients described as “easily anxious” had higher odds of a phobic disorder, as did patients with another physical illness. These findings should be interpreted carefully: the “easily anxious” measure came from a single checklist item that may overlap with the anxiety being assessed.
Age, sex, acne duration, and current isotretinoin use did not show a clear link with phobic disorders in the study.
Why the results need cautious interpretation
The study was cross-sectional, so it cannot establish whether acne-related experiences came before the phobic disorder or whether one caused the other. It also used convenience sampling at a specialist hospital, meaning the reported rate may not represent people with acne in the wider community.
The participation rate was unknown because the researchers did not keep records of how many people were approached or declined. The analysis included only 69 cases across nine factors, which may make some estimates unstable.
The study did not document use of a validated structured interview, and the Vietnamese Fear Questionnaire had not been formally validated. Several measures, including acne severity, treatment response, life impact, and being “easily anxious,” were study-specific and unvalidated. Self-esteem, body image, and perceived stigma were not measured.
The association with scarring also became less clear after people with current anxiety or depression symptoms were removed from the analysis: the adjusted odds ratio was 2.47, with a 95% confidence interval of 0.98 to 6.19.
What the findings may mean in clinical conversations
The researchers recommend that acne clinicians ask about avoidance, fear of being judged, and whether acne interferes with school, work, or relationships, particularly when patients have scarring or a difficult treatment course.
The study does not establish a screening cutoff or referral pathway for Vietnamese patients. A positive questionnaire result is not, by itself, a diagnosis. The findings instead suggest that emotional and social effects may be worth discussing as part of broader acne care, especially when patients report persistent fear, avoidance, or disruption to daily life.
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