Severe acne vulgaris exerts a profound impact on patients’ psychological well-being, social interactions, and overall perception of health. Beyond its visible inflammatory manifestations, the condition often influences self-image, confidence in professional and personal environments, and daily behavioral patterns. The persistent nature of severe acne, together with concerns about scarring and long-term aesthetic outcomes, may intensify emotional stress and social self-consciousness. Therefore, the subjective burden of the disease frequently extends beyond objective clinical severity and plays a crucial role in therapeutic decision-making. [1]
For this reason, assessment of treatment outcomes should incorporate validated patient-reported measures that capture real-life experience rather than relying exclusively on clinical parameters. The present study evaluated quality-of-life changes using the Dermatology Life Quality Index (DLQI), alongside patient satisfaction assessed through the Visual Analogue Scale (VAS), in individuals treated with long-pulsed Nd:YAG laser therapy or oral isotretinoin. The combined use of these instruments enabled a broader evaluation of both functional recovery and personal perception of therapeutic benefit. [2,3]
At baseline, patients demonstrated significant impairment in psychosocial functioning, including reduced self-confidence, heightened awareness of appearance, and limitations in social engagement. Many participants reported discomfort in interpersonal communication and increased emotional sensitivity related to visible skin lesions. During treatment, progressive improvement in DLQI domains was observed in both groups, reflecting gradual reduction of emotional burden and restoration of daily functioning. Improvements were noted not only in social activity scores but also in domains related to emotional stability and personal relationships. [4]
Patient-reported satisfaction measured by VAS revealed distinct differences between therapeutic approaches. Individuals undergoing laser therapy described a steady and progressively increasing sense of satisfaction, often associated with visible incremental improvement and structured treatment sessions. The localized and procedural nature of laser therapy appeared to enhance the perception of therapeutic control and predictability. The absence of systemic exposure and the experience of gradual aesthetic refinement may have contributed to a more positive and stable subjective evaluation. [5]
In contrast, while isotretinoin therapy resulted in noticeable dermatological improvement, patient satisfaction occasionally demonstrated variability throughout the treatment course. Such fluctuations were frequently linked to treatment-related discomfort and heightened awareness of systemic therapy, which could influence overall perception despite objective skin improvement. These observations highlight that subjective experience of treatment may differ even when clinical outcomes are favorable. [6]
The combined evaluation of DLQI and VAS provides a multidimensional understanding of therapeutic impact, integrating emotional, functional, and perceptual dimensions of care. While both treatment modalities were associated with meaningful enhancement of quality of life, Nd:YAG laser therapy demonstrated a tendency toward more consistent patient-reported satisfaction alongside psychosocial recovery. [7]
These findings emphasize the importance of integrating quality-of-life indices and satisfaction scales into routine management of severe acne. Incorporating patient-centered outcome measures supports a more holistic therapeutic approach and aligns with contemporary principles of personalized dermatological care.
Reference
1. El Kazzi T, Shahine M, Salameh P. Effect of severity of acne on the mental health of Lebanese patients with acne: findings from an online survey. BMC Psychol. 2025;13:502. https://doi.org/10.1186/s40359-025-02808-8
2. Gold MH, Manturova NE, Kruglova LS, Ikonnikova EV. Treatment of moderate to severe acne and scars with a 650-microsecond 1064-nm laser and isotretinoin. J Drugs Dermatol. 2020;19(6):646–651. https://doi.org/10.36849/jdd.2020.m5108
3. Chernyshov PV, Zouboulis CC, Tomas-Aragones L, Jemec GBE, Manolache L, Tzellos T, et al. Quality of life measurement in acne. J Eur Acad Dermatol Venereol. 2017;31(9):1453–1462. https://doi.org/10.1111/jdv.14585
4. Marron SE, Chernyshov PV, Tomas-Aragones L. Quality-of-life research in acne vulgaris: current status and future directions. Am J Clin Dermatol. 2019;20(4):527–538. https://doi.org/10.1007/s40257-019-00438-6
5. van Zuuren EJ, Arents BWM, Miklas M, Schoones JW, Tan J. Identifying and appraising patient-reported outcome measures on treatment satisfaction in acne: a systematic review. Br J Dermatol. 2021;185(1):36–51. https://doi.org/10.1111/bjd.19675
6. He SX, Wang Y, Wang J, Tang L, Yang L, Ye FL. Isotretinoin combined laser/light-based treatments versus isotretinoin alone for the treatment of acne vulgaris: a meta-analysis. J Cosmet Dermatol. 2024. https://doi.org/10.1111/jocd.16639
7. Gold MH, Goldberg DJ, Nestor MS. Current treatments of acne: medications, lights, lasers, and a novel 650-μs 1064-nm Nd:YAG laser. J Cosmet Dermatol. 2017;16(3):345–352. https://doi.org/10.1111/jocd.12367
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