Scars That Stay: How Skin Health Impacts Mental Health

Delphine Kerob, M.D.

Credit: Caribbean Dermatology Association

As part of our World Mental Health Day coverage, The Educated Patient explores how skin and mind are more connected than many realize. In the moving documentary Scars of Life, La Roche-Posay highlights the hidden emotional burden carried by people living with visible and invisible skin conditions. To understand the science and the stories behind this global initiative, we spoke with Delphine Kerob, M.D., international scientific director of La Roche-Posay Laboratories. Kerob explains how scars — whether from acne, eczema, surgery or cancer treatment — can affect confidence, relationships and overall mental health, and shares how innovations like 3D bio-printed skin may one day transform healing from the inside out.

How can scars — whether from acne, eczema, surgery or cancer treatment — affect mental health and daily life?

Delphine Kerob, M.D.: Scars can deeply affect both mental health and daily life. They are not just a physical mark, they often carry emotional weight and can trigger anxiety, social withdrawal or low self-esteem.

They can indeed be visible after surgery or acne, or invisible, as for eczema. For example, research shows that 46% of acne patients are more likely to develop major depression, 90% of eczema sufferers experience nighttime itching, leading to sleep disturbances in 60% of children, and 22% of patients with hyperpigmentation feel less loved.

Why is it important to consider skin health as a mental health issue, not just a cosmetic or dermatological one?

DK: Today, more than 2 billion people worldwide live with skin conditions that impact self-esteem, mental health and social lives.
Earlier this year, the World Health Organization officially recognized skin health as a global health priority, calling for action regarding not only the physical aspects of skin disease but also the stigma, anxiety and emotional distress they cause. It has been well described that dermatological issues can lead to anxiety, depression and sometimes suicidal ideation. In the Scars of Life study into atopic dermatitis (AD), more commonly known as eczema, we found suicidal ideation to be significantly higher in the population with atopic dermatitis compared to the control population without AD. On the other hand, stress is also recognized as a factor contributing to the flare-up or worsening of some chronic inflammatory conditions such as psoriasis, eczema and seborrheic dermatitis.
Considering skin health as a mental health issue allows health care professionals to provide more holistic care, addressing both physical symptoms and the psychological distress that may accompany them, so that no scars stay for life.

What does the research from La Roche-Posay’s Scars of Life study reveal about the emotional toll of scarring?

DK: At La Roche-Posay, we have launched the Scars of Life research program: a series of epidemiological studies exploring the lifelong impact and invisible scars left by living with skin conditions. This project aimed to understand the long-term visible and invisible "scars of life" caused by dermatological diseases. The first study, conducted in 2024, explored AD. This study has been led by La Roche-Posay with the support of international experts in AD and patient associations. It involved 30,801 adults across 27 countries and five continents. In this study, we analyzed different populations of adults: adults with physician-confirmed AD that started during childhood or adolescence and has persisted during adulthood, the second one with adult-onset AD (no AD during childhood/adolescence), the third one with childhood or adolescent onset AD that resolved during adulthood, and a fourth group without AD (control group).

Our data shows that AD starting in childhood has a stronger impact on quality of life, stigmatization and life trajectories than when it starts in adulthood. Regarding stigmatization, 46% refuse direct contact with the public, 38% feel they have been less loved by their family and friends, 39% notice people avoid shaking their hands, and 55% conceal the visible parts of their affected skin. The group that had AD since childhood consistently reported higher levels of bullying than the group who developed AD during adolescence, with 56.31% versus 39.72%, respectively, for feelings of exclusion, 47.65% versus 35.97% for mean teasing, and 37.43% versus 22.96% for violence, suggesting a more intense experience of harassment when AD starts in childhood. These findings confirm that eczema’s impact goes far beyond the skin. It affects self-esteem, relationships and overall quality of life.

How can patients cope with the social stigma or anxiety that may come with visible scars?

DK: Coping starts with understanding that these feelings are real and valid. Seeking support from dermatologists and mental health professionals is key.

At La Roche-Posay, we also support patient associations that encourage dialogue and community. Breaking the silence and sharing experiences are essential steps in reducing stigma.

How might innovations like 3D bio-printed skin change the future of scar treatment and overall skin health?

DK: 3D bio-printed skin is an exciting breakthrough that is becoming increasingly sophisticated. Today, we can already recreate skin models that include certain pathologies or skin damage — for example, a small scar or pigmentation, or even UV-induced DNA damage. This progress opens new possibilities for research and testing. We can now evaluate active ingredients and skin care products on reconstructed skin to measure their efficacy in helping repair and regenerate.
The ultimate challenge is to get as close as possible to real human skin, including elements like hair follicles, nerves and microvessels, which are key to nourishing cells and removing waste.

Tomorrow, these technologies could also allow us to better understand how environmental changes (such as climate or pollution) affect the skin, and how we can protect and repair it more effectively.

What advice would you give to someone struggling with self-esteem or confidence because of visible or invisible scars?

DK: First, remember that your skin story is part of who you are, but it does not define you. And if scars are affecting your confidence, don’t hesitate to reach out for support.

Kerob is a board-certified dermatologist with a degree in oncology-radiation therapy and a master’s degree in biological and molecular sciences, and clinical pharmacology. She is a consultant in the oncodermatology outpatient department at St. Louis Hospital. Since 2010, Kerob has had 9 years of experience as medical affairs director at Galderma, two years as international medical director of Vichy Laboratories and since 2021 as international scientific director of La Roche-Posay Laboratories.