Living with a chronic skin condition can be far more than skin deep-it can quietly affect a person's mental health, emotions, and daily habits. A large pan-European study published in the Journal of the European Academy of Dermatology and Venereology has revealed a worrying link between poorer quality of life and addictive behaviors in people with chronic skin diseases such as psoriasis, vitiligo, hidradenitis suppurativa, and atopic dermatitis. The findings suggest that for many patients, emotional distress may lead to maladaptive coping mechanisms, including addiction.
Chronic dermatologic conditions have long been associated with anxiety, depression, and social isolation. The constant stress, visible symptoms, and stigma can push patients toward behaviors that temporarily relieve discomfort—such as smoking, drinking, or compulsive internet use. Yet, evidence from large, multicenter studies on addiction in dermatology was scarce until now. To fill this gap, researchers led by Dr. Stefanie Ziehfreund from the Technical University of Munich conducted one of the most comprehensive analyses across 20 European countries.
The cross-sectional study involved 3,585 adults diagnosed with various chronic skin disorders treated at tertiary dermatology centers. Participants completed standardized questionnaires assessing disease characteristics, demographic details, and patterns of addictive behavior—including smoking, alcohol consumption, drug use, gambling, eating disorders, and internet addiction—alongside the Dermatology Life Quality Index (DLQI), a validated measure of how skin disease impacts daily life.
The results were striking: 25.7% of patients smoked, 8.8% showed hazardous drinking, 5.3% had drug use disorders, 4.5% reported gambling problems, and nearly 30% screened positive for internet addiction. Smoking was particularly common among those with psoriasis and hidradenitis suppurativa, while gambling tendencies appeared more in patients with alopecia areata and vitiligo. Statistical analysis revealed that higher DLQI scores—indicating a worse quality of life—were consistently linked to higher rates of addictive behaviors. Young, single, and male participants were especially at risk.
By screening for addiction and offering mental health support alongside medical treatment, clinicians could help patients break harmful cycles and improve overall wellbeing.
This landmark study reframes chronic skin disease as not purely a physical disorder—but a biopsychosocial challenge intertwining visible symptoms with invisible struggles of coping and self control.
REFERENCE: Ziehfreund, S., Saak, M., Schaal, A., Mazilu, R., Mahé, E., Hajj, C., Johansson, E. K., Lysell, J., Sigurdardottir, G., Legat, F. J., Koch, C., Schmieder, A., Glatzel, C., Kirby, B., Pender, E., Zalewska-Janowska, A., Tomaszewska, K., Ciccarese, G., Lauriola, P., . . . Zink, A. Addiction and chronic skin diseases: A Pan-European study on prevalence, associations and patient impact. Journal of the European Academy of Dermatology and Venereology. https://doi.org/10.1111/jdv.70245
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