Parga Andres D, Liska Taryn M
Medicine, Hospital Corporation of America (HCA) Florida Oak Hill Hospital, Brooksville, USA.
Intensive Care Unit, Banner Health University Medical Center, Phoenix, USA.
Cureus. 2025 Jun 16;17(6):e86171. doi: 10.7759/cureus.86171. eCollection 2025 Jun.
Visible skin diseases such as acne, eczema, vitiligo, and keloids exert a disproportionate psychosocial burden on marginalized adolescents, particularly among Indigenous, Latinx, and migrant youth. This review illuminates how the cycle of stigma, bullying (both in-person and online), and discrimination is amplified by intersecting cultural, racial, and socioeconomic factors, leading to elevated rates of depression, anxiety, self-harm, and suicide risk. However, despite the gravity of these challenges, psychosocial distress remains routinely underdiagnosed and undertreated in these populations, with significant barriers to mental health care and a lack of culturally competent interventions. Drawing from a broad and interdisciplinary evidence base, we explore not only the epidemiology and risk factors unique to minoritized youth but also the powerful influence of cultural identity, family support, traditional practices, and peer mentorship in shaping resilience. Our review uniquely highlights integrative and creative therapies as promising adjuncts to conventional care. We emphasize the centrality of internalized stigma as a therapeutic target and urge a shift toward trauma-informed care. The findings presented call for coordinated action among dermatologists, pediatricians, psychiatrists, psychologists, educators, and family members as key stakeholders in supporting the psychosocial needs of adolescents with visible skin disease. We recommend systematic psychosocial screening, routine use of validated quality-of-life and stigma measures, family- and community-centered support, and the integration of mental health resources into dermatologic care. Ultimately, by embracing culturally sensitive, multi-level strategies and addressing persistent policy and research gaps, we can not only mitigate the harms of visible skin disease but also transform vulnerability into resilience and agency for the most underserved youth.
痤疮、湿疹、白癜风和瘢痕疙瘩等可见性皮肤病给边缘化青少年带来了不成比例的心理社会负担，在原住民、拉丁裔和移民青年中尤为明显。本综述阐明了耻辱感、欺凌行为（包括面对面和网络欺凌）以及歧视的循环是如何因文化、种族和社会经济因素的交织而加剧的，进而导致抑郁症、焦虑症、自我伤害和自杀风险的上升。然而，尽管这些挑战十分严峻，但在这些人群中，心理社会困扰仍常常未得到充分诊断和治疗，存在着心理健康护理的重大障碍以及缺乏具有文化胜任力的干预措施。基于广泛的跨学科证据基础，我们不仅探讨了少数族裔青少年特有的流行病学和风险因素，还探讨了文化认同、家庭支持、传统习俗和同伴指导在塑造复原力方面的强大影响。我们的综述独特地强调了综合和创造性疗法作为传统护理的有前景的辅助手段。我们强调将内化耻辱感作为治疗靶点的核心地位，并敦促转向以创伤为导向的护理。所呈现的研究结果呼吁皮肤科医生、儿科医生、精神科医生、心理学家、教育工作者和家庭成员作为关键利益相关者采取协调行动，以支持患有可见性皮肤病青少年的心理社会需求。我们建议进行系统的心理社会筛查，常规使用经过验证的生活质量和耻辱感测量工具，以家庭和社区为中心的支持，以及将心理健康资源整合到皮肤科护理中。最终，通过采用文化敏感的多层次策略并解决持续存在的政策和研究差距，我们不仅可以减轻可见性皮肤病的危害，还可以将最弱势群体的脆弱性转化为复原力和能动性。
