Stigma, Bullying, and Resilience: Psychosocial Outcomes in Marginalized Adolescents With Visible Dermatologic Conditions.

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.