Stigmatisation, media and acne: A mixed methods interdisciplinary approach.

Acne is associated with a range of psychosocial impacts, including stigmatisation. Yet little is understood about the role of sociocultural context in acne-related stigma. Media representations and consumption are likely to play a role in the nature of such impacts. This thesis adopts a novel mixed methods, interdisciplinary approach to examine how media messages relate to stigma surrounding acne. An ethnographic content analysis (Study 1) of 637 magazine advertisements (1972 – 2008), indicated that acne was framed as a cosmetic concern, with acne opposed to the ideal of perfect skin. Within advertisements, acne was associated with negative characteristics and psychosocial maladjustment. However, several advertisements normalised acne. The frequency and content of acne-related advertisements differed over time and between magazines, suggesting a shift away from acne myths, yet increased pressures to meet unrealistic ideals. Thematic analysis of semi-structured interviews (Study 2) investigated 15 women’s experiences of acne in the context of contemporary media culture. Participants compared themselves to the media-disseminated ideal of perfect skin, describing themselves as looking and feeling different. Participants were frustrated by stigmatising messages and the absence of acne across media. However, participants also identified benefits to digital media, cautiously using online information to inform treatment, and seeking out images and experiences of acne. Within an online survey (Study 3) of 650 individuals with acne, negative comparisons mediated the relationship between photo-function use and feelings of stigma in Facebook (but not Instagram) users, although negative comparisons continued to predict feelings of stigma. Furthermore, self-compassion was consistently associated with lower levels of negative comparisons and feelings of stigma. The findings suggest that individuals with acne are exposed to idealised images of skin and stigmatising messages about acne, which influence feelings of stigma. Cognitive processes like comparisons appear to play an important role in feelings of stigma in this population.