PS54 Psychological impact of facial hyperpigmentation in Moroccans

Abstract

Facial hyperpigmentation is a frequent reason for dermatology consultations. Due to its visibility, it can negatively affect body image and contribute to psychological distress. However, this dimension remains insufficiently addressed in routine clinical practice. This study aimed to assess the psychological impact of facial hyperpigmentation in patients seen at the Souss-Massa University Hospital in Agadir and to identify the associated clinical and sociodemographic factors. A cross-sectional, observational and analytical study was conducted between July 2023 and May 2025, including 120 patients aged 18–65 years with facial hyperpigmentation. All patients underwent a joint ­dermatology–psychiatry consultation. Data were analysed using JAMOVI software, with a significance level set at P < 0.05. The mean age was 31.9 years (SD 10.3), with a strong female predominance (97%). The most common diagnosis was melasma (50.0%), followed by postinflammatory hyperpigmentation (21.7%) and lentigines/freckles (19.2%). The mean Dermatology Life Quality Index (DLQI) score was 12.8 (SD 7.8). High DLQI scores were significantly associated with lesion severity (P < 0.001), aetiology (P < 0.001), age (P = 0.02) and a family history of hyperpigmentation (P = 0.05). Hospital Anxiety and Depression Scale (HADS)-Anxiety scores were significantly associated with lesion colour (P = 0.03) and aetiology (P = 0.01). HADS-Depression scores were associated with age (P = 0.02), severity (P < 0.001) and aetiology (P < 0.001). Low self-esteem, found in 77.5% of patients, was significantly associated with female sex (P = 0.02), younger age (P = 0.005), chronic course (P = 0.001), family history (P = 0.02) and aetiology (P < 0.001). Camouflage behaviours were reported by 57.5% of patients and were significantly associated with female sex (P = 0.04), younger age (P < 0.001), low self-esteem (P < 0.001) and high DLQI scores (P < 0.001). The findings highlight the importance of incorporating psychological assessment into the management of facial hyperpigmentation, particularly within the framework of joint dermatology–­psychiatry consultations.