Abstract
BACKGROUND: Atrophic acne scarring is a chronic dermatological condition with significant psychosocial impact, yet the psychological burden it imposes has been relatively underexplored in clinical practice. OBJECTIVE: To explore the psychological experiences of patients with Atrophic Acne Scarring during the disease progression, and analyze their emotional changes and coping strategies based on uncertainty in illness theory. METHODS: A qualitative descriptive design was employed for this study. Purposeful sampling was chosen from a tertiary hospital in Henan Province, China. Semi-structured in-depth interviews were conducted with 15 patients with Atrophic Acne Scarring. The interview data was analyzed using the Colaizzi's method and results were reported following the COREQ standards. RESULTS: A total of 4 themes and 12 sub-themes were extracted, including: 1) Confusion and Denial in the Initial Diagnosis Stage: Disease-related cognitive bias, information confusion and incorrect interventions, normalization tendency. 2) Anxiety and Shame in the Flareup Stage: Appearance monitoring behaviors, social evaluation pressure, impaired social functioning. 3) Coping Strategies in the Long-Term Adaptation Stage: Positive coping, negative coping, polarized adaptation patterns. 4) Psychological Adjustment in the Recovery Stage: Contradictory acceptance, post-traumatic growth, behavioral-psychological asynchronous improvement. Uncertainty in illness was present throughout the process, affecting patients' self-recognition, social behaviors, and treatment adherence. CONCLUSION: This study demonstrates that patients with atrophic acne scarring experience a four-stage psychological journey (confusion/denial, anxiety/shame, coping adaptation, and recovery adjustment), with illness uncertainty persistently impacting their psychological and social functioning. Healthcare providers should offer personalized psychological support based on the framework of uncertainty in illness theory to enhance patients' quality of life.