BackgroundAcne treatment cycle lasts long and will cause facial appearance damage. Many patients are prone to psychological problems and severe patients may even experience suicidal ideation.However， the influencing factors of psychological health problems in acne patients are still unclear. ObjectiveTo investigate the mental health status of patients with moderate-to-severe acne and to analyze the influencing factors of their psychological health problems， so as to provide references for improving their mental health. MethodsA total of 120 patients with moderate-to-severe acne of grades II-IV were selected as the research subjects， who were treated in the dermatology outpatient department of the Third Hospital of Mianyang from June 2021 to June 2023. All subjects were evaluated by using the Acne-Specific Quality of Life Questionnaire（Acne-QoL）， Self-rating Depression Scale （SDS）， Self-rating Anxiety Scale （SAS）， Rosenberg Self-Esteem Scale （RSES） and Social Phobia Inventory （SPIN）. According to the evaluation results of SDS， SAS， RSES， SPIN， subjects were divided into a group with mental health problems （n=21） and a group without mental health problems （n=99）. Binary Logistic regression anaylsis was adopted to explore the influencing factors of psychological health problems in acne patients. ResultsA total of 21 patients （17.50%） were detected to have symptoms of depression， anxiety， inferiority or social dysfunction. Statistically significant difference was observed in comparison between two groups in gender， profession， acne classification， dietary habit， age， illness course as well as the factor scores of self perception， emotional function， social function and acne symptom in Acne-QoL （χ²=7.013， 23.123， 9.028， 11.327， t=9.913， 13.022， 4.081， 5.383， 5.361， 10.203，P<0.05）. The results of binary Logistic regression analysis showed that the followings were risk factors for the occurrence of psychological health problems in acne patients： female （OR=2.243， 95% CI： 1.136~4.429）， acne of grade III （OR=3.615， 95% CI： 1.269~10.295） or IV （OR=1.872， 95% CI： 1.073~3.266）， course of disease≥ 1.6 years （OR=2.499， 95% CI：1.068~5.851）， a spicy or greasy diet （OR=3.811， 95% CI： 1.169~12.427）， Acne-QoL self perception score ≤18 （OR=1.802， 95% CI：1.227~2.646）， Acne-QoL emotional function score ≤18 （OR=2.252， 95% CI： 1.016~4.992）， Acne-QoL social function score ≤14 （OR=3.515， 95% CI： 1.534~8.053） and Acne-QoL acne symptom score ≤18 （OR=3.586， 95% CI： 1.098~11.715）. Protective factors for psychological health problems in acne patients included age over 30 years old （OR=0.429， 95% CI： 0.283~0.648）， occupation as professional cadre or enterprise employee （OR=0.483， 95% CI： 0.249~0.939） and other occupations （OR=0.276， 95% CI： 0.090~0.850）. ConclusionA part of patients with moderate-to-severe acne may experience psychological health problems. Patients with female gender， higher acne grades， longer disease duration， preference for greasy or spicy foods and lower scores in all Acne-QoL factors have a higher risk of experiencing psychological health problems.