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Kutlu Ö, Karadağ AS, Wollina U. Adult acne versus adolescent acne: a narrative review with a focus on epidemiology to treatment. An Bras Dermatol 2023; 98:75-83. [PMID: 36253244 PMCID: PMC9837660 DOI: 10.1016/j.abd.2022.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/02/2022] [Accepted: 01/17/2022] [Indexed: 01/21/2023] Open
Abstract
Acne vulgaris is one of the most common chronic inflammatory diseases and is characterized by papules, pustules, comedones, and nodules. Although adolescence is the preferential age group, acne may affect various age groups. Acne shares different properties in adults and adolescents. These differences extend from epidemiology to treatments. Increased awareness of these two subtypes will allow for better management of the disease. In this review, the authors examined all aspects of acne in adults and adolescents under the light of current literature.
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Affiliation(s)
- Ömer Kutlu
- Department of Dermatology and Venereology, School of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey,Corresponding author.
| | - Ayşe Serap Karadağ
- Department of Dermatology and Venereology, Memorial Ataşehir Hospital, İstanbul, Turkey
| | - Uwe Wollina
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden, Dresden, Germany
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2
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Alowairdhi Y, Alrasheed F, Alghubaywi F, Alqirnas MQ, Alajroush WA. Association Between Acne Vulgaris and Body Mass Index in Adult Population: A Tertiary Hospital-Based Retrospective Study in Riyadh, Saudi Arabia. Cureus 2022; 14:e32867. [PMID: 36699779 PMCID: PMC9870603 DOI: 10.7759/cureus.32867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND/OBJECTIVES Acne vulgaris (AV) is the common form of acne, characterized by a polymorphic eruption of inflammatory non-papules, pustules, nodules, blackheads, and whiteheads. Acne was eighth among the top 10 disorders in terms of prevalence in 2010. The objective of this study was to see if there was any association between acne vulgaris and BMI in the young adult population. METHODS This is a single-center retrospective study conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Adult patients diagnosed with acne vulgaris from January 2017 to June 2022 were enrolled. The estimated sample size was reached using consecutive, non-probability sampling. RESULTS A total of 596 participants were selected as a match to the criteria of the research objectives. Of the participants, slightly more than half were males (52.5%) and the rest were females (47.5%). There was a nearly equal number of cases and controls, around 48.7% of the patients had acne while the rest did not. The majority were of the age group 18 to 19 years followed by 22 to 23 years (25.2%). A majority had a normal BMI of 18.5 to 24.9 (40.4%). A significant difference was found between the means of the BMI of the participants who had acne and those who did not (p<0.05). Conclusion: No significant association was found between age group, gender, BMI, and acne. To fully comprehend how dietary factors affect the severity of acne, more studies are required.
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Affiliation(s)
- Yazeed Alowairdhi
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Faisal Alrasheed
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Faisal Alghubaywi
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Muhannad Q Alqirnas
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Waleed A Alajroush
- Pediatric Dermatology, King Abdullah Specialized Children's Hospital, Riyadh, SAU
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Zhang R, Zhou L, Lv M, Yue N, Fei W, Wang L, Liu Z, Zhang J. The Relevant of Sex Hormone Levels and Acne Grades in Patients with Acne Vulgaris: A Cross-Sectional Study in Beijing. Clin Cosmet Investig Dermatol 2022; 15:2211-2219. [PMID: 36281268 PMCID: PMC9587737 DOI: 10.2147/ccid.s385376] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
Background The tests of sex hormones play pivotal roles in the clinical diagnosis and treatment of acne vulgaris, but the majority of patients with acne vulgaris present regular sex hormone levels within the normal reference range. Objective To determine the correlation among levels of sex hormones, ratio of androgen to estrogen and acne grades in patients with acne vulgaris. Methods A cross-sectional study was applied to collect 693 patients with acne vulgaris. All samples were screened by cluster sampling among those who underwent tests of sex hormones at Beijing Jingcheng Skin Hospital from July 2021 to June 2022. A gender stratified analysis was performed to classify acne grades I–IV. Spearman correlation analysis was used to analyze the relationship between age, sex hormones, ratio of androgen to estrogen and acne grades, with multinomial logistic regression to analyze the association of sex hormones with acne grades in patients with acne. Results (1) The testosterone levels were mostly within normal reference values for both males and females with varying degrees of acne. For females, the serum follicle-stimulating hormone, estradiol, progesterone, testosterone, and ratio of androgen to estrogen were significantly different between acne grades. For males, there were significant differences in serum estradiol, testosterone, and ratio of androgen to estrogen across acne grades. (2) The acne grade was negatively correlated with estradiol and positively correlated with the ratio of androgen to estrogen; the female acne grade was also negatively correlated with age and progesterone, but positively correlated with follicle-stimulating hormone. (3) Multivariate logistic regression analysis indicated that the ratio of androgen to estrogen was independently correlated with the grade of acne and that acne grade worsened as the ratio increased. Conclusion The increase in the ratio of androgen to estrogen may aggravate the acne grade in patients with acne vulgaris.
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Affiliation(s)
- Rui Zhang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 102488, People’s Republic of China
| | - Lanhua Zhou
- Department of Dermatology, Beijing Jingcheng Skin Hospital, Beijing, 100192, People’s Republic of China
| | - Meiyu Lv
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 102488, People’s Republic of China
| | - Na Yue
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 102488, People’s Republic of China
| | - Wenting Fei
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, 102488, People’s Republic of China
| | - Linyuan Wang
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, 102488, People’s Republic of China
| | - Zhaolan Liu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 102488, People’s Republic of China
| | - Jianjun Zhang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 102488, People’s Republic of China,Correspondence: Jianjun Zhang, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Liangxiang Town, Fangshan District, Beijing, 102488, People’s Republic of China, Email
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Özkesici Kurt B. The course of acne in healthcare workers during the COVID-19 pandemic and evaluation of possible risk factors. J Cosmet Dermatol 2021; 20:3730-3738. [PMID: 34637186 PMCID: PMC8662215 DOI: 10.1111/jocd.14530] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/16/2021] [Accepted: 10/05/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND There are a limited number of publications reporting an increase in acne in the COVID-19 outbreak. OBJECTIVE The study aimed to evaluate the course and the clinical features of acne and possible risk factors during the COVID-19 pandemic in healthcare workers. METHOD A total of 172 physicians (female, n = 159, male; n = 13, mean age = 35.03 ± 5.27 years) who had acne in any period of their life were included in the study. A self-administered online questionnaire was applied. RESULTS During the COVID-19 pandemic, 45.35% of the participants reported that their acne complaints increased, 27.33% reported relapses, and 7.56% reported occurrence for the first time. Newly formed acne was reported most frequently on the chin (78.26%). The number of female participants, smoking, increased stress, and the rate of surgical mask use were found to be higher in the group whose acne occurred for the first time, relapsed, or increased than in the group whose acne complaints were unchanged or decreased (p < 0.05). In the group whose acne relapsed or increased, adult-onset acne, presence of scar, and use of systemic acne treatment before the COVID-19 pandemic were more common than in the group whose acne complaints were unchanged or decreased (p < 0.05). CONCLUSION Almost half of the participants reported an increase in acne. More than a third of the participants reported that their acne relapsed or they had acne for the first time. In addition to the use of surgical masks, factors such as increased stress, smoking, adult-onset acne, presence of scar, and previous systemic acne treatment were found to be responsible for acne development.
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Adolescents' beliefs and perceptions of acne vulgaris: A cross-sectional study in Montenegrin schoolchildren. PLoS One 2021; 16:e0253421. [PMID: 34133464 PMCID: PMC8208562 DOI: 10.1371/journal.pone.0253421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/06/2021] [Indexed: 11/19/2022] Open
Abstract
Background Acne is a common chronic inflammatory skin disease with a high prevalence in adolescent and early adult years. The aim of this study was to assess the self-perceived beliefs of Montenegrin secondary school pupils regarding the acne aggravating and ameliorating factors. Methods This cross-sectional survey of the pupils was conducted during October and November 2020 in four randomly selected public secondary schools in Podgorica, Montenegro. All 500 pupils were asked to fill in a questionnaire that included questions on age, sex, presence of acne, perceived acne aggravating and ameliorating factors, and sources of their information about acne. Results A total of 500 pupils, 234 (46.8%) boys, and 266 (53.2%) girls, aged 14−17 years, participated in the study. Acne was self-reported in 249 (49.8%) pupils, whereas 251 (50.2%) did not report acne. Factors most often believed to aggravate acne were inadequate face washing (85.0%), hormones (84.0%), sweets (82.0%), greasy food (72.6%), makeup (71.2%), and stress (67.8%). Overall the most prevalent acne ameliorating factors were cosmetic treatment (80.4%), increased water consumption (77.6%), a diet change to a healthier food choice (77.4%), and being on school holidays (62.2%). Girls reported more frequently that genetics, stress, sweets consumption, inadequate face wash, and makeup are acne exacerbating factors, whilst cosmetic treatment, increased water consumption, smoking, and being on school holidays are acne ameliorating factors. Boys more frequently considered the benefit of losing weight. There was no statistically significant difference between pupils with and without acne in perceived factors, except for cosmetic treatment. Those with acne more frequently believed in the benefits of cosmetic treatment. Conclusions Many adolescents’ self-perceived beliefs about factors that aggravate and ameliorate acne are myths and misconceptions without evidence-based justification. More efforts are needed to educate pupils about the acne aggravating and ameliorating factors, its health-related consequences, and the treatment possibilities.
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Heng AHS, Say YH, Sio YY, Ng YT, Chew FT. Epidemiological Risk Factors Associated with Acne Vulgaris Presentation, Severity, and Scarring in a Singapore Chinese Population: A Cross-Sectional Study. Dermatology 2021; 238:226-235. [PMID: 34062533 DOI: 10.1159/000516232] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/27/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Acne vulgaris is classified based on the severity of skin lesions and post-healing scar types of these lesions. Numerous epidemiology studies have investigated the risk factors associated with acne presentation and severity, but studies for acne scarring are lacking. OBJECTIVE To investigate the prevalence of acne, severity, and scarring grades and their associated risk factors among Singapore Chinese. METHODS A total of 3,888 subjects (2,090 cases/1,798 controls; median age = 21 ± 4.589; range 17-71) completed an investigator-administered questionnaire as part of a cross-sectional study, which included sociodemographics, familial medical history, lifestyle factors, dietary habits, and acne history. Acne cases were further evaluated for their severity (n = 991) and scarring (n = 988) grades by a trained personnel. RESULTS The majority of the acne cases had mild acne/grade 1 scarring, while less than 1% had severe acne/grade 4 scarring. Parental acne was significantly associated with acne presentation and moderate/severe acne, while sibling acne was significantly associated with grade 3/4 scarring. Gender and age affected acne severity and scarring but not acne presentation, while tertiary maternal education level and the possession of ≥3 siblings were particularly associated with acne scarring. Underweight BMI was protective against acne presentation, while atopic diseases (asthma, allergic rhinitis, eczema) were its predisposing factors. Of the evaluated lifestyle factors, computer/TV usage had significant association with acne presentation, while alcohol consumption was significantly associated with acne severity. Frequent milk consumption was associated with a protective effect for moderate-severe acne, while frequent butter consumption had a detrimental effect on acne scarring extent. CONCLUSION Positive familial history is a strong predisposing factor in determining acne presentation, severity, and scarring. Demographic factors (gender, age) and sedentary lifestyle (increased computer/TV usage) influence acne presentation, while dietary habits (milk and butter consumption) influence acne severity and scarring. The predisposing factors revealed in this study could help us to gain insights into acne pathophysiology and hence develop interventions especially targeting modifiable risk factors.
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Affiliation(s)
- Anna Hwee Sing Heng
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
| | - Yee-How Say
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore,
| | - Yang Yie Sio
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
| | - Yu Ting Ng
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
| | - Fook Tim Chew
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
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Say YH, Heng AHS, Reginald K, Wong YR, Teh KF, Rawanan Shah SM, Sio YY, Ng YT, Matta SA, Pang SL, Chew FT. Modifiable and non-modifiable epidemiological risk factors for acne, acne severity and acne scarring among Malaysian Chinese: a cross-sectional study. BMC Public Health 2021; 21:601. [PMID: 33773591 PMCID: PMC8005239 DOI: 10.1186/s12889-021-10681-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background Acne vulgaris, a highly prevalent multifactorial inflammatory skin disease, can be categorised into different severity and scarring grades based on the type, number, and severity of lesions. While many epidemiology studies have investigated the risk factors for acne presentation, fewer studies have specifically studied the risk factors for acne severity and scarring. Therefore, this study investigated the prevalence of acne, acne severity and scarring grades, and their associated non-modifiable and modifiable epidemiological risk factors among Malaysian Chinese. Methods A total of 1840 subjects (1117 cases/723 controls) completed an investigator-administered questionnaire as part of a cross-sectional study, which include socio-demographics, familial history, lifestyle factors, dietary habits, and acne history. Acne cases were further evaluated for their severity (n = 1051) and scarring (n = 1052) grades by a trained personnel. Results Majority of the acne cases (up to 69%) had mild acne or Grade 1/2 scarring, while 21.6% had moderate/severe acne and 5.5% had Grade 3/4 scarring. Males had significantly higher risk of presenting with higher grades of acne scarring. Those who had acne, regardless of severity and scarring grades, had strong positive familial history (either in parents and/or sibling). Frequent consumption (most or all days) of foods that are commonly consumed during breakfast (butter, probiotic drinks, cereals and milk) decreased the risk for acne presentation and higher acne scarring, while periodic consumption (once/twice per week) of nuts and burgers/fast food decreased the risk for higher acne severity. Alcohol drinking was significantly associated with increased risk for acne presentation, while paternal, parental and household smoking were associated with reduced risk of more severe acne. Conclusions In conclusion, positive familial history is a strong predisposing factor in influencing acne presentation, severity and scarring. Frequent consumption of foods that are commonly consumed during breakfast is protective against acne presentation. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10681-4.
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Affiliation(s)
- Yee-How Say
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Anna Hwee Sing Heng
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Kavita Reginald
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, 47500, Petaling Jaya, Selangor, Malaysia
| | - Yi Ru Wong
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, 47500, Petaling Jaya, Selangor, Malaysia
| | - Keng Foo Teh
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, 47500, Petaling Jaya, Selangor, Malaysia
| | - Smyrna Moti Rawanan Shah
- Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, 47500, Petaling Jaya, Selangor, Malaysia
| | - Yang Yie Sio
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Yu Ting Ng
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Sri Anusha Matta
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Sze Lei Pang
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore
| | - Fook Tim Chew
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, Block S2, Level 5, 14 Science Drive 4, Lower Kent Ridge Road, Singapore, 117543, Singapore.
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Adamski Z, Gornowicz-Porowska J, Sobkowska D, Kaszuba K, Czajkowski R. Acne - therapeutic challenges to the cooperation between a dermatologist and a cosmetologist. Postepy Dermatol Alergol 2021; 38:21-31. [PMID: 34408562 PMCID: PMC8362767 DOI: 10.5114/ada.2021.104273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 07/21/2020] [Indexed: 12/12/2022] Open
Abstract
Acne vulgaris is one of the most common skin diseases in adolescence, causing a significant negative impact on the quality of life of young people who - in a large percentage of cases - do not accept their appearance. The complex pathogenesis of this disease requires appropriate preventive and curative treatment from both a dermatologist and a cosmetologist. The aim of the study was to discuss the methods currently used by dermatologists in local therapy for mild and intermediate forms of acne vulgaris, and to provide an overview of possible preventive and caring activities in the cosmetologist's office. Possible directions of cooperation between the dermatologist and the cosmetologist in the prevention of acne relapse and treatment of possible acne complications were also discussed.
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Affiliation(s)
- Zygmunt Adamski
- Chair and Clinic of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Justyna Gornowicz-Porowska
- Clinic of Natural Medicinal and Cosmetic Raw Materials, The Laboratory of Practical Cosmetology, Poznan University of Medical Sciences, Poznan, Poland
| | - Daria Sobkowska
- Clinic of Natural Medicinal and Cosmetic Raw Materials, The Laboratory of Practical Cosmetology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Rafał Czajkowski
- Chair of Dermatology, Department of Dermatology and Venerology, Faculty of Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
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Does smoking affect your skin? Postepy Dermatol Alergol 2021; 38:371-376. [PMID: 34377115 PMCID: PMC8330869 DOI: 10.5114/ada.2021.103000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/21/2020] [Indexed: 11/17/2022] Open
Abstract
Smoking has a negative influence on human beings. Carcinogens detected in smoke can increase the risk of developing chronic disorders, cancer and premature death. Nicotine can also affect dermatological diseases such as psoriasis, hidradenitis suppurativa, chronic dermatoses, alopecia, lupus erythematosus, polymorphous light eruption, skin cancer and tobacco-associated oral lesions. Advanced education at a doctor's surgery in various medical occupations can change the bad habits and protect people from the consequences.
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Savo I, Jorgaqi E, Fida M, Vasili E, Kuci M, Doci X, Toci E, Jafferany M. Therapeutic considerations and clinical characteristics of a sample of adolescent patients with acne vulgaris in Tirana, Albania: A cross‐sectional study. Dermatol Ther 2020; 33:e13384. [DOI: 10.1111/dth.13384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/05/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Irena Savo
- Dermatology Unit American Hospital Tirana Albania
| | - Ekleva Jorgaqi
- Dermatology Service University Hospital Center “Mother Theressa” Tirana Albania
| | - Monika Fida
- Dermatology Service University Hospital Center “Mother Theressa” Tirana Albania
| | - Ermira Vasili
- Dermatology Service University Hospital Center “Mother Theressa” Tirana Albania
| | - Maurizia Kuci
- Dermatology Service University Hospital Center “Mother Theressa” Tirana Albania
| | - Xhiliola Doci
- Dermatology Unit Regional Hospital of Durres Durres Albania
| | - Ervin Toci
- Institute of Public Health Tirana Albania
| | - Mohammad Jafferany
- Division of Psychodermatolog Central Michigan University Saginaw Michigan USA
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Heng AHS, Chew FT. Systematic review of the epidemiology of acne vulgaris. Sci Rep 2020; 10:5754. [PMID: 32238884 PMCID: PMC7113252 DOI: 10.1038/s41598-020-62715-3] [Citation(s) in RCA: 140] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/16/2020] [Indexed: 12/18/2022] Open
Abstract
A systematic review was conducted on epidemiology studies on acne obtained from a Web of Science search to study risk factors associated with acne presentation and severity. A strong association was observed between several risk factors – family history, age, BMI and skin type – and acne presentation or severity in multiple studies. The pooled odds ratio of 2.36 (95% CI 1.97–2.83) for overweight/obese BMI with reference to normal/underweight BMI and the pooled odds ratio of 2.91 (95% CI 2.58–3.28) for family history in parents with reference to no family history in parents demonstrate this strong association. In addition, a pooled odds ratio of 1.07 (95% CI 0.42–2.71) was obtained for sex (males with reference to females). However, the association between other factors, such as dietary factors and smoking, and acne presentation or severity was less clear, with inconsistent results between studies. Thus, further research is required to understand how these factors may influence the development and severity of acne. This study summarizes the potential factors that may affect the risk of acne presentation or severe acne and can help researchers and clinicians to understand the epidemiology of acne and severe acne. Furthermore, the findings can direct future acne research, with the hope of gaining insight into the pathophysiology of acne so as to develop effective acne treatments.
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Affiliation(s)
- Anna Hwee Sing Heng
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
| | - Fook Tim Chew
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore.
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12
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Markovic M, Soldatovic I, Bjekic M, Sipetic-Grujicic S. Adolescents' self perceived acne-related beliefs: from myth to science. An Bras Dermatol 2019; 94:684-690. [PMID: 31789254 PMCID: PMC6939091 DOI: 10.1016/j.abd.2019.02.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 02/19/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Acne vulgaris is recognized as the third most prevalent skin disease worldwide, with highest prevalence among adolescents. Beliefs and perceptions of adolescents about acne are incoherent in the literature. OBJECTIVES To assess the most frequently reported acne-related beliefs in adolescents in order to focus on misconceptions and develop proper recommendations. METHODS A cross-sectional community-based study on representative sample of 2516 schoolchildren was conducted in six randomly selected secondary schools in Belgrade, Serbia. Only schoolchildren with present or past acne history participated. Factors believed to aggravate or ameliorate acne were recorded and analyzed, and the comparisons between girls and boys were evaluated using Pearson's chi-squared test. RESULTS A total of 1452 schoolchildren with acne participated, aged 14-18 years, among them 801 (55.2%) girls and 651 (44.8%) boys. Boys significantly more frequently believed that sweating, exercise, and dairy foods aggravate acne, whereas girls significantly more frequently blamed emotional stress, sweets, fatty foods, sun, and lack of sleep. The top four amelioration factors were as follows: comedone extraction, healthy diet, sun exposure, and increased water consumption. Acne regression was more frequently perceived to be linked with cigarettes in boys, but with sun exposure and weight loss in girls. STUDY LIMITATIONS The narrow age span of adolescents (14-18 years) and exclusion of acne-free adolescents are limitations due to study design. CONCLUSION This survey is part of the first epidemiological study on a representative sample in the Western Balkan region. The significance of the most frequent acne-related beliefs is discussed and myths about acne are highlighted.
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Affiliation(s)
- Milica Markovic
- Department for Facial Dermatoses, City Institute for Skin and Venereal Diseases, Belgrade, Serbia.
| | - Ivan Soldatovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Bjekic
- Department of General Dermatovenereology, City Institute for Skin and Venereal Diseases, Belgrade, Serbia
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Wolkenstein P, Machovcová A, Szepietowski J, Tennstedt D, Veraldi S, Delarue A. Acne prevalence and associations with lifestyle: a cross-sectional online survey of adolescents/young adults in 7 European countries. J Eur Acad Dermatol Venereol 2017; 32:298-306. [DOI: 10.1111/jdv.14475] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 06/28/2017] [Indexed: 11/26/2022]
Affiliation(s)
- P. Wolkenstein
- Department of Dermatology; Hôpital Henri Mondor; APHP; UPEC; Créteil France
| | - A. Machovcová
- Department of Dermatology and Venerology; Motol Hospital; Prague Czech Republic
| | - J.C. Szepietowski
- Department of Dermatology, Venerology and Allergology; Medical University; Wroclaw Poland
| | - D. Tennstedt
- Department of Dermatology; UCL; Cliniques Universitaires Saint-Luc; Brussels Belgium
| | - S. Veraldi
- Department of Pathophysiology and Transplantation; University of Milan; Milan Italy
| | - A. Delarue
- Pierre Fabre Dermatologie; Les Cauquillous; Lavaur France
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Abstract
Acne vulgaris is a chronic inflammatory disease - rather than a natural part of the life cycle as colloquially viewed - of the pilosebaceous unit (comprising the hair follicle, hair shaft and sebaceous gland) and is among the most common dermatological conditions worldwide. Some of the key mechanisms involved in the development of acne include disturbed sebaceous gland activity associated with hyperseborrhoea (that is, increased sebum production) and alterations in sebum fatty acid composition, dysregulation of the hormone microenvironment, interaction with neuropeptides, follicular hyperkeratinization, induction of inflammation and dysfunction of the innate and adaptive immunity. Grading of acne involves lesion counting and photographic methods. However, there is a lack of consensus on the exact grading criteria, which hampers the conduction and comparison of randomized controlled clinical trials evaluating treatments. Prevention of acne relies on the successful management of modifiable risk factors, such as underlying systemic diseases and lifestyle factors. Several treatments are available, but guidelines suffer from a lack of data to make evidence-based recommendations. In addition, the complex combination treatment regimens required to target different aspects of acne pathophysiology lead to poor adherence, which undermines treatment success. Acne commonly causes scarring and reduces the quality of life of patients. New treatment options with a shift towards targeting the early processes involved in acne development instead of suppressing the effects of end products will enhance our ability to improve the outcomes for patients with acne.
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Racine A, Cuerq A, Bijon A, Ricordeau P, Weill A, Allemand H, Chosidow O, Boutron-Ruault MC, Carbonnel F. Isotretinoin and risk of inflammatory bowel disease: a French nationwide study. Am J Gastroenterol 2014; 109:563-9. [PMID: 24535094 DOI: 10.1038/ajg.2014.8] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 12/03/2013] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Isotretinoin, a drug widely prescribed for severe acne, has been suspected to increase the risk of ulcerative colitis (UC), but data are conflicting. To further examine the association between isotretinoin use and risk for UC and Crohn's disease (CD), we conducted a large nationwide case-control study in France. METHODS We used information from the National Health Insurance system for all French people covered by the general scheme between 1 January 2008 and 31 December 2010, totaling over 50 million individuals (i.e., 76% of the whole French population). All incident claims for UC and CD and all medical drug reimbursements were automatically recorded in the database. For each case, four controls were matched on age, gender, year of enrollment, and follow-up duration. The association between isotretinoin use and UC or CD claim was estimated by conditional logistic regression. RESULTS We included 7,593 cases of inflammatory bowel disease (IBD; 3,187 UC, 4,397 CD, and 9 indeterminate colitis) and 30,372 controls; among them, 26 cases (0.3%) (15 UC (0.5%) and 11 CD (0.3%)) and 140 controls (0.4%) were exposed to isotretinoin. Isotretinoin exposure was not associated with an increased risk for UC (odds ratio (OR)=1.36 (95% confidence intervals (CI): 0.76, 2.45)) but was associated with a decreased risk for CD (OR=0.45 (95% CI: 0.24, 0.85)), P value for homogeneity between UC and CD=0.001. Results were similar in analyses restricted to individuals below the age of 40 years, to cases with colonoscopy or intestinal surgery, or when adjusting for other acne treatments. CONCLUSIONS In this population-based case-control study, isotretinoin use was not associated with increased UC risk but was associated with a decreased CD risk. This study provides reassuring data for people using isotretinoin.
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Affiliation(s)
- Antoine Racine
- 1] Department of Gastroenterology, University Hospital of Bicêtre, Assistance Publique Hôpitaux de Paris, Université Paris-Sud, Le Kremlin Bicêtre, France [2] INSERM, UMRS 1018, Team 9, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France
| | - Anne Cuerq
- Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés, Paris, France
| | - Anne Bijon
- INSERM, UMRS 1018, Team 9, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France
| | - Philippe Ricordeau
- Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés, Paris, France
| | - Alain Weill
- Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés, Paris, France
| | - Hubert Allemand
- Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés, Paris, France
| | - Olivier Chosidow
- Department of Dermatology, Hôpital Henri-Mondor, Assistance Publique Hôpitaux de Paris, Université Paris Est Créteil Val de Marne, Créteil, France
| | - Marie-Christine Boutron-Ruault
- INSERM, UMRS 1018, Team 9, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France
| | - Franck Carbonnel
- 1] Department of Gastroenterology, University Hospital of Bicêtre, Assistance Publique Hôpitaux de Paris, Université Paris-Sud, Le Kremlin Bicêtre, France [2] INSERM, UMRS 1018, Team 9, Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Université Paris-Sud, Villejuif, France
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Karciauskiene J, Valiukeviciene S, Gollnick H, Stang A. The prevalence and risk factors of adolescent acne among schoolchildren in Lithuania: a cross-sectional study. J Eur Acad Dermatol Venereol 2013; 28:733-40. [DOI: 10.1111/jdv.12160] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 03/18/2013] [Indexed: 11/29/2022]
Affiliation(s)
- J. Karciauskiene
- Department of Skin and Venereal Diseases; Lithuanian University of Health Sciences; Kaunas Lithuania
| | - S. Valiukeviciene
- Department of Skin and Venereal Diseases; Lithuanian University of Health Sciences; Kaunas Lithuania
| | - H. Gollnick
- Department of Dermatology and Venereology; Otto-von-Guericke-University; Magdeburg Germany
| | - A. Stang
- Institute of Clinical Epidemiology; Martin-Luther-University; Halle Germany
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Perkins AC, Maglione J, Hillebrand GG, Miyamoto K, Kimball AB. Acne vulgaris in women: prevalence across the life span. J Womens Health (Larchmt) 2011; 21:223-30. [PMID: 22171979 DOI: 10.1089/jwh.2010.2722] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Acne vulgaris is a common skin disease with a large quality of life impact, characterized by comedones, inflammatory lesions, secondary dyspigmentation, and scarring. Although traditionally considered a disease of adolescence, reports suggest it is also a disease of adults, especially adult women. Our objectives were to determine acne prevalence in a large, diverse group of women and to examine acne by subtype and in relation to other skin findings, measurements, and lifestyle factors. METHODS We recruited 2895 women aged 10-70 from the general population. Photographs were graded for acne lesions, scars, and dyspigmentation. Measurements were taken of sebum excretion and pore size, and survey data were collected. RESULTS Of the women studied, 55% had some form of acne: 28% had mild acne, and 27% had clinical acne, 14% of which was primarily inflammatory and 13% of which was primarily comedonal. Acne peaked in the teenage years, but 45% of women aged 21-30, 26% aged 31-40, and 12% aged 41-50 had clinical acne. Women with inflammatory acne were younger than those with comedonal acne (p≤0.001), and postmenopausal women had less acne than age-matched peers (p<0.0001). Acne was associated with facial hirsutism (p=0.001), large pores (p=0.001), and sebum excretion (p=0.002). Smokers had more, primarily comedonal, acne than nonsmokers. CONCLUSIONS The cross-sectional design precludes conclusions about progression of acne with age. Participation was restricted to women. The photographic nature of the study imposes general limitations. Techniques used in this study were not sufficiently sensitive to identify cases of subclinical acne. More than a quarter of women studied had acne, which peaked in the teens but continued to be prevalent through the fifth decade.
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Affiliation(s)
- Alexis C Perkins
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts, USA
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Abstract
The prevalence of acne is about 80% in the majority of the countries worldwide. Moderate and severe acne account for 20% of all cases. Prognostic factors of acne severity were identified: hyper seborrhea, an age of beginning of acne after 17 years or pre pubertray, extension of acne lesions to the trunk, stress for the two sexes, and notion of family acne (hereditary). The role of cigarette and food remains discussed. Acne of the adult (man and woman) is in increase and is estimated at 40% of the adults. In addition, recent epidemiologic data reveal that the acneic subject consults little the doctor (on average, one out of two) and, in the same way, only one young person out of two teenagers declaring a severe acne is treated. Actually, acne is regarded today as a chronic disease requiring treatment of induction and maintenance.
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Capitanio B, Sinagra JL, Bordignon V, Cordiali Fei P, Picardo M, Zouboulis CC. Underestimated clinical features of postadolescent acne. J Am Acad Dermatol 2010; 63:782-8. [DOI: 10.1016/j.jaad.2009.11.021] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 11/09/2009] [Accepted: 11/13/2009] [Indexed: 01/22/2023]
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Abstract
Smoking negatively impacts the health of the skin as it does every organ system. This contribution reviews the effect of cigarette smoking on wound healing, wrinkling, and aging of the skin, skin cancer, psoriasis, and other inflammatory skin diseases, hidradenitis suppurativa, acne, alopecia, lupus erythematosus, polymorphous light eruption, and tobacco-associated oral lesions. Dermatologists need to encourage their patients to discontinue this deleterious habit.
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Biver-Dalle C, Humbert P. Tabac et peau. Ann Dermatol Venereol 2010; 137:568-72; quiz 567. [DOI: 10.1016/j.annder.2010.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 03/09/2010] [Accepted: 05/21/2010] [Indexed: 11/29/2022]
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Prevalence, severity, and severity risk factors of acne in high school pupils: a community-based study. J Invest Dermatol 2009; 129:2136-41. [PMID: 19282841 DOI: 10.1038/jid.2009.47] [Citation(s) in RCA: 194] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
A cross-sectional, community-based study was performed to determine the prevalence and severity of acne vulgaris in adolescents and of factors influencing the acne severity risk. The presence of acne was clinically determined and the secondary outcome measures of family acne history and the relation of acne to nutrition habits, emotional stress, menstruation, and smoking were recorded in a questionnaire. A representative sample of 1,002 pupils aged 16+/-0.9 years was enrolled. The overall acne prevalence was 93.3, 94.4% for boys and 92.0% for girls. Moderate to severe acne was observed in 14%. The prevalence of moderate to severe acne was 19.9% in pupils with and 9.8% in those without a family history of acne (P<0.0005; OR: 2.3). Acne severity risk increased with the number of family members with acne history. A mother with acne history influenced the severity of acne the most. Increasing pubertal age, seborrhea, the premenstrual phase, mental stress, and sweet and oily foods were recognized as risk factors for moderate to severe acne. In contrast, gender, spicy foods, and smoking were not associated with acne severity. In conclusion, acne is a common disorder in Iranian adolescents, with a low rate of moderate to severe acne. A genetic background is suggested, with mother's acne history being the most important prognostic factor. Skin quality and certain nutrition habits may affect acne severity.
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Rehn LMH, Meririnne E, Höök-Nikanne J, Isometsä E, Henriksson M. Depressive symptoms, suicidal ideation and acne: a study of male Finnish conscripts. J Eur Acad Dermatol Venereol 2008; 22:561-7. [PMID: 18221339 DOI: 10.1111/j.1468-3083.2007.02514.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To investigate the association among acne, depressive symptoms and suicidal ideation in Finnish male military conscripts. METHODS Consecutive 165 acne patients and 150 patients with mild knee symptoms for comparison were enrolled in the study conducted in the Central Military Hospital, Helsinki, Finland. They filled out the following questionnaires: General Health Questionnaire (GHQ-12), Beck Depression Inventory (BDI), Alcohol Use Disorders Identification Test and Rosenberg Self-Esteem Scale. The Leeds acne grading scale was used to estimate the severity of acne. RESULTS Sixteen (9.7%) acne patients and 20 (13.3%) comparison patients had at least moderate level of depressive symptoms (BDI score 10; P > 0.05, between groups). Suicidal ideation (BDI suicidal item score 1) was reported by 24 (14.5%) acne patients and 16 (10.7%) comparison patients (P > 0.05, between groups). When comparing the mild facial acne patients (Leeds score 0-3) with those with moderate-severe facial acne (Leeds score 4), there were no statistical differences in depressive symptoms (9.5% vs. 10.0%) or suicidal ideation (13.7% vs. 15.7%). No linear relationship was observed between the BDI and facial Leeds scores (P > 0.05). Risk factors for suicidal ideation among the acne patients were depression and alcohol risk use. CONCLUSION Young male patients with acne do not suffer more depressive symptoms or suicidal ideation than patients with mild knee symptoms, and the severity of acne is not associated with the presence of depressive symptoms. The risk factors for suicidal ideation among acne patients seem to be similar to those found in the general population.
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Affiliation(s)
- L M H Rehn
- Helsinki City Health Center, Department of Psychiatry, Helsinki, Finland.
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