Relationship between acne vulgaris and cosmetic usage in Sri Lankan urban adolescent females

Knowledge, perceptions, and consumption behaviour of cosmetics among undergraduates of Sri Lanka: a descriptive cross-sectional study

Background

Despite the increasing usage of personal care products among young adolescents in Sri Lanka, limited studies have been conducted to understand the behaviour of cosmetic users and associated health complications. Therefore, the current study was conducted to evaluate the cosmetic consumption related behaviour of the undergraduate community in Sri Lanka and to identify the driving factors behind the incidences of cosmetic related adverse health effects.

Method

An analytical cross-sectional study was conducted by recruiting 421 undergraduates from five state universities in Sri Lanka through stratified random sampling, as the study population. Information on socio-demographic factors and cosmetic consumption behaviour of the participants were acquired through a self-administrated structured questionnaire, along with Knowledge, Attitudes and Practices (KAP) relevant for cosmetic usage. The Binary Logistic Regression model was used to determine the significant socio-demographic driving factors on cosmetic usage among the undergraduate community in Sri Lanka at a confidence level of 95%.

Results

Around 96.4% of the study population used one or more cosmetic products (77%) out of which, 75.3% experienced cosmetic related adverse health effects. Skin dryness (24%), acne (21%), allergies (20.5%) and rashes (19.8%), were identified as the most dominant adverse health effects, related to cosmetic usage. Perfumes (65.6%), face cream (63.2%) and body lotion/hand cream (60.6%), were the mostly used cosmetic products. Even though half of the study population exhibited higher levels of good practices during purchase (54.9%) and application (52%) of cosmetics, around 47.5% were characterized with a low level of knowledge on cosmetics. Gender, academic year, knowledge on cosmetics, monthly expenditure on cosmetics, source of recommendation for cosmetics, practices related to purchase and consumption of cosmetics and preference to receive medical care in case of cosmetic related emergency were recognized as significant risk factors (p < 0.05) associated with the incidence of cosmetic related adverse health effects among undergraduate students.

Conclusion

Given the high prevalence of cosmetic related adverse health effects, the health authorities of Sri Lanka should pay more attention towards the wellbeing and responsible cosmetic usage among undergraduates. Designing of effective tools and regulations to monitor the cosmetic market and improving the knowledge on cosmetics are recommended to ensure safe cosmetic usage within the country in general and of adolescent users in particular.

The Effect of Cosmetic Treatment and Gel Laser Therapy on the Improvement of Comedogenic Skin Type

Comedogenic skin care receives little attention compared to the care or treatment of more serious acne manifestations. Traditional therapies may have limited success with potential side effects. Cosmetic care supported by the effect of a biostimulating laser may offer a desirable alternative. The aim of the study was to evaluate the biological effectiveness of combined cosmetic treatment with lasotherapy on comedogenic skin type using noninvasive bioengineering methods. Twelve volunteers with comedogenic skin type underwent a 28-week application of Lasocare Basic 645^® cosmetic gel containing Lactoperoxidase and Lactoferrin in combination with laser therapy (Lasocare^® method). The effect of treatment on skin condition was monitored using noninvasive diagnostic methods. The parameters were the amount of sebum, the pore count, the ultraviolet-induced red fluorescence assessment of comedonic lesions (percentage of the area and quantification of orange-red spots), hydration, transepidermal water loss, and pH. A statistically significant decrease in sebum production was observed on the skin of the treated volunteers, as well as a decrease in porphyrins, indicating the presence of Cutibacterium acnes populating comedones and causing enlarged pores. The balance of epidermal water in the skin was regulated adjusting the acidity of the skin coat in individual zones, which decreased the presence of Cutibacterium acnes. Cosmetic treatment in combination with the Lasocare^® method successfully improved the condition of comedogenic skin. In addition to transient erythema, there were no other adverse effects. The chosen procedure appears to be a suitable and safe alternative to traditional treatment procedures known from dermatological practice.

Comparisons of Four Acne Grading Systems Recommended in China, Korea, and Japan

Introduction

Acne vulgaris is one of the most prevalent skin disorders. The treatment regimen depends on how severe the AV is. The acne grading system is crucial for clinical and research work. The aim of this work was to evaluate intra-grader differences between 5 investigators using Acne Grading System (AGS), the International Improved Grading System (IIGS), the Korean Acne Grading System (KAGS), and the Japanese Acne Grading System (JAGS) to assess acne vulgaris (AV) severity.

Patients and Methods

AV sufferers from dermatological clinics of five hospitals in China were the subject of a prospective cross-sectional study. AGS, IIGS, KAGS and JAGS were utilized by 5 investigators to verify the severity of AV. The correlation between AGS, IIGS, KAGS and JAGS was examined.

Results

A complete of 1107 AV sufferers were enrolled in the study. There were indications that the AGS, IIGS, KAGS and JAGS had sufficient internal consistency. As for the reliability amongst raters, AGS, IIGS, KAGS and JAGS confirmed gorgeous reliability. There were strong correlations amongst AGS, IIGS, KAGS and JAGS (P≤0.01). The interior reliability of investigator 1 one year ago and later after usage of AGS and IIGS was excellent (P≤0.01).

Conclusion

IIGS and AGS exhibited great correlation with KAGS and JAGS and were highly reliable.

Changes in consumers’ awareness and interest in cosmetic products during the pandemic

This research investigates the impact of the COVID-19 pandemic on consumers’ perspectives of beauty and individual cosmetic products. Since the first confirmed case of COVID-19 was announced on December 31st, 2019, the search volumes of Google News have been updated and information on confirmed cases of the disease has been collected. This study used Python 3.7, NodeXL 1.0.1, and Smart PLS 3.0 to analyze consumer awareness of cosmetic products during the pandemic. The results reveal that consumers’ perspectives of beauty are impacted by a pandemic. Global consumers perceive skincare as an important aspect during the pandemic, while the importance of makeup fell after the outbreak. The awareness of skincare and makeup products has changed. The spread of the pandemic (SOP) has a positive impact on skincare products, but a negative impact on makeup products, except for eye makeup products, which was positive. Finally, the SOP was not significant in terms of consumers’ interest in masks. Fifth, interest in masks showed a positive relationship with interest in skincare products, such as cleansing products, while a negative relationship was observed with interest in makeup products. Overall, this study concludes that pandemics certainly have an impact on global consumers’ perspectives. As a pandemic spread, interest in skincare products increases, while interest in makeup products decreases. This study has academic significance in that it investigates the effects of consumption of cosmetic products during the stay-at-home rules. It can be used as standard information for setting marketing strategies in pandemic-like situations in the future.

Precipitating Factors of Acne Vulgaris at Dr. Saiful Anwar Hospital Malang

Background: Acne vulgaris (AV) is an inflammatory disease of the pilosebaceous unit, which often causes stress and disrupts quality of life. Correctly identifying precipitating factors and preventing disease development will holistically increase the effectiveness of acne therapy, enabling better therapeutic outcomes to be achieved. Purpose: The objective of this study is to identify the clinical profile and precipitating factors of AV patients who visited Dr. Saiful Anwar Hospital between 2015 until 2017. Methods: This was a descriptive study, using a retrospective case study approach. The sample data was collected from medical records of AV patients from the period of 2015–2017 who met the following inclusion criteria: new AV cases with a complete medical record including gender, age, and precipitating factors. The dependent variable of this study was new AV patients, while the independent variables were the patient clinical profile and precipitating factors. Results: This study included 930 samples, with the number of female patients significantly higher (75.48%) than the number of males. The highest AV prevalence was found in the 15–24 years age group. The most common precipitating factors in females were hormonal issues, stress, and cosmetics; in males, these were stress, genetics, and dietary factors. Conclusion: The incidence of AV at Dr. Saiful Anwar Hospital mostly occurs in the 15–24 years age group, with varying trigger factors. The most frequent AV trigger factor in female patients was hormonal issues; in males, this was stress.

Rates of skincare product and cosmetic procedure use in patients with acne vulgaris and the effective factors: A multicenter study with 1,755 patients

BACKGROUND

Skincare products and cosmetic procedures are used as an adjunct or complementary to conventional drug therapy for acne vulgaris (AV).

OBJECTIVE

To evaluate the use of skincare products and the frequency of cosmetic procedures in AV treatment.

METHODS

A total of 1,755 patients with AV completed the survey prepared by the researchers and the Cardiff Acne Disability Index (CADI) questionnaire. The clinical findings and the Food and Drug Administration (FDA) severity scores were recorded by the dermatologists.

RESULTS

For AV, 66.7% of the patients stated that they used skincare products and 26.7% had undergone cosmetic procedures. The use of skincare products was statistically significantly higher in women (female: 74.5%, male: 57.7%, p < 0.0001); older people (users: 22 ± 7.6years, non-users: 21.2 ± 5.7 years, p < 0.0001); patients with a higher CADI score (users: 7 ± 3.7, non-users: 6.9 ± 4.3, p = 0.010); FDA severity score 2 and 3 (FDA-1: 58.1%; FDA-2: 72.4%, FDA-3: 73%, FDA-4: 67%, p < 0.0001); long-term disease (users: 57 ± 43 months; non-users: 47.7 ± 42.3 months, p < 0.0001); facial involvement (present: 70.2%, absent: 51.4%, p = 0.017); high income levels (users: 73.5%; non-users: 26.5%, p = 0.001); and graduate or post-graduate degrees (undergraduate≤%62.8, graduate≥%76.8, p < 0.0001). The rate of cosmetic procedures was higher in those with higher CADI scores (users: 7.8 ± 3.8; non-users: 7.1 ± 3.96, p < 0.0001); older patients (users: 22.7 ± 10.7 years; non-users: 21.3 ± 5 years, p < 0.0001); high school (25.6%); and graduate (28.9%) education (p = 0.043), those with lower disease severity (FDA-1: 31.1%; FDA-2: 28.5%, FDA-3: 27.1%, FDA-4: 20.4%, p = 0.022); smokers (smokers: 32.5%; non-smokers: 25.5%, p = 0.020), and those with AV in the family (present: 29.8%; absent: 24.2%, p = 0.009). The patients most frequently used cleansers (85.2%) as cosmetic products, and most commonly underwent skincare treatment (71%) as an interventional procedure. They mostly learned about such products and methods from the Internet, and 33.3% of the participants had undergone procedures performed by non-physicians.

CONCLUSION

The patients generally choose skincare products as a result of their Internet search and sometimes have these procedures performed by non-physicians. Dermatologists should be aware of this situation and inform their patients about appropriate products and procedures.

Potential health risks of metals in skin care products used by Chinese consumers aged 19-29 years

Metal contamination of skin care products that occurs during their production poses potential health risks, which are of increasing concern, to consumers. Here, we collected 570 responses to an online survey to analyze the usage pattern of skin care products across China. Then a total of 30 commonly used skin care products with various prices and applications were purchased. The concentrations of metals (Al, Zn, Cu, Ni, Cr, Pb, Hg, and Cd) and metalloid As, were determined. Next, we improved the frequency calculation method and used the weighted exposure frequency to calculate the dermal absorption dose (DAD). The amounts of Zn, Cr, and Al that were assimilated by the human body via uptake were approximately 2 orders of magnitude greater than those of Pb, Hg, Cd, Ni and metalloid As. In addition, younger consumers were at higher risk of metals exposure than older consumers because of their higher frequency of use of skin care products. Al and Zn posed higher risk to consumers because of its high DAD. There was no significant chronic non-carcinogenic health risk (hazard index < 1) posed by skincare product use.

Relationship between acne and the use of cosmetics: Results of a questionnaire study in 539 Korean individuals

BACKGROUND

Acne vulgaris is one of the most common dermatological diseases, and it is known that various factors are related to triggering this condition in a patient. In particular, although the use of cosmetics is thought to be associated with the onset of a patient developing acne, there are few studies that have been conducted to date on this disease and its related factors.

METHODS

To begin with, a total of 539 patients with acne vulgaris, who visited three dermatologic clinics in Korea, were asked to complete a questionnaire regarding their condition in relation to clinical features and exacerbating factors, including the use of cosmetics. The patients all provided an accurate acne treatment history as well.

RESULTS

Among the respondents, 38.1% of patients who failed treatment answered that the condition of their acne was worsened by the continued use of cosmetics, which was significantly higher than 26.3% of the surveyed treatment-naive patients (P < .05). In this relation, double cleansing (cleansing twice using oil and water-based cleanser) and the number of cosmetics in use were also noted in higher numbers than in the treatment-failure patients. As noted, the liquid-type foundation and concealer were frequently used in this group.

CONCLUSIONS

This study showed the influence of cosmetics, especially in acne patients with a history of treatment failures. These results also show differences according to specific cosmetic types and formulations. Therefore, overall dermatologists should consider advising about cosmetic use to acne patients along with medical treatment options for the patients with acne.

Post-Rhinoplasty Acne, Frequency and Role Players

Introduction

Acne is a common complain among post rhinoplasty patients. While rhinoplasty is done for aesthetic reasons and acne expressively affects the individual’s appearance, we aimed to study its incidence and role players.

Materials and Methods:

A descriptive cross-sectional study was performed on 152 (143 females and 9 males) patients admitted for rhinoplasty during January 2016 to March 2017. Patients were examined by a dermatologist prior to surgery and 7, 30 and 90 days after rhinoplasty using the Global Acne Grading System and responded to a list of questions on the probable risk factors of acne. Psychological status was examined by the perceived stress scale-14 and the Hospital Anxiety and Depression Scale.

Results:

The patients' mean age was 28.9±3.82 yrs. Mild and moderate acne were observed in 21.7% (n=33) of the cases in the preoperative visit. The incidence of mild and moderate acne was 36.1%, 42.8% and 23% after 7, 30 and 90 days of surgery, respectively. One week after rhinoplasty, acne manifested in 14.9% of cases with no history of acne. Mean age significantly differed between those with and without post-surgical acne at all post-surgical visits (P> 0.001 and P=0.001 and P=0.015, respectively). Hospital anxiety and depression and perceived stress levels were significantly higher in patients who presented with acne on the first post-surgical visit compared to those with no acne presentations (P=0.04 and P=0.02, respectively).

Conclusion:

External psychological stress may be the main role player in post-rhinoplasty acne. Consultation or referral of patients to an experienced psychologist is highly recommended for a better outcome and fewer complications.

A Review of Advancement on Influencing Factors of Acne: An Emphasis on Environment Characteristics

Background: Acne vulgaris is known as a commonly-seen skin disease with a considerable impact on the quality of life. At present, there have been a growing number of epidemiological, medical, demographic and sociological researches focusing on various influencing factors in the occurrence of acne. Nevertheless, the correlation between environmental factors and acne has yet to be fully investigated. Objective: To assess the impacts of individual, natural and social environmental factors on acne and to construct a framework for the potential impact of built environment on acne. Methods: A thorough review was conducted into the published social demographical, epidemiological, and environmental studies on acne through PubMed, Google Scholar and Web of Science, with reference made to the relevant literature. Results: The influencing factors in acne are classed into four major categories. The first one includes individual socio-economic and biological factors, for example, gender, age, economic level, heredity, obesity, skin type, menstrual cycle (for females), diet, smoking, cosmetics products, electronic products, sleep quality and psychological factors. The second one includes such natural environmental factors as temperature, humidity, sun exposure, air pollution and chloracne. The third one relates to social environment, including social network and social media. The last one includes built environmental factors, for example, population density, food stores, green spaces, as well as other built environment characteristics for transport. Acne can be affected negatively by family history, overweight, obesity, oily or mixed skin, irregular menstrual cycles, sugary food, greasy food, dairy products, smoking, the improper use of cosmetics, the long-term use of electronics, the poor quality of sleep, stress, high temperature, sun exposure, air pollution, mineral oils and halogenated hydrocarbons. Apart from that, there are also potential links between built environment and acne. Conclusions: It is necessary to determine the correlation between the built environment and acne based on the understanding of the impact of traditional factors (sociology of population and environment) on acne gained by multidisciplinary research teams. Moreover, more empirical studies are required to reveal the specific relationship between built environment and acne.

Systematic review of the epidemiology of acne vulgaris

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.

Adolescents' self perceived acne-related beliefs: from myth to science

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.

The association between stress and acne among female medical students in Jeddah, Saudi Arabia

INTRODUCTION

Although there is widespread acceptance of a relationship between stress and acne, not many studies have been performed to assess this relationship. The objective of this study was to determine the relationship between stress and acne severity.

METHODS

A cross-sectional study was conducted among 144 6th year female medical students 22 to 24 years in age attending the medical faculty at King Abdulaziz University. This study used the global acne grading system (GAGS) to assess acne severity in relation to stress using the Perceived Stress Scale (PSS). The questionnaire also included some confounding factors involved in acne severity.

RESULTS

The results indicated an increase in stress severity strongly correlated with an increase in acne severity, which was statistically significant (p<0.01). Subjects with higher stress scores, determined using the PSS, had higher acne severity when examined and graded using the GAGS.

CONCLUSION

On the basis of this study, it is concluded that stress positively correlates with acne severity.