Acne Vulgaris Amongst Students: Mapping Severity Prevalence, Practices, and Psychological Implications: A Multi-institutional Cross-Sectional Study
DOI:
https://doi.org/10.21649/akemu.v31iSpl2.5709Keywords:
acne vulgaris, self-esteem, psychosocial disorders, observational studyAbstract
Background: Acne vulgaris (AV) not only affects the skin but also precipitates emotional and psychological effects on the self-esteem of individuals.
Objective: To assess the effect of AV on the self-esteem of adolescents, and map treatment practices and severity of AV.
Methods: We conducted an observational cross-sectional study at different educational institutes in Karachi, Pakistan. Data was collected from individuals who had visible acne and were aged 14-25 years. Severity was evaluated using the Leeds classification for AV. Self-esteem was assessed using Rosenberg’s self-esteem scale. We used the Chi-square test to look for significant associations between variables.
Results: We received 374 responses from individuals with AV, out of which 313 (83.7%) individuals had normal self-esteem while only 61 (16.3%) had low self-esteem. Self-esteem was low amongst females when compared to males (18.1% vs. 10.9%, p=0.104), in the age group 20-25 versus the age group 14-19 (17.2% vs. 14.9%, p=0.564), and in individuals with degree 2-3 severity when compared to degree 1 severity (25.4% vs. 14.6%, p=0.171). However, none of these associations were significant. More than half of AV cases were not clinically diagnosed (57.8%). Up to 44.1% of students used home-based remedies, and only 19% used prescribed medications for AV.
Conclusion: Unlike prior literature, AV did not have a significantly negative impact on the self-esteem of individuals in our study.
References
1. Karimkhani C, Dellavalle RP, Coffeng LE, Flohr C, Hay RJ, Langan SM et al. Global skin disease morbidity and mortality: an update from the global burden of disease study 2013. JAMA Dermatol. 2017;153(5):406-12.
2. Morris-Jones R. ABC of Dermatology. 6th ed. Hoboken: John Wiley and Sons Ltd; 2014.
3. Gisondi P, Puig L, Richard MA, Paul C, Nijsten T, Taieb C, et al. Quality of life and stigmatization in people with skin diseases in Europe: A large survey from the 'burden of skin diseases' EADV project. J Eur Acad Dermatol Venereol. 2023;37 (7):6-14.
4. Salman A, Kurt E, Topcuoglu V, Demircay Z. Social anxiety and quality of life in vitiligo and acne patients with facial involvement: a cross-sectional controlled study. Am J Clin Dermatol. 2016;17(3):305-11.
5. Henriksen IO, Ranøyen I, Indredavik MS, Stenseng F. The role of self-esteem in the development of psychiatric problems: a three-year prospective study in a clinical sample of adolescents. Child Adolesc Psychiatry Ment Health. 2017;11(1):68.
6. Singh JA, Siddiqi M, Parameshwar P, Chandra-Mouli V. World Health Organization guidance on ethical considerations in planning and reviewing research studies on sexual and reproductive health in adolescents. J Adolesc Health. 2019;64(4):427-9.
7. Reena Kumari S, Sunil D, Amarjeet S, Amrinder JK. Epidemiological patterns of acne vulgaris among adolescents in North India: A cross-sectional study and brief review of literature. Indian J Pediatr. 2017;18(3):65.
8. Babar O, Mobeen A. Prevalence and Psychological Impact of Acne Vulgaris in Female Undergraduate Medical Students of Rawalpindi and Islamabad, Pakistan. Cureus. 2019;11(9):e5722.
9. Sharma R, Dogra N, Arora M. Psychosocial impact of acne vulgaris on the quality of life among adolescents versus adults. Clin Med (Lond). 2023;23(6):35.
10. Lim TH, Badaruddin NSF, Foo SY, Bujang MA, Muniandy P. Prevalence and psychosocial impact of acne vulgaris among high school and university students in Sarawak, Malaysia. Med J Malaysia. 2022;77(4):446-53.
11. Gallitano SM, Berson DS. How acne bumps cause the blues: the influence of acne vulgaris on self-esteem. Int J Womens Dermatol. 2017;4(1):12-7.
12. Wichstrøm L, von Soest T. Reciprocal relations between body satisfaction and self-esteem: A large 13-year prospective study of adolescents. J Adolesc. 2016;47(1):16-27.
13. O'Brien SC, Lewis JB, Cunliffe WJ, The Leeds revised acne grading system. J Dermatol Treat. 1998;9(4):215-20.
14. Rosenberg M. Society and the adolescent self-image. Princeton University Press; 1965.
15. Sheroze MW, Haider Zaidi SA, Mehmood BB, Khan E, Ali SA, Mazher S, et al. Frequency of skin diseases and associated factors in a tertiary care hospital in Karachi. Pakistan Association of Dermatologists. 2020;30(3):456-60.
16. Dréno B, Tan J, Kang S, Rueda MJ, Torres Lozada V, Bettoli V, et al. How People with Facial Acne Scars are Perceived in Society: an Online Survey. Dermatol Ther (Heidelb). 2016;6(2):207-18.
17. Liu Q, Jiang M, Li S, Yang Y. Social support, resilience, and self-esteem protect against common mental health problems in early adolescence: A nonrecursive analysis from a two-year longitudinal study. Medicine (Baltimore). 2021;100(4):e24334.
18. Masselink M, Van Roekel E, Oldehinkel AJ. Self-esteem in early adolescence as predictor of depressive symptoms in late adolescence and early adulthood: the mediating role of motivational and social factors. J Youth Adolesc. 2018;47(5):932-946.
19. Martinsen KD, Neumer SP, Holen S, Waaktaar T, Sund AM, Kendall PC. Self-reported quality of life and self-esteem in sad and anxious school children. BMC Psychol. 2016;4(1):45.
20. Hosthota A, Bondade S, Basavaraja V. Impact of acne vulgaris on quality of life and self-esteem. Cutis. 2016;98(2):121-4
21. Zhang H, Zhang Z. Genetic Variants Associated with Acne Vulgaris. Int J Gen Med. 2023;16:3843-3856.
22. Zeichner JA, Baldwin HE, Cook-Bolden FE, Eichenfield LF, Fallon-Friedlander S, Rodriguez DA. Emerging Issues in Adult Female Acne. J Clin Aesthet Dermatol. 2017;10(1):37-46.
23. Nandy P, Shrivastava T. Exploring the Multifaceted Impact of Acne on Quality of Life and Well-Being. Cureus. 2024;16(1):e52727.
24. Vilar GN, Santos LA, Sobral Filho JF. Quality of life, self-esteem and psychosocial factors in adolescents with acne vulgaris. An Bras Dermatol. 2015;90(5):622-9.
25. Kaikati J, Zoghaib S, Kechichian E, Stephan F, Helou J, Sleilaty G, et al. The impact of acne treatment on quality of life and self-esteem: A prospective cohort study from Lebanon. Int J Womens Dermatol. 2021;7(4):415-21.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Annals of King Edward Medical University

This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk