Abstract
Introduction
Half of the individuals with facial acne develop truncal acne, but the impact of combined facial and truncal acne (CA) on patients’ quality of life is poorly researched.
Methods
A 60-min interview of 30 participants with CA was conducted that formed the basis for a cross-sectional survey of 694 adolescents and adults with CA.
Results
The main themes identified from the qualitative interviews among CA subjects included acceptability to self and others, social functioning and emotional wellbeing. Feelings of embarrassment, self-consciousness and low confidence were experienced often or all the time by over 50% of participants, and were more frequent in those who perceived their acne to be out of control (P = 0.003). Half of patients reported feeling stigmatised because of their CA, and 65.4% believed that others associated their truncal acne with unhealthy or unhygienic habits. Perceived stigma was associated with more feelings of embarrassment (P = 0.005), self-consciousness (P = 0.034) and low self-confidence (P = 0.017). Overall, 64% participants reported that CA interfered with daily life, 46.4% often or always avoided social interaction, 48.6% were often concerned about talking to unfamiliar people and 47.4% were uncomfortable showing affection. Further, 32% and 24.4% participants ≥ 16 years old avoided dating or having romantic/intimate relationships because of their facial and truncal acne, respectively. Social and leisure activities were more frequently negatively impacted among those with perceived uncontrolled CA than among those with controlled CA. Avoiding undressing in front of spouse/partner/friends/relatives was more commonly reported by participants with perceived uncontrolled truncal acne than by those with controlled truncal acne (90.5% versus 80.6%, P = 0.031).
Conclusion
CA is associated with considerable psychological morbidity, with several exacerbating (e.g. perceived stigma) and attenuating factors (e.g. acne being perceived as being under control) that should be accounted for in CA management.
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Details
1 Western University Canada, Schulich School of Medicine and Dentistry, Windsor, Canada
2 University Hospital Carl Gustav Carus, TU Dresden, Department of Dermatology, Dresden, Germany (GRID:grid.412282.f) (ISNI:0000 0001 1091 2917)
3 Mount Sinai Department of Dermatology, New York, New York, USA (GRID:grid.416167.3) (ISNI:0000 0004 0442 1996)
4 Galderma SA, Zug, Switzerland (GRID:grid.419905.0) (ISNI:0000 0001 0066 4948)
5 The Dermatology and Skin Care Center of Birmingham, Vestavia Hills, USA (GRID:grid.419905.0)
6 The University of Texas Medical School-Houston, Houston, USA (GRID:grid.267308.8) (ISNI:0000 0000 9206 2401)
7 Austin Institute for Clinical Research, Pflugerville, USA (GRID:grid.267308.8)
8 Hull York Medical School, Heslington, UK (GRID:grid.413631.2) (ISNI:0000 0000 9468 0801)
9 Federal University of São Paulo, São Paulo, Brazil (GRID:grid.411249.b) (ISNI:0000 0001 0514 7202)
10 Georgia Dermatology Partners, (Formerly, Gwinnett Dermatology, PC), Snellville, USA (GRID:grid.477293.c)
11 CHU Nantes-Place Alexis Ricordeau, Unité Thérapie Cellulaire et Génique, Faculté de Médecine de Nantes, Cedex 01, France (GRID:grid.277151.7) (ISNI:0000 0004 0472 0371)