Acne prevalence, knowledge about acne and psychological morbidity in mid-adolescence: a community-based study

Background Acne vulgaris is a distressing condition that affects the majori ty of adolescents, but its impact on mental health in this age group is poo rly understood. Objectives To determine the prevalence of acne. knowledge about acne and ra tes of help-seeking behaviour in English teenagers. It was hypothesized tha t presence of acne would be associated with higher rates of emotional and b ehavioural difficulties. Methods Three hundred and seventeen pupils (80% response rate) aged 14-16 y ears participated from a comprehensive school in Nottingham. An age-appropr iate. validated measure of emotional well-being, the Strengths and Difficul ties Questionnaire (SDQ), and an Acne Management Questionnaire were used to assess participants' psychological health, level of acne knowledge and hel p-seeking behaviour. Acne severity was by graded by visual facial examinati on using an adaptation of the Leeds Acne Grading Technique. Results There was a prevalence of acne in 50% of the study sample, with 11% of participants having moderate to severe acne (> 20 inflammatory lesions) . Participants with definite acne (12+ lesions) (P < 0.01) and girls (P < 0 .05) had higher levels of emotional and behavioural difficulties. Participa nts with acne were nearly twice as likely as those without acne to score in the abnormal/borderline range of the SDQ (32% vs. 20%: odds ratio 1.86, 95 % confidence interval 1.03-3.34). Knowledge about the causes of acne was lo w (mean 45%), and was unrelated to acne status. Fewer than a third of parti cipants with definite acne had sought help from a doctor. Conclusions Acne is a common disorder in English adolescents and appears to have a considerable impact on emotional health in this age group. Low leve ls of acne knowledge and poor acne management are concerns that could be am enable to a school-based education programme.