Abstract
BackgroundAcne 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.MethodsA 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.ResultsMajority 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.ConclusionsIn 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.
Highlights
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
Participants and data collection A cross-sectional study aimed to investigate the epidemiology of acne presentation, severity and scarring in a Malaysian Chinese population was conducted at Universiti Tunku Abdul Rahman (UTAR), Malaysia, in 2016 and 2018, and in Sunway University, Malaysia, in 2019
Frequent consumption of foods that are commonly consumed during breakfast decreased the risk for acne presentation and higher acne scarring, while periodic consumption of nuts and burgers/fast food decreased the risk for higher acne severity
Summary
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. Acne vulgaris ( acne) is a chronic inflammatory skin disorder with a multifactorial pathogenesis It is the eighth most common skin disease worldwide, with the 2010 Global Burden of Disease Study estimating a global prevalence of acne (for all ages) of 9.38% [1]. Scars, erythema and hyperpigmentation could be present in more severe acne [6] For this reason, acne may be present in a wide variety of clinical forms depending on the type, number, and severity of the predominant lesions, and could be categorised into different severity [7] and scarring [8] grades
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