Cardiff Acne Disability Index Research Articles

Self-Esteem, Social Appearance Anxiety and Quality of Life among Adolescents with Acne

Background: Acne is a common dermatological condition affecting adolescents, often leading to psychological issues such as low self-esteem and social appearance anxiety. Understanding the impact of acne on quality of life during adolescence is crucial for developing effective interventions. Objective: To explore the relationship between acne, self-esteem, social appearance anxiety, and quality of life among adolescents, and to identify gender differences and significant predictors of quality of life in this population. Methods: This cross-sectional study employed purposive sampling to recruit 327 adolescents aged 12-19 years from various educational institutions in Islamabad and Rawalpindi. Participants completed the Cardiff Acne Disability Index (CADI), Social Appearance Anxiety Scale (SAAS), Rosenberg Self-Esteem Scale (RSES), and Teenager's Quality of Life Index (T-QoL). Informed consent was obtained directly from participants aged 18 and older, and from guardians for those younger than 18. Data analysis was performed using SPSS version 25, employing Pearson's correlation, t-tests, and linear regression to assess relationships and predictors. Reliability of the scales was confirmed, and psychometric properties were evaluated. Results: Significant correlations were found between acne and social appearance anxiety (r = 0.523, p < 0.01), acne and self-esteem (r = -0.320, p < 0.01), and acne and quality of life (r = 0.566, p < 0.01). Females reported higher self-esteem (M = 27.46, SD = 4.59) compared to males (M = 26.33, SD = 3.50, t(325) = -2.52, p = 0.01). Social appearance anxiety was the most significant predictor of quality of life (β = 0.61, p < 0.01), followed by self-esteem (β = -0.12, p = 0.01). Conclusion: Acne significantly impacts adolescents' psychological well-being, particularly through increased social appearance anxiety and reduced self-esteem. Gender differences highlight the need for tailored interventions. Addressing social appearance anxiety can improve the quality of life for adolescents with acne.

Validation and Cultural Adaptation of the Sinhala Translation of the Cardiff Acne Disability Index (CADI).

Quality of life (QoL) is impaired in patients with acne vulgaris. The Cardiff Acne Disability Index (CADI) that assesses QoL of acne patients was initially developed in English and is being currently used widely after being validated in different languages. This study was conducted to validate the CADI in Sinhala, a language used by the majority of Sri Lanka. The CADI was translated into Sinhala, and lingually validated as per published guidelines. This CADI-Sinhala version and the Sinhala version of the Dermatology Life Quality Index (DLQI) were simultaneously administered to 150 Sinhala-speaking young adults with acne. The clinical severity of acne was assessed using the Global Acne Grading System (GAGS). The Cronbach's alpha and Spearman correlation coefficients were used to determine the internal consistency, reliability, and validity of the CADI-Sinhala. Construct validity was examined using a factor analysis. The study included 90% females and their mean age was 23 (SD, 2.5) years. The majority (97.3%) had acne of mild to moderate severity when measured by the GAGS. The CADI-Sinhala Scale showed a Cronbach's alpha coefficient of 0.819 indicating high internal consistency and reliability. The mean item-total correlation coefficient was 0.74 (range, 0.42-0.87) with CADI Q3 having the lowest correlation. CADI Sinhala showed a strong and highly significant correlation with the Sinhala DLQI (Spearman's rho = 0.66; P< 0.001) indicating concurrent validity. The correlation with GAGS was of low intensity, although it was statistically significant (p < 0.01). The CADI-Sinhala is a reliable and valid tool for assessing the QoL of Sinhala-speaking acne patients. This five-item tool will help clinicians to provide holistic treatment through improved understanding of patient's perspectives.

Prevalence of acne and its impact on quality of life and practices regarding self-treatment among medical students

Acne vulgaris is one of the most common skin diseases worldwide and causes great distress to patients. In addition, most acne patients suffer from low self-esteem and social withdrawal. This study aimed to assess the prevalence of acne and its impact on quality of life among medical students. It also evaluates the patterns of self-treatment use. The study population consisted of all medical students from An-Najah National University (ANU) and the hospital. The questionnaire consists of three parts, and the first part consists of questions regarding demographic information. The second part consisted of questions to measure the severity of acne using the acne severity scale as well as the Cardiff Disability Index, which assesses the quality of life concerning acne in medical students. Finally, the third part consisted of questions exploring and assessing acne self-treatment. The mean age of our study sample was 21.3 ± 1.9 years, with a female predominance of 72.3%. The prevalence of acne among medical students was 80.9%, and 36.6% practiced self-medication. Acne was strongly associated with female sex (p < 0.001) and skin type (p = 0.024). Regarding diet, dairy consumption (p = 0.007), sweets (p < 0.001), chocolate (p < 0.001), and oily food (p = 0.006) were all significantly associated with acne. Skin type was strongly associated with the severity of acne (p < 0.001) and the Cardiff acne disability index (p = 0.016). Gender (p = 0.039) was also associated with Cardiff acne disability. A significant correlation was found between the severity of acne and impaired quality of life. The most commonly used topical agent for self-treatment remedies was antibiotics (70.3%). The most commonly used oral agent was isotretinoin (9.4%). A total of 22.7% of the students used herbal products, while 47.7% used home remedies. Acne is prevalent among medical students, with a high percentage of students having different degrees of impairment in their daily lives. As a result, self-medication among acne sufferers is highly common. Awareness of the appropriate use of self-medication should increase among medical students.

Psychological Distress and Its Association with Functional Disability Index Among Acne Patients Attending Dermatology Clinics in the Kuantan Tertiary Hospitals

Introduction: Acne is the most common skin disease among adolescents and has significant psychological distress. Our objective is to assess acne severity, functional disability, and its psychological distress among acne patients. Methods: A cross-sectional study was conducted from November 2021 to May 2022 among 163 acne patients attending Dermatology Clinics in the district of Kuantan, Pahang. The severity of acne was graded using the Comprehensive Acne Severity Scale (CASS). The functional disability index was measured using a Cardiff Acne Disability Index (CADI), while Depression, Anxiety and Stress Scale (DASS-21) questionnaires were used as a screening tool to detect the psychological distress of acne. Data were analysed using a Chi-square test, Fisher’s exact test and multiple logistic regression. Results: The mean age was 23 years, 60.1% were female, 94.5% were Malay, and 68.1% were unemployed. The severity of acne was more prominent in the mild (30.7%) and moderate (28.2%) categories. A total of 20.2%, 11.7%, and 4.9% of the respondents had anxiety, depression, and stress symptoms, respectively. Regarding the respondents’ functional disability, 40.5% had mild impairment, 38.0% had moderate impairment, and 13.5% had severe impairment. Acne severity was found to be significantly associated with the functional disability index (P&lt;0.05). The functional disability index was also found to be significantly associated with depression (p=0.019) and anxiety symptoms (p=0.042). Conclusion: Clinical management of acne patients should include not only pharmacological treatment but also consideration of the disease’s functional disability status and psychological distress.

Females May Have Less Severe Acne, but They Suffer More: A Prospective Cross-Sectional Study on Psychosocial Consequences in 104 Consecutive Polish Acne Patients.

Acne is a common skin condition affecting both adolescents and adults, and it can profoundly impact patients' quality of life and mental well-being. This prospective cross-sectional study aims to explore the differences in psychosocial aspects between male and female acne patients in Poland. A total of 104 consecutive acne patients were included in this study. Clinical severity, patients' quality of life, stigmatization levels, and psychiatric disturbances were evaluated using the following instruments: Investigator Global Assessment (IGA), Dermatology Life Quality Index (DLQI), Cardiff Acne Disability Index (CADI), 6-Item Stigmatization Scale (6-ISS), and Hospital Anxiety and Depression Scale (HADS). This study found that female patients exhibited significantly less severe acne and experienced significantly decreased quality of life and increased levels of stigmatization. Furthermore, anxiety levels among female patients exceeded those observed in their male counterparts. Notably, no disparities in the severity of depression were observed between the two gender groups. Correlations were discerned among all psychosocial parameters in the entire study cohort and in the female subgroup, while such correlations were not uniformly observed among male participants. This study underscores the importance of considering psychosocial aspects and implementing routine measurements in the management of acne to improve patients' well-being.

Quality of Life in Patient with Acne Vulgaris

INTRODUCTION Acne Vulgaris is one of the common skin disease which can impair the quality of life of the individual. This study is done to assess the quality of life in patient with acne using Dermatology life quality index (DLQI) and Cardiff acne disability index (CADI). MATERIAL AND METHODS This was a cross-sectional, questionnaire-based study in 101 patients of acne vulgaris at dermatology and Venerology OPD of Universal College of Medical Science, Bhairahawa, Nepal. The participants were given DLQI and CADI to assess the quality of life. The severity of acne was assessed by simple grading system. RESULTS There was some effect in quality of life in patient with acne but there was no significant relation with severity of acne and quality of life. CONCLUSION Psychological assessment should be done in patient with acne vulgaris as it can have negative effect in quality of life.

The Efficacy of a Herbal Syrup (Containing Plum, Jujube, Yellow Myrobalan, Golden Shower, Tamarind, Honey) in the Treatment of Mild to Moderate Acne Vulgaris: A Triple- Blinded Randomized Clinical Trial

Background: Many patients, chiefly teenagers, seek effective treatment for acne vulgaris. Besides topical treatments, antibiotics, and anti-androgens, herbal treatments have been used against it. Objectives: This study aims to evaluate the effects of an herbal combination based on Prunus domestica L., Tamarindus indica L., Terminalia chebula L., Ziziphus jujube L., and Cassia fistula L. on acne vulgaris. Methods: This randomized, triple-blind, placebo-controlled, two-arm parallel trial was conducted in patients with mild-to-moderate acne vulgaris. Patients were randomized, 55 in each group, to receive either herbal syrup or placebo (10 cc every 8 hours) for 12 weeks and were followed for 4 weeks. The severity of acne and participants’ psychological status was assessed by acne severity index (ASI) and Cardiff acne disability index (CADI), respectively. Results: No significant changes were observed up to the sixth week of treatment in both groups (P ≥ 0.05). From 6 weeks to 12 weeks, the outcomes indicated a significant reduction in the mean number of comedones (P &lt; 0.030), papules (P &lt; 0.045), pustules (P &lt; 0.026), nodules (P &lt; 0.044), and ASI (P &lt; 0.001) in the herbal syrup group compared to the placebo group. Nevertheless, this did not continue after 4 weeks of follow-up (16th week). Conclusions: The herbal syrup could be an alternative treatment in patients with mild to moderate acne vulgaris. Indeed, more clinical trials are needed to confirm its efficacy and safety.

Effect of Acne Vulgaris and its Impact on Quality of Life of Adolescents in Bengaluru

Background and Objective: Acne vulgaris is a chronic condition affecting more than 85% of adolescents and young adults. This study was conducted to assess the prevalence of acne vulgaris and its impact on quality of life (QoL) and to study socio-demographic factors, family history and lifestyle among the selected schools at Jalahalli area in Bengaluru. Materials and Methods: This study was a descriptive cross sectional school based study and 200 subjects were included. Predesigned, questionnaire to assess socio-demographic profile and QoL and symptoms of acne vulgaris were administered to the participants fulfilling inclusion criteria. Data were obtained by using different methods such as Global Acne Grading System (GAGS), Cardiff Acne Disability Index and Children’s Dermatology Life Quality Index/Dermatology Life Quality Index (CDLQI/DLQI) respectively. SPSS 18.0 software was used for data analysis. Results: Findings showed that Acne prevalence was 87% affecting both sexes. Self-reported mild acne was present in 85.1% and moderate severe acne in 14.9% of the adolescents. The mean age of the subjects was 14.78 years, with 52.5% females and 47.5% males. A strong relation was found between the severity of acne and QoL (p&lt;0.001). Heredity was correlated with acne and its severity was significant. Conclusion: Acne affects the QoL of an adolescent, and the impact is proportional to the severity of acne. Severe acne is associated with a greater effect on QoL. Evaluation of QoL in such patients may greatly help in the better management of acne, hence improving their quality of life.&#x0D; Keywords: Acne vulgaris; Adolescent; Quality of life; GAGS; CDLQI; DLQI.

Comparative Efficacy Between Intense Pulsed Light Narrow Spectrum and Broad Spectrum in the Treatment of Post-Acne Erythema (PAE).

Post-acne erythema (PAE) is one of the most common physical sequelae of acne regression, PAE can resolve spontaneously, but in some patients it may last for years. This study aimed to evaluate the efficacy and safety of narrow and broad spectrum filters of intense pulsed light (IPL) for the treatment of PAE. This prospective study evaluated 60 patients with PAE for at least 6 months, assigned equally to three groups: 1st group received narrow-spectrum with vascular filter (530-650 nm and 900-1200 nm), 2nd group received broad-spectrum with (560/590-1200 nm) filters, the appropriate adjustments were made according to patient's skin colour. Every patient received four sessions one month apart. 3rd group is blank control group did not receive any treatment. CAT (CEA (Clinical Erythema Assessment), Area, and Telangiectasia) used to grade clearance of PAE before and after treatment, Investigators Global Assessment (IGA) used to assess the improvement score after the treatment, and Cardiff Acne Disability Index (CADI) used to evaluate the impact of PAE on patients' Quality of Life (QoL). Self-satisfaction scale completed at the follow-up. Adverse events and acne relapse were recorded. A significant decrease of CAT score in vascular group (P<0.05). IGA scale showed significant improvement after vascular treatment. A significant decrease in CADI (P<0.05) after vascular treatment. Patient satisfaction was higher in vascular group than control and blank control groups. Acne relapse observed in control and blank control groups (40% and 15%, respectively).10% of patients showed pigmentation, 15% had blisters after 590 nm treatment. IPL vascular filter (530-650 nm and 900-1200 nm) have efficacy in the treatment of PAE. CADI score, patient satisfaction, and acne relapse were significantly better after vascular narrow spectrum treatment than broad-spectrum treatment.

Effects of acne severity and acne-related quality of life on depressive symptoms among adolescents and young adults: a cross-sectional study in Bangladesh.

Depression is a common mental health disorder and one of the major causes of disability. This study aimed at investigating the relationship of acne severity and acne-related quality of life with depressive symptoms, and the mediating effect of acne-related quality of life in a relationship between acne severity and depressive symptoms. This is a cross-sectional study. Data were collected from acne patients attending a tertiary-level hospital, using a questionnaire that comprised three validated instruments - Investigator's Global Assessment (a single item) scale, Cardiff Acne Disability Index, and Beck Depression Inventory for measuring acne severity, acne-related quality of life, and depressive symptoms, respectively. Logistic regression and linear regression were used to examine the association between acne severity and depressive symptoms and a correlation between the acne-related quality of life and depressive symptoms, respectively. A mediation analysis was also performed to see the mediation effects of acne-related quality of life in a relationship between acne severity and depressive symptoms. A total of 185 acne patients (155 females, 83.8%) with a mean age was 22.55 ± 8.67 years were included in the study. Adolescents and young adults with severe and moderate acne had 6.14-and 2.28 times higher odds of depression compared to their peers with mild acne, respectively. Patients with low levels of acne-related quality of life had a higher level of depressive symptoms (β = 0.42, p < 0.001). The total effect (direct + indirect) was also significant (β = 0.27, 95% CI: 1.29-4.09), implying the effect of acne severity on depression. The present study suggests that acne severity and acne-related quality of life were associated with depressive symptoms among patients with acne vulgaris. The study also indicates that the relationship between acne severity and depressive symptoms might occur through a chain-mediating effect of acne disability in this population.

A study of psychological impact of acne vulgaris on quality of life using CADI &amp; DLQI scoring in patients attending dermatology OPD in tertiary care hospital

Acne Vulgaris is a chronic inflammatory disease with multifactorial etiology. It is one of the leading reasons for visiting a dermatologist. Acne patients undergo considerable amount of psychological impairment as face is socially and psychologically the most important body region. There is no sufficient data available on the Impact of acne on QoL in Indian patients.To Determine the Impact of Acne Vulgaris on Quality of Life using two different scoring systemsi.e.CADI &amp; DLQIIt is a hospital based cross sectional study done at dermatology Opd in tertiary care. It is a one year study from January 2016 to December 2016. 500 diagnosed cases of acne Vulgaris of the age groups 15-30 were studied. Informed written consent and Photographs was obtained from all patients. A complete history, clinical examination, was done in all patients. A baseline ‘global acne grading system’ was being performed. Quality of life in acne vulagaris patients were studied using pre- structured questionnaire of DLQI (Dermatological life quality index) &amp; CADI (Cardiff acne disability index scoring systems).Based on GAGS, 80% of the patients were mild, 19% moderate and remaining 1% had severe grading of acne. Majority of the patients had very large effect on quality of life (76%) on DLQI scoring and medium impact in quality of life (86%. 12.4%) on CADI scoring.The results of the study show that majority had medium &amp; large effect on QoL. Hence the disability caused by acne must be taken into account when individualizing treatment by health professionals and include QoL measurements to provide better care.

The Effectiveness of Pyruvic Acid Peeling in Improving the Quality of Life of Patients with Acne Vulgaris.

Improving the quality of life (QoL) of patients with various chronic diseases has become a challenge and priority of contemporary medicine. The aim of this study was to assess the impact of pyruvic acid peeling on the QoL of patients with acne vulgaris. The study group consisted of 200 young patients (mean age 23.04 ± 4.71) with acne vulgaris of mainly mild or moderate severity. Basic data about the patient were collected using a self-reported questionnaire. The assessment of QoL was carried out using standardized questionnaires: CADI (Cardiff Acne Disability Index), DLQI (Dermatology Life Quality Index), SWLS (Satisfaction With Life Scale), and BDI (Beck Depression Inventory). The cosmetic intervention consisted of chemical peeling with 35% pyruvic acid for acne lesions on the body and included four series repeated at 7-day intervals. This study demonstrated that acne vulgaris impairs the quality of life of young people. There were no significant differences between the severity of acne and the lifestyles of the subjects. The applied cosmetic procedure significantly decreased the severity of the acne and improved the quality of life of the patients.

Translation, Cultural Adaptation and Validation of Cardiff Acne Disability Index in Nepali Language.

Acne causes significant impairment in the quality of life of patients, but clinicians in Nepal lack a simple validated tool to measure the psychological side of acne. We planned to translate and validate Cardiff Acne Disability Index, a five item questionnaire into Nepali language to address this need. A linguistic translation with semantic equivalence to the original English language Cardiff Acne Disability Index was achieved through standard forward and backward translation into Nepali language. All eligible patients were requested to fill the Nepali translated version of both Cardiff Acne Disability Index and Dermatology Life Quality Index questionnaires. Reliability and validity of the newly translated questionnaire were established, based on statistical analyses of factor structure, item correlations and concurrent correlations. This validity study included 94 patients with male: female ratio of 1:3.27 and mean age 21.29 (±3.92) years. Reliability analysis revealed a Cronbach's alpha of .72 and mean inter item correlation coefficient of .337. A single factor was extracted on Principal Component Analysis explaining 48.40% of variance. A strong correlation of Cardiff Acne Disability Index scores to the Dermatology Life quality Index score (rs>.7) indicated good concurrent validity. The newly translated Nepali Cardiff Acne Disability Index is a valid tool to measure the impact of acne in Nepalese patients. This short and simple assessment tool will help clinicians understand the patient's perspective of her acne.

Prevalence and quality of life of secondary school students with acne vulgaris in Riyadh, Saudi Arabia

Background: Acne vulgaris is one of the most common dermal medical conditions that affect adolescents and young adults. The psychosocial impacts of acne appear in terms of social, vocational, and academic performance. This study aimed to determine the self-reported prevalence of acne and its repercussions on the quality of life of high and secondary school pupils in Riyadh region of Saudi Arabia. Methodology: This cross-sectional study was conducted among secondary and high school students in Riyadh, Saudi Arabia. The study was conducted among 901 students from different schools in the Riyadh region who were randomly included using a questionnaire distributed online. The Cardiff Acne Disability Index was used to assess the quality of life of acne students. After collecting the data, MS Excel was used for data entry, cleaning, and coding. SPSS version 23 (SPSS Inc, Chicago, IL, USA) was used for data analysis. Results: The prevalence of acne among students was 57.4 %. According to the Cardiff Acne Disability Index, 19.4 % of patients with acne had a high disability, 40.1 % had a moderate disability, and 40.5 % had a low disability. The index score in this study ranged from 0 (16 patients showed a score of zero with a percentage of 3.1%) to 15 (16 patients showed a score of 15 with a percentage of 3.1%) with a mean score of 6.15 (standard deviation=3.79). Conclusion: This study confirmed the results of previous studies that acne causes quality of life disabilities among school-age students. Our study showed a high prevalence of acne among students with a more significant negative impact than previous studies. Keywords: Acne vulgaris, teens, quality of life, Saudi Arabia

Validation of the Cardiff acne disability index and the impact of educational materials in a Romanian cultural adaptation context.

Acne has a high impact on patients being a chronic, common, and visible skin condition. Knowledge regarding treatment improves outcomes. The Cardiff Acne Disability Index (CADI) is commonly used in clinical practice for quality-of-life assessment. It has been validated in many languages, however, not in Romanian. To validate the Romanian adaptation of the CADI and educational materials for acne patients. A 12-week prospective cross-sectional Web-based study, including 3rd- to 5th-year medical students attending our university was conducted. We obtained permission from the CADI copyright owner and performed the steps of the standardized translation process. The Romanian CADI adaptation was delivered online in a test-retest setup, during which participants were offered acne educational materials and completed a knowledge evaluation questionnaire. A total of 95 complete answers were analyzed. The Romanian CADI adaptation showed good internal consistency, with Cronbach's α= 0.807 in the first application and Cronbach's α= 0.839 in the second. High test-retest reliability was observed, with interclass correlation coefficient ICC=0.987 and Spearman's rank correlation coefficient rs =0.970 for the overall CADI scores between the two administrations. The mean baseline score in the knowledge evaluation questionnaire was 15.52 points (±1.556), with a statistically significant improvement after exposure to the educational material (Z=-7.207, p< 0.001). This material was considered useful or very useful by 78(82.8%) participants. Romanian acne patients can benefit from CADI, a reliable and disease-specific tool for quality-of-life evaluation, together with validated, guideline-aligned educational material in their language.

Influence of Selected Food Product Groups Consumption Frequency on Acne-Related Quality of Life in a National Sample of Polish Female Adolescents.

Acne vulgaris affects over 80% of adolescents, mainly female ones, and may reduce their general quality of life, so its prevention and treatment are becoming necessary, while among the options for acne management, the potential influence of diet is indicated. The aim of the study was to assess the influence of selected food product groups consumption frequency on acne-related quality of life in a national sample of Polish female adolescents. The studied population of 1370 Polish female adolescents was gathered using random quota sampling of secondary schools representative of the whole country. The acne-related quality of life was assessed using the Acne Quality of Life (AQoL) Scale with the calculated Social Quality of Life (SOCQOL) Score, as well as the Acne Disability Questionnaire (ADQ) with the calculated Cardiff Acne Disability Index (CADI). The acne-related food product groups’ consumption frequency was assessed using the Acne-specific Food Frequency Questionnaire (Acne-FFQ). There were no differences in food product consumption between subgroups stratified by the acne-related quality of life (p > 0.05), and there was no correlation between food product consumption and the results of the SOCQOL Score (p > 0.05). For the CADI, positive correlations were indicated for fast foods (p = 0.0450; R = 0.0688), salty snacks (p = 0.0342; R = 0.0727), and chocolate confectionary (p = 0.0147; R = 0.0837), while a negative correlation was indicated for dairy beverages other than milk (p = 0.0414; R = −0.0701). In the studied group of Polish female adolescents, fast foods, salty snacks, and chocolate confectionary were indicated as potential acne-promoting factors, while dairy beverages other than milk were indicated as a potential acne-protective factor.

Montelukast as an effective adjuvant in the treatment of moderate acne vulgaris.

Although antibiotics are among the most commonly used treatments of acne, there are refractory cases, or they can cause some complications. Recently, leukotriene B4 has been found to play a major role in inflammatory acne lesions. This double blind, randomized clinical trial was conducted on 108 patients with acne who needed systemic therapy and referred to dermatology clinics affiliated to Shiraz University of Medical Sciences. One group (53 patients) received 100 mg doxycycline daily plus placebo and the other group (55 patients) received 100 mg daily doxycycline plus 10mg daily montelukast. Both groups also received topical benzoyl peroxide 5% every other night. The study period was 3 months and the patients were investigated by lesion count, investigator global assessment (IGA), global acne grading system (GAGS), and Cardiff acne disability index (CADI) scoring systems. Total lesion count, inflammatory lesion count, and non-inflammatory lesion count as well as IGA and GAGS decreased in both treatment groups. At the end of the study, however, the inflammatory lesion count and IGA score reduced more significantly in the montelukast group (p=0.018 and 0.045, respectively). In addition, the two groups were significantly different with regard to the percentage of decrease in the total lesion count, inflammatory lesions, and IGA (p=0.033, 0.003, and 0.044, respectively). Thus, montelukast can be used as an adjuvant therapy besides other treatments of acne, especially for inflammatory lesions.

Association between Nutritional Behaviours and Acne-Related Quality of Life in a Population of Polish Male Adolescents.

Acne vulgaris is diagnosed in the majority of adolescents, decreasing their quality of life, while the diet may influence its aetiology in a gender-dependent manner. The aim of the study was to analyse associations between nutritional behaviours and acne-related quality of life in a population of Polish male adolescents. The study was conducted on a population of Polish secondary school adolescents (a studied sample of 925 adolescents), while the random quota sampling procedure of secondary schools was applied. To assess acne-related quality of life, the Acne Quality of Life (AQoL) Scale and Acne Disability Questionnaire (ADQ) were applied, while the Social Quality of Life (SOCQOL) Score and Cardiff Acne Disability Index (CADI) were calculated. To assess the diet, an Acne-specific Food Frequency Questionnaire (Acne-FFQ) was applied. Neither for the ADQ results, nor for the CADI calculated on the basis of ADQ, was there an association with dietary intake (p > 0.05). The results of the SOCQOL Score (calculated on the basis of AQoL) were positively correlated with the intake of fish (p = 0.0085; R = 0.1144), salty snacks (p = 0.0495; R = 0.0854), and non-chocolate confectionary (p = 0.0078; R = 0.1156). In a group of respondents declaring any acne-related quality of life problems in AQoL, while compared with those declaring no such problems, higher intakes of dairy beverages other than milk (p = 0.0063), white bread (p < 0.0001), other white cereal products (p < 0.0001), fast foods (p = 0.0006), salty snacks (p < 0.0001), chocolate confectionary (p < 0.0001), and other confectionary (p < 0.0001), but lower intake of wholegrain bread (p = 0.0084) were observed. It may be concluded that acne-related quality of life is associated with dietary intake in a population of Polish male adolescents. In the studied population, the most prominent influencing factors were salty snacks and non-chocolate confectionary, with both of them having a proacnegenic effect.

Therapeutic evaluation of herbal formulation in acne vulgaris and its influence on quality of life—A single-arm clinical trial

IntroductionAcne vulgaris is a disease of the pilosebaceous unit that primarily affects teenagers and young adults. It relates to significant psychological morbidity and, on rare occasions, fatality due to suicidal tendencies. Though Unani medicines have been used to treat it for millennia, scientific investigations and evidence-based literature are rare. Thus, the purpose of this study was to determine the efficacy of the herbal formulation Ṭilā-i Muhāsa consisting of Azadirachta indica A. Juss., Albizia lebbeck L., and Iris ensata Thunb. in treating acne vulgaris as well as the influence on patients’ quality of life. MethodsIn this clinical trial, 31 clinically diagnosed patients with acne vulgaris received Ṭilā-i Muhāsa to be applied on the afflicted site every night and washed off with normal water after 20–30 min, of whom 30 completed the protocol therapy. The primary outcome measures were changes in subjective parameters such as comedones, papules, pustules, erythema, and itching, assessed on a 4-point grading scale, and change in investigator’s global assessment (IGA) for overall disease severity, at baseline, 7th, 14th, and 21st days. The secondary outcome measure was change in quality of life (QoL), assessed on the Cardiff acne disability index (CADI). ResultsThe per-protocol analysis of subjective parameters revealed statistically significant improvement in comedones, papules, pustules, erythema, nodules, and itching. Additionally, statistically significant improvements in IGA and QoL were also detected. ConclusionThe findings of the present study indicated that topical use of Ṭilā-i Muhāsa is an effective and well-tolerated therapeutic option for patients with moderate to severe acne vulgaris.

Intense Pulsed Light Therapy Improves Acne-Induced Post-inflammatory Erythema and Hyperpigmentation: A Retrospective Study in Chinese Patients.

IntroductionPost-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH) are the most common acne-related sequelae with no effective treatments. By combining different cut-off filters, intense pulsed light (IPL) therapy can effectively treat these conditions with few side effects. While the safety and effectiveness of IPL for treating post-burn hyperpigmentation is well known, there is little evidence for its benefits for acne-related PIH. In this article, we evaluate the efficacy and safety of IPL for the treatment of acne-related PIE and PIH.MethodsThis retrospective study evaluated 60 patients with more than 6 months of PIE and PIH treated by the same IPL device and similar protocols. The treatment included three to seven sessions at 4–6-week intervals, and three cut-off filters (640 nm, 590 nm and 560 nm) were used sequentially in each session. Using the Global Aesthetic Improvement Scale (GAIS), Cardiff Acne Disability Index (CADI), and Erythema Assessment Scale (EAS), patients were evaluated on the basis of their facial photographs. The facial brown spots and red areas were visualised and analysed using the VISIA-CR system. Six months after the last treatment, the patients were assessed for acne relapse or any side effects.Please check and confirm that the authors and their respective affiliations have been correctly processed and amend if necessary.Checked and confirmed. No further corrections.ResultsOn the basis of the GAIS, 49 of 60 patients (81.7%) showed complete or partial clearance of erythema and hyperpigmentation. The CADI and EAS scores showed significant improvement (p < 0.01) after IPL treatment compared with pre-treatment. A significant reduction (p < 0.01) in the facial brown spots and red areas was seen after IPL treatment. While no long-term side effects were reported, seven patients (11.7%) experienced acne relapse at follow-up.ConclusionIPL is an effective and safe treatment for acne-related PIE and PIH.