Introduction
Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit characterised by seborrhoea, open and closed comedones, papules, pustules and, in more severe cases, nodules and pseudocysts. It commonly affects the face, upper chest and upper back. Individuals can develop acne throughout their life.
Skin plays an important role in socialisation. Cosmetic disfigurement produces social disapproval and an increase in self-consciousness. It can result in social poor eye contact, academic underachievement and psychosocial disturbances. These patients are more prone to depression and anxiety. Acne can lead to social withdrawal.
Evaluation of acne using clinical assessment alone cannot assess the impact of the disease adequately. Assessment of the impact on health-related quality of life (HRQoL) is important to know the overall disease burden. The aim of following study is to assess such impact in two population groups, adolescents and adults, and then compare among the two groups.
Material and methods
A hospital-based cross-sectional study was undertaken in the dermatology department of Government Medical College, Jammu, over 1 year. A total of 400 acne patients aged ≥13 years were considered after taking informed consent. Patients were divided into two groups: adolescents and adults (≥18 years). Patients suffering from medical disorders, those on topical and systemic drugs known to predispose them to acne or having major psychiatric disorders were excluded from the study. Detailed demographic data was collected and acne grading was done using a simple global acne grading system (GAGS).
The following tools were used for assessment:
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BREF-WHOQOL Scale: to determine the quality of life of patients.
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CADI (Cardiff Acne Disability Index): to assess the psychosocial impact of acne.
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HADS (Hospital Anxiety and Depression Scale):to evaluate the psychological impact of acne.
Statistical analysis was done and p value of less than 0.05 was considered statistically significant.
Results and discussion
Various important findings in the present study were:
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Acne vulgaris in both adolescents and adults had significant impact on quality of life and mental health of patients. Several studies illustrate this phenomenon.1, 2
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There was significant psychological impact in both adults and adolescents. More adolescents had anxiety as compared to adults who had more of depressive symptoms. There was a correlation between acne severity and psychological impact in both adolescents and adults. Another study shows similar findings.3
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Both adolescents and adults experienced psychological impact related specifically to acne, as assessed by the acne specific CADI scale, which correlated to the HADS scale.
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Adolescents and adults who were more educated had more psychological impairment.
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Adult females had more psychological impact.
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There was greater impairment in quality of life in rural dwellers in both adolescents and adults.
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Adolescents and adults with longer duration of acne experienced a greater effect on their mental health.
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Involvement of sites other than face/neck, such as trunk and arms, had a greater effect on quality of life as well as on mental wellbeing in both adolescents and adults. Adolescents with truncal involvement had varying degrees of anxiety. Another study shows similar findings.4
Conclusion
The present study concludes that all acne patients, irrespective of their gender, residence or qualification, have some impact on their psychological status as well as quality of life.
References
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