Acne Vulgaris Amongst Students: Mapping Severity Prevalence, Practices, and Psychological Implications: A Multi-institutional Cross-Sectional Study

Background: Acne vulgaris (AV) not only affects the skin but also precipitates emotional and psychological effects on the self-esteem of individuals. Objective: To assess the effect of AV on the self-esteem of adolescents, and map treatment practices and severity of AV. Methods: We conducted an observational cross-sectional study at different educational institutes in Karachi, Pakistan. Data was collected from individuals who had visible acne and were aged 14-25 years. Severity was evaluated using the Leeds classification for AV. Self-esteem was assessed using Rosenberg’s self-esteem scale. We used the Chi-square test to look for significant associations between variables. Results: We received 374 responses from individuals with AV, out of which 313 (83.7%) individuals had normal self-esteem while only 61 (16.3%) had low self-esteem. Self-esteem was low amongst females when compared to males (18.1% vs. 10.9%, p=0.104), in the age group 20-25 versus the age group 14-19 (17.2% vs. 14.9%, p=0.564), and in individuals with degree 2-3 severity when compared to degree 1 severity (25.4% vs. 14.6%, p=0.171). However, none of these associations were significant. More than half of AV cases were not clinically diagnosed (57.8%). Up to 44.1% of students used home-based remedies, and only 19% used prescribed medications for AV. Conclusion: Unlike prior literature, AV did not have a significantly negative impact on the self-esteem of individuals in our study.