Association among presentation, severity, and risk factors of acne vulgaris among Chinese college students: A cross-sectional study

At present, research on acne among Chinese college students is limited, and the risk factors associated with acne remain to be further explored. This study investigated the prevalence and severity of acne among Chinese college students, while also exploring potential risk factor such as tongue manifestation. In total, 1084 participants (476 cases/608 controls; median age = 19 ± 2.075; range 17-30) were surveyed by collecting face and tongue images and questionnaires, which included basic information and acne questionnaires. Acne diagnoses and severity ratings were performed by trained personnel. The overall prevalence of acne was 43.91%, among which the prevalence of male was 51.18% and female acne was 40.59%. The prevalence of acne was significantly different for students from different regions (c2 = 14.095; P = .029). Good social relationships may also be a preventative factor for acne (adjusted odds ratios [OR] = 0.653), and abnormal emotions, such as anxiety and depression, are risk factors for acne (adjusted OR = 1.588). Overweight body mass index as a risk factor for acne (OR = 1.481). Sleep disorders were a risk factor for acne (adjusted OR = 1.351). A significant association between sleep problems and acne remained (adjusted OR = 1.310, 95% confidence intervals: 1.017-1.687, P = .037). The stained tongues (adjusted OR = 1.381) and thick coatings (adjusted OR = 1.526) were significantly associated with acne and were both risk factors. Individuals experiencing digestive issues exhibited a lower likelihood of developing severe acne (adjusted OR = 0.622). Acne is prevalent among young individuals and is associated with distinct risk factors. Risk factors for acne included male sex, sleep issues, negative emotions, tooth-marked tongue, and a thick tongue coating were risk factors for acne presentation, whereas good social relationships and digestive problems served as protective factors. Overweight was a potential risk factor for acne. Male sex and changes in residential region increased the risk of severe acne, while digestive problems served as protective factors.