Analysis and Comparison of the Trends in Burden of Acne Vulgaris in China and Worldwide from 1990 to 2021

He Shi,1,* Lin Song,2,* Meng Liu,3,* Xiao Geng,3 Yueming Ding,3 Yuancheng Zhang4 1Department of Dermatology, General Hospital of Northern Theater Command, Shenyang, Liaoning, People’s Republic of China; 2Department of Traditional Chinese Medicine, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, People’s Republic of China; 3Department of Traditional Chinese Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning, People’s Republic of China; 4Department of Burn and Plastic Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuancheng Zhang, Department of Burn and Plastic Surgery, General Hospital of Northern Theater Command, No. 83, Wenhua Road, Shenhe District, Shenyang, Liaoning, 110016, People’s Republic of China, Email [email protected]: Acne vulgaris is a common chronic inflammatory skin disease with substantial psychosocial consequences, primarily affecting adolescents. Despite its global prevalence and significant impact on quality of life, long-term and standardized comparisons of acne burden between China and the rest of the world remain limited. This study aimed to analyze and compare trends in the burden of acne vulgaris in China and worldwide from 1990 to 2021, with a particular focus on sex- and age-specific differences.Methods: Data were extracted from the Global Burden of Disease 2021 study. Incidence, prevalence, and disability-adjusted life years were assessed. Age-standardized rates were calculated, and trends quantified using average annual percentage change and Joinpoint regression.Results: Globally, acne burden increased, with age-standardized incidence rising from 1442.92 to 1645.24 per 100,000. In China, absolute cases declined, but standardized rates increased. Adolescents aged 10– 19 years consistently showed the highest burden, with females more affected. China exhibited earlier and faster increases in standardized rates compared to global trends.Conclusion: The acne burden has increased over the past three decades, especially among adolescents and females, highlighting the need for targeted prevention and management strategies.Keywords: acne vulgaris, disease burden, global burden of disease, age-standardized rates, temporal trends, China