A Statistical Analysis of the Epidemiology, Clinical Features and Perceptions of Acne in Middle School Students in Seoul Seongdong Area

Shin, Hyewon; Ko, Joo Yeon; Ro, Young Suck

Abstract

BACKGROUND
Acne is one of the most common dermatologic disorders of adolescence. Despite this, there have been few epidemiological studies conducted in Korea.
OBJECTIVE
The purpose of this study was to evaluate the prevalence, severity, and clinical characteristics of acne. In addition, the perceptions regarding acne causation, exacerbating factors, treatments, and sources of information among middle school students were investigated.
METHODS
In a middle school in Seoul, Korea, 629 students (all girls) in 2004 and 832 students (435 boys and 397 girls) in 2008 were asked to complete a questionnaire about the epidemiology, clinical features, and perceptions of acne.
RESULTS
In 2004, the prevalence of acne was 66.1% for girls and in 2008, the prevalence was 57.9% and 67.8% for boys and girls respectively. The severity of acne was evaluated using the Korean Acne Grading System (KAGS) and the results showed severity rates of 38.2%, 38.2% and 49.1% for grade 1, 21.6%, 15.2% and 16.1% for grade 2, 5.7%, 4.1% and 2.3% for grade 3, 0.3%, 0.2% and 0.3% for grade 4 and 0.3%, 0.2% and 0% for grade 5 for girls in 2004, and for boys and girls in 2008, respectively. In 2008, the prevalence of acne was higher in girls than boys (p=0.004); however, overall KAGS grades were higher in boys than girls (p=0.034). Additionally, an earlier onset of clinical acne was observed in girls (age 12.08) than boys (age 12.78) (p<0.001). The onset of clinical acne tended to be at a younger age in girls with an earlier onset of the first menarche (p<0.01). In both 2004 and 2008, more than 98% of the students reported their first case of acne on the face alone; however, current sites tended to involve the trunk along with the face (p=0.009, p<0.001, respectively). In 2008, the most commonly involved first site for facial acne was the forehead that over 70% of boys and girls had acne on their foreheads. The students thought high stress (64.5%, 42.0%, 51.2%), lack of sleep (33.8%, 35.7%, 40.2%), and lack of cleansing (26.6%, 35.7%, 45.7%) were the most common aggravating factors of acne for the girls in 2004, and for the boys and girls in 2008, respectively. In both 2004 and 2008, only about 10% of all acne patients had any kind of treatment for acne. Additionally, the students responded that they received information about the treatment of acne mostly from the Internet. The survey showed that 'broadcasting' was the most important point to consider when choosing a hospital and 'efficacy' when choosing a treatment option.
CONCLUSION
We evaluated the epidemiological and clinical features of acne in adolescents, and learned that despite the high prevalence of acne among adolescents, only a few had actually had any treatment. Therefore, it is worthwhile to better inform middle school students about acne and the necessity for treatment to reduce acne severity and its impact on those affected.