Acne vulgaris: prevalence and clinical forms in adolescents from São Paulo, Brazil

Bagatin, Ediléia; Timpano, Denise Lourenço; Guadanhim, Lilia Ramos dos Santos; Nogueira, Vanessa Mussupapo Andraus; Terzian, Luiz Roberto; Steiner, Denise; Florez, Mercedes

doi:10.1590/abd1806-4841.20142100

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Investigation • An. bras. dermatol. 89 (3) • May-Jun 2014 • https://doi.org/10.1590/abd1806-4841.20142100 copy

Acne vulgaris: prevalence and clinical forms in adolescents from São Paulo, Brazil^* * Work performed at the Department of Dermatology - Federal University of Sao Paulo (UNIFESP) - Sao Paulo (SP), Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

BACKGROUND:

Acne is a common disease in adolescents, but there are no epidemiological data for acne in Brazil.

OBJECTIVES:

To estimate the prevalence and degree of acne in adolescents from Sao Paulo and study socio-demographic factors, family history and lifestyle, associated with the disease.

METHODS:

Cross-sectional study with 452 adolescents aged between 10 and 17 (mean=13.3 years), students from elementary and high school, examined by 3 independent evaluators.

RESULTS:

62.4% were female, 85.8% white and 6.4% were aged 14. The prevalence was 96.0% and increased with age - all students over 14 had acne. The most prevalent form of acne was comedonal (61.1%), followed by mild (30.6%) and moderate (7.6%) papular-pustular, which affected mostly the face (97.5%). About half of the adolescents reported family history for acne in mother or father, and 20.6% reported previous treatment for acne. There was a higher chance of presenting non-comedonal acne with increased age (p<0.001). DISCUSSION: The prevalence of acne in adolescents varies widely due to the clinical features and diagnostic methods used. Adolescents whose brothers/sisters had acne (OR=1.7-p=0.027) and those over 13 (OR=8.3-p<0.001), were more likely to have non-comedonal acne.

CONCLUSION:

This study showed high prevalence of acne in adolescents from Sao Paulo, predominantly the comedonal form on the face, with a higher chance of presenting non-comedonal acne with increased age.

Acne vulgaris; Demographic data; Family characteristics; Prevalence; Socioeconomic factors

	No.	%	CI 95%
Affected area
Face	423	97.5	[95.5% ; 98.6%]
Face and trunk	10	2.3	[1.3% , 4.2%]
Trunk	1	0.2	[0.0% ; 1.3%]
Age of onset
≤ 9 years	27	6.2	[4.3% ; 8.9%]
10 years	70	16.2	[13.0% ; 19.9%]
11 years	116	26.7	[22.8% ; 31.1%]
12 years	103	23.7	[20.0% ; 28.0%]
13 years	72	16.6	[13.4% ; 20.4%]
14 - 17 years	36	8.3	[6.1% ; 11.3%]
Don't know	10	2.2	[1.3% ; 4.2%]
Total	434	100

	No.	%	CI 95%
Father's Educational level
Total	452	100
Incomplete Basic Education	26	5.8	[4.0% ; 8.3%]
Basic Education	9	2.0	[1.1% ; 3.7%]
Incomplete High School	5	1.1	[0.5% ; 2.6%]
High School	63	13.9	[11.0% ; 17.4%]
Incomplete College	17	3.8	[2.4% ; 5.9%]
College	284	62.8	[58.3% ; 67.2%]
Unkown father/ignored	48	10.6	[8.1% ; 13.8%]
Father with acne
No	165	36.5	[32.2% ; 41.0%]
Yes. in adolescence	144	31.9	[27.7% ; 36.3%]
Yes. in adulthood	1	0.2	[0.0% ; 1.2%]
Unkown father/ignored	142	31.4	[27.3% ; 35.8%]
Father with acne scars
No	333	73.6	[69.4% ; 77.5%]
Yes	69	15.3	[12.2% ; 18.9%]
Unkown father/ignored	50	11.1	[8.5% ; 14.3%]
Mother's Educational level
Incomplete Basic Education	25	5.5	[3.8% ; 8.0%]
Basic Education	16	3.5	[2.2% ; 5.7%]
Incomplete High School	6	1.3	[0.6% ; 2.9%]
High School	79	17.5	[14.3% ; 21.2%]
Incomplete College	14	3.1	[1.9% ; 5.1%]
College	284	62.8	[58.3% ; 67.2%]
Unkown mother/ignored	28	6.3	[4.3% ; 8.8%]
Mother with acne
No	189	41.8	[37.4% ; 46.4%]
Yes. in adolescence	165	36.5	[32.2% ; 41.0%]
Yes. in adulthood	7	1.5	[0.8% ; 3.2%]
Unkown mother/ignored	91	20.1	[16.7% ; 24.1%]
Mother with acne scars
No	368	81.4	[77.6% ; 84.7%]
Yes	60	13.3	[10.5% ; 16.7%]
Unkown mother/ignored	24	5.3	[3.6% ; 7.8%]

	Acne Inflammatory	Comedonal	OR	CI 95%	p-value
Gender					0.615
Male	108 (39.9%)	163 (60.1%)	1.108
Female	61 (37.4%)	102 (62.6%)	1.000

Age (Years)					<0.001
10/11	11 (11.7%)	83 (88.3%)	1.000
12	22 (22.4%)	76 (77.6%)	2.184	[0.993 ; 4.802]
13	20 (47.6%)	22 (52.4%)	6.860	[2.865 ; 16.423]
14	23 (47.9%)	25 (52.1%)	6.942	[2.978 ; 16.181]
15	45 (58.4%)	32 (41.6%)	10.611	[4.888 ; 23.036]
16	18 (56.2%)	14 (43.8%)	9.701	[3.790 ; 24.831]
17	30 (69.8%)	13 (30.2%)	17.413	[7.044 ; 43.043]

Skin color					0.912
White	146 (39.4%)	225 (60.6%)	1.000
Black/Brown	15 (36.6%)	26 (63.4%)	0.889	[0.456 ; 1.735]
Yellow	8 (36.4%)	14 (63.6%)	0.881	[0.360 ; 2.151]

Smoking					0.198
No	163 (38.4%)	261 (61.6%)	1.000
Yes	6 (60.0%)	4 (40.0%)	2.402	[0.668 ; 8.640]

Previous Treatment					<0.001
No	118 (34.6%)	223 (65.4%)	1.000
Yes	47 (55.3%)	38 (44.7%)	2.337	[1.443 ; 3.786]

	Acne Inflammatory	Comedonal	OR	CI 95%	p-value
Father's Educational level					0.008
≤ High School	70 (47.6%)	77 (52.4%)	1.726	[1.151 ; 2.588]
College	99 (34.6%)	188 (65.5%)	1.000

Mother's Educational level					0.001
≤ High School	74 (49.7%)	75 (50.3%)	1.973	[1.317 ; 2.958]
College	95 (33.3%)	190 (66.7%)	1.000

Father with acne?					0.052
No	52 (32.5%)	108 (67.5%)	1.000
Yes	89 (42.6%)	120 (57.4%)	1.540	[1.002 ; 2.367]

Mother with acne?					0.085
No	62 (34.1%)	120 (65.9%)	1.000
Yes	93 (42.5%)	126 (57.5%)	1.429	[0.951 ; 2.146]

Sibling with acne?					0.002
No	78 (33.5%)	155 (66.5%)	1.000
Yes	70 (49.3%)	72 (50.7%)	1.932	[1.261 ; 2.961]

Cousin with acne?					0.365
No	85 (37.6%)	141 (62.4%)	1.000
Yes	63 (42.3%)	86 (57.7%)	1.215	[0.797 ; 1.853]

Uncle/Aunt with acne					0.942
No	123 (39.5%)	188 (60.5%)	1.000
Yes	25 (39.1%)	39 (60.9%)	0.980	[0.565 ; 1.700]

	OR Adjusted	p-value <0.001
Age (years)
10/11	1.0
12	2.2	0.061
13	8.3	<0.001
14	7.1	<0.001
15	10.1	<0.001
16	9.4	<0.001
17	17.0	<0.001

Mother's Educational level		0.110
≤ High School	1.5
College	1.0

Siblings with acne?		0.027
No	1.0
Yes	1.7

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E-mail: revista@sbd.org.br

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Acne vulgaris: prevalence and clinical forms in adolescents from São Paulo, Brazil* * Work performed at the Department of Dermatology - Federal University of Sao Paulo (UNIFESP) - Sao Paulo (SP), Brazil.

BACKGROUND:

OBJECTIVES:

METHODS:

RESULTS:

CONCLUSION:

Acne vulgaris: prevalence and clinical forms in adolescents from São Paulo, Brazil^* * Work performed at the Department of Dermatology - Federal University of Sao Paulo (UNIFESP) - Sao Paulo (SP), Brazil.