Disease perception, treatment-seeking behaviour and psychosocial impact of acne vulgaris among university students - A cross-sectional study.

Abstract

Introduction: Acne is a common chronic inflammatory disease. Misconceptions hinder effective management. This study aimed to explore disease perception, treatment-seeking behaviour and the psychosocial impact of acne.

Methods: A cross-sectional study was conducted in four universities. A self-administered questionnaire was developed and validated. During clinical examination, acne severity was determined using the Comprehensive Acne Severity Scale (CASS) and psychosocial impact using the Cardiff Acne Disability Index (CADI).

Results: Four hundred students with acne aged 20±1.62 years participated, among whom 62.5% were women. The self-perceived acne severity matched the CASS score in 54.4% of the participants but was worse in 37.5%. Approximately 80.5% correctly recognised acne as a disease, while beliefs about its chronicity varied. The aggravating factors were food (92.8%), genetic predisposition (92.8%), stress (91.3%), hygiene (86.3%) and menstruation (84.8%). The information sources were families (79.7%), online social media platforms (60.2%) and friends (58.5%). Doctor consultation was significantly associated with correct disease perception, severe disease and higher psychosocial impact. Cost was the commonest deterrent for seeking (63.8%) and discontinuing treatment (43.2%). The psychosocial impact was predominantly mild (71%). The CADI domains mostly affected were feelings and psychological state. The clinical (odd ratio [OR] =2.29, 95% confidence interval [CI] = 1.45, 3.61) and self-perceived acne severity (OR=4.83, 95% CI=2.79, 8.35) predicted a higher psychosocial impact.

Conclusion: Misconceptions about acne as a disease were not prevalent, and aggravating factors other than food were correctly identified. Common information sources may further perpetuate misconceptions. Financial treatment barriers should be addressed especially in patients with severe acne and psychosocial impacts.