Self-Esteem, Social Appearance Anxiety and Quality of Life among Adolescents with Acne

Background: Acne is a common dermatological condition affecting adolescents, often leading to psychological issues such as low self-esteem and social appearance anxiety. Understanding the impact of acne on quality of life during adolescence is crucial for developing effective interventions. Objective: To explore the relationship between acne, self-esteem, social appearance anxiety, and quality of life among adolescents, and to identify gender differences and significant predictors of quality of life in this population. Methods: This cross-sectional study employed purposive sampling to recruit 327 adolescents aged 12-19 years from various educational institutions in Islamabad and Rawalpindi. Participants completed the Cardiff Acne Disability Index (CADI), Social Appearance Anxiety Scale (SAAS), Rosenberg Self-Esteem Scale (RSES), and Teenager's Quality of Life Index (T-QoL). Informed consent was obtained directly from participants aged 18 and older, and from guardians for those younger than 18. Data analysis was performed using SPSS version 25, employing Pearson's correlation, t-tests, and linear regression to assess relationships and predictors. Reliability of the scales was confirmed, and psychometric properties were evaluated. Results: Significant correlations were found between acne and social appearance anxiety (r = 0.523, p < 0.01), acne and self-esteem (r = -0.320, p < 0.01), and acne and quality of life (r = 0.566, p < 0.01). Females reported higher self-esteem (M = 27.46, SD = 4.59) compared to males (M = 26.33, SD = 3.50, t(325) = -2.52, p = 0.01). Social appearance anxiety was the most significant predictor of quality of life (β = 0.61, p < 0.01), followed by self-esteem (β = -0.12, p = 0.01). Conclusion: Acne significantly impacts adolescents' psychological well-being, particularly through increased social appearance anxiety and reduced self-esteem. Gender differences highlight the need for tailored interventions. Addressing social appearance anxiety can improve the quality of life for adolescents with acne.