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Clin Cosmet Investig Dermatol. 2018 May 10;11:245-252. doi: 10.2147/CCID.S158129. eCollection 2018.

The impact of acne and facial post-inflammatory hyperpigmentation on quality of life and self-esteem of newly admitted Nigerian undergraduates.

Author information

1
Dermatology Unit, Department of Internal Medicine, Ladoke Akintola University of Technology, Ogbomoso and LAUTECH Teaching Hospital, Ogbomoso, Nigeria.
2
Dermatology Unit, Department of Medicine, Nnamdi Azikiwe University, Nnewi, Nigeria.
3
Department of Dermatology and Venereology, Obafemi Awolowo University and OAUTHC, Ile-Ife, Nigeria.
4
Department of Internal Medicine, Ladoke Akintola University of Technology, Ogbomoso and LAUTECH Teaching Hospital, Ogbomoso, Nigeria.

Abstract

Background:

Acne and facial post-inflammatory hyperpigmentation are relatively common clinical conditions among adolescents and young adults, and inflict psychosocial injuries on sufferers.

Objective:

To document the psychosocial and self-esteem implications of acne and facial hyperpigmentation on newly admitted undergraduates.

Materials and methods:

A cross-sectional survey was conducted among 200 undergraduates. Demographics and clinical characteristics were obtained and acne was graded using the US Food and Drug Administration 5-category global system of acne classification. Participants completed the Cardiff Acne Disability Index (CADI) and the Rosenberg self-esteem scale (RSES), and data were analyzed using SPSS 20.

Results:

Mean age of acne onset was 16.24 ± 3.32 years. There were 168 (84.0%) cases categorized as almost clear, 24 (12.0%) as mild acne, 4 (2.0%) as moderate acne and 4 (2.0%) as severe acne. Acne with facial hyperpigmentation, compared to acne without hyperpigmentation, was associated with significant level of anxiety in 30 participants (26.5% vs 10.3%, p=0.004) and emotional distress in 40 (35.4% vs 10.3%, p<0.001). Acne severity correlated with total CADI score but not with total RSES score. Quality of life (QoL) was significantly reduced among acne patients with facial hyperpigmentation (1.77±1.62, vs 1.07±1.02, p<0.001) compared to those without hyperpigmentation. Acne and facial hyperpigmentation was associated with social life interference, avoidance of public facilities, poor body image and self-esteem and perception of worse disease. There was no association between gender and QoL but acne was related to a reduction of self-worth. Low self-esteem was present in 1.5%, and severe acne was associated with an occasional feeling of uselessness in the male gender.

Conclusion:

Acne with facial hyperpigmentation induces poorer QoL and self-esteem is impaired only in severe acne. Beyond the medical treatment of acne, dermatologists should routinely assess the QoL and give attention to treatment of facial post-inflammatory hyperpigmentation among people of color.

KEYWORDS:

acne; facial hyperpigmentation; quality of life; self-esteem; undergraduates

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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