Modifiable and non-modifiable epidemiological risk factors for acne, acne severity and acne scarring among Malaysian Chinese: a cross-sectional study

Abstract

Background Acne vulgaris, a highly prevalent multifactorial inflammatory skin disease, can be categorised into different severity and scarring grades based on the type, number, and severity of lesions. While many epidemiology studies have investigated the risk factors for acne presentation, fewer studies have specifically studied the risk factors for acne severity and scarring. Therefore, this study investigated the prevalence of acne, acne severity and scarring grades, and their associated non-modifiable and modifiable epidemiological risk factors among Malaysian Chinese. Methods A total of 1840 subjects (1117 cases/723 controls) completed an investigator-administered questionnaire as part of a cross-sectional study, which include socio-demographics, familial history, lifestyle factors, dietary habits, and acne history. Acne cases were further evaluated for their severity (n = 1051) and scarring (n = 1052) grades by a trained personnel. Results Majority of the acne cases (up to 69%) had mild acne or Grade 1/2 scarring, while 21.6% had moderate/severe acne and 5.5% had Grade 3/4 scarring. Males had significantly higher risk of presenting with higher grades of acne scarring. Those who had acne, regardless of severity and scarring grades, had strong positive familial history (either in parents and/or sibling). Frequent consumption (most or all days) of foods that are commonly consumed during breakfast (butter, probiotic drinks, cereals and milk) decreased the risk for acne presentation and higher acne scarring, while periodic consumption (once/twice per week) of nuts and burgers/fast food decreased the risk for higher acne severity. Alcohol drinking was significantly associated with increased risk for acne presentation, while paternal, parental and household smoking were associated with reduced risk of more severe acne. Conclusions In conclusion, positive familial history is a strong predisposing factor in influencing acne presentation, severity and scarring. Frequent consumption of foods that are commonly consumed during breakfast is protective against acne presentation.

Role of Certain Diet and Body Mass Index on Severity of Acne

“…The examination of the patients included the face, chest and upper back regions. The acne severity was assessed using Global Acne Grading (GAG) System [(mild (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), moderate (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) was (several comedones, papules, pustules and few to several nodules), severe (31)(32)(33)(34)(35)(36)(37)(38) was (numerous comedons, papules, pustules and many nodules) and very severe >39] (15,16). Statistical analysis: The data was cleaned by removing any invalid or inconsistent responses.…”

Golgin A7 family member B ( GOLGA7B ) is a plausible novel gene associating high glycaemic index diet with acne vulgaris

“…Cross‐sectional studies aimed to investigate the epidemiology of acne presentation, severity and scarring in the Singapore and Malaysia Chinese population were conducted at National University of Singapore (NUS) in 2014, 2015 and 2019, in Universiti Tunku Abdul Rahman (UTAR), Malaysia, in 2016 and 2018, and in Sunway University, Malaysia, in 2019 8,9 . An investigator‐administered questionnaire designed to collect information on demographics, personal and lifestyle habits, medical history, family history, dietary habits, socioeconomic status and acne history was administered to participants.…”

“…An investigator‐administered questionnaire designed to collect information on demographics, personal and lifestyle habits, medical history, family history, dietary habits, socioeconomic status and acne history was administered to participants. Participants were assessed for acne presentation and were classified as acne cases or controls; acne cases were further assessed objectively for severity and scarring grades by a postdoctoral personnel trained by a dermatologist, and a selected subset of the assessment was further validated by the dermatologist 8,9 . Ethical approval was granted from the Institutional Review Board (IRB) of NUS (NUS IRB‐13‐075, NUS IRBH‐18‐036), Scientific and Ethical Review Committee (SERC) of UTAR (Ref.…”

“…Cross-sectional studies aimed to investigate the epidemiology of acne presentation, severity and scarring in the Singapore and Malaysia Chinese population were conducted at National University of Singapore (NUS) in 2014, 2015 and 2019, in Universiti Tunku Abdul Rahman (UTAR), Malaysia, in 2016 and 2018, and in Sunway University, Malaysia, in 2019. 8,9 An investigator-administered questionnaire designed to collect information on demographics, personal and lifestyle habits, medical history, family history, dietary habits, socioeconomic status and acne history was administered to participants. Participants were assessed for acne presentation and were classified as acne cases or controls; acne cases were further assessed objectively for severity and scarring grades by a postdoctoral personnel trained by a dermatologist, and a selected subset of the assessment was further validated by the dermatologist.…”

Diet and acne: A systematic review

“…Overall, 17.9% (5/28) of the observational studies exclusively assessed the association between GI/ glycemic load and acne (Table I). [19][20][21][22][23] Overall, 35.7% (10/28) exclusively commented on the association between dairy and acne (Table II), [24][25][26][27][28][29][30][31][32][33] and 46.4% (13/28) described the associations of dairy products and GI/glycemic load with acne (Table III). [34][35][36][37][38][39][40][41][42][43][44][45][46] All the interventional trials included examined the effect of GI/glycemic load on acne (Table IV).…”