Assessment of Skin Care Behavior and Cognition of Patients with Acne Vulgaris in China
Acne vulgaris (AV) is a prevalent skin condition, particularly among adolescents, with varying incidences worldwide. It significantly impacts patients’ facial appearance, psychological well-being, social interactions, and overall quality of life. This study aimed to investigate the skin care behavior and cognition of AV patients in China, focusing on their understanding of predisposing factors, treatment methods, and the impact of AV on their daily lives.
The study was conducted from June 1 to June 30, 2020, involving 654 AV patients from outpatient departments of four hospitals: Shanghai Renji Hospital, Shanghai Ninth People’s Hospital, Shanghai Skin Disease Hospital, and China-Japan Friendship Hospital. Additionally, 465 students with AV were enrolled from four universities: Chongqing Medical University, Xi’an Jiaotong University, East China University of Science and Technology, and China-Japan Friendship School of Clinical Medicine. All participants provided written informed consent and completed an anonymous electronic questionnaire, resulting in 1119 validated responses for analysis.
The prevalence of AV among adolescents ranges from approximately 40% to 90%, with an increasing number of adults also affected. Women are more frequently affected than men. Among the 1119 participants, 798 (71.31%) were female, and 321 (28.69%) were male. The participants’ ages ranged from 11 to 69 years, with a mean age of 28.32 ± 7.96 years. The characteristics of AV patients in different age groups are detailed in Supplementary Table 1.
AV lesions typically appear on the face, negatively affecting patients’ self-esteem, mood, and quality of life. In this study, AV was found to have adverse effects on patients’ appearance (78.11%), emotions (70.15%), social interactions (39.86%), job/study performance (31.46%), love life (26.9%), and self-confidence (4.38%). The severity of AV among participants was categorized as mild (32.62%), moderate (52.46%), and severe (14.92%). The duration of AV varied: ≤6 months (28.51%), 6–12 months (13.76%), 1–3 years (17.52%), and ≥3 years (40.21%). Despite the high prevalence and severity of AV, only 64.25% of patients sought treatment from professional dermatologists, with 58.80% using topical medications and 37.27% using oral medications. Notably, 69.97% of patients reported squeezing pimples with their hands.
Participants’ skin types were categorized into five groups: oily (37.27%), combination (44.41%), neutral (10.28%), dry (4.02%), and sensitive (4.02%). Previous studies have shown a significant association between skin types and AV, and this study confirmed a significant association between skin type and the severity of AV (P = 0.04). A majority of patients believed that skin care products (59.16%) and dermocosmetics (71.85%) could improve AV. Commonly used products included cleansers (75.87%) and moisturizers (53.44%), while only 25.56% used sunscreen, and 9.29% did not use any products. No significant association was found between the severity of AV and the use of cosmetics (P > 0.05).
AV patients obtained recommendations for dermocosmetics from various sources, including friends (37.89%), doctors (31.81%), and the internet (30.29%). Knowledge about AV care was primarily acquired from doctors (69.17%), followed by brand officials (45.13%), Sina Weibo or Little Red Book (26.90%), Zhihu (24.31%), and TikTok/Kuaishou (17.61%). These findings suggest that social media platforms could be effective channels for healthcare providers to disseminate AV-related knowledge and care skills.
The study also assessed patients’ cognition of AV. Approximately 39.50% of patients believed that AV would disappear naturally after adolescence. Patients were concerned about disease recurrence (66.76%), large pores (60.68%), red spots/pigmentation/atrophic scars (55.50%), and oily skin (40.39%). Predisposing factors acknowledged by participants included familial inheritance (9.65%) and environmental factors such as staying up late/sleeplessness (79.98%), incorrect skin care methods (53.80%), mood (48.44%), diet (33.15%), ultraviolet light (10.01%), and air quality (7.33%). The low recognition of air quality as a predisposing factor suggests the need for further research on the association between AV and air pollution.
The COVID-19 pandemic necessitated extended periods of mask-wearing, which has been linked to increased AV flare-ups due to higher temperatures and humidity on the facial skin. In this study, 73.28% of patients believed that prolonged mask-wearing exacerbated the severity of AV. Recommendations for AV patients included: (1) wiping the face with a wet towel containing moisturizing ingredients; (2) using cleansing products and emollients with oil control ingredients; and (3) consulting dermatologists for topical or oral medications if AV lesions persist or worsen.
In conclusion, this study provides valuable insights into the skin care behavior and cognition of AV patients in China. It highlights the significant impact of AV on patients’ lives, the varying severity and duration of the condition, and the limited proportion of patients seeking professional treatment. The findings underscore the importance of educating patients about effective skin care practices and the potential benefits of dermocosmetics. Additionally, the role of social media in disseminating AV-related knowledge and care skills is emphasized. Future research should explore the association between AV and environmental factors, particularly air pollution, to further enhance understanding and management of this prevalent skin condition.
doi.org/10.1097/CM9.0000000000001397
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