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Rebecca Jane Lasek, MA, PhD; Mary-Margaret Chren, MD

Arch Dermatol. 1998;134:454-458.

Objective  To determine the effects of acne vulgaris on the quality of life of adult dermatology patients.

Design  Cross-sectional and longitudinal questionnaire study.

Patients  Sixty patients with acne vulgaris attending appointments with their dermatologists.

Main Outcome Measures  Findings using Skindex, a validated 29-item instrument to measure the effects of skin disease on patients' quality of life. Results are reported as 3 scale scores (functioning, emotions, and symptoms) and a composite score (average scale score). In addition, dermatologists rated the clinical severity of patients' skin disease, and patients responded to a global question about how they are bothered by acne. Higher Skindex scores indicate greater effects on quality of life.

Results  Patients with acne experienced functioning and emotional effects from their skin disease comparable with those of patients with psoriasis, but experienced fewer symptoms (for patients with acne and psoriasis, respectively, Skindex functioning scores of 14.9 and 22.8 [P=.08]; emotion scores, 39.2 and 38.9 [P=.95]; and symptoms scores, 29.5 and 42.1 [P<.05]). Skindex scores were higher in older patients than in younger patients, and patients aged 40 years or older were less likely to report improvement in their acne after 3 months (43% vs 85%; P<.05). Among patients reporting no improvement in their acne, older patients reported greater effects of their acne on their quality of life. Furthermore, in multivariate analyses, older adults reported more effects of acne on their quality of life than younger adults, even after controlling for sex and acne severity as judged by the dermatologist.

Conclusions  Acne vulgaris significantly affects patients' quality of life. Regardless of the severity of acne, older adults were more affected by their acne.

From the Dermatology Service, Cleveland Veterans Affairs Medical Center, and the Departments of Dermatology and Medicine, University Hospitals of Cleveland and Case Western Reserve University, Cleveland. Dr Chren is now with the San Francisco Veterans Affairs Medical Center, University of California at San Francisco.