Risk Factors and Epidemiology of Acne Severity and Acne Scar Development: A Comprehensive Clinical Study.

INTRODUCTION

Acne vulgaris, affecting around 9.4% of the global population, is a common disorder of the pilosebaceous unit. Approximately 95% of affected individuals develop some degree of scarring, which, along with active acne, contributes significantly to psychosocial morbidity.

OBJECTIVES

This study aimed to evaluate the factors influencing acne severity, the development of acne scars, and the severity of scarring in patients with acne vulgaris.

METHODS

A cross-sectional study was conducted between May and November 2024 at the dermatology outpatient clinic of Ordu University, Turkey. Demographic data, characteristics of acne lesions, treatment history, and various potential risk factors for acne and scarring were recorded. Acne severity and scar severity were evaluated using standardized grading systems.

RESULTS

A total of 269 patients (175 females, 94 males) were included, with acne scars observed in 71.3%. Younger age, earlier, and adolescent-onset acne were significantly associated with greater acne severity and scarring. Male sex and severe acne further increased the risk and severity of scars. Patients with scarring reported higher emotional stress. Post-lesional hyperpigmentation and erythema predicted more severe scarring. Prior use of topical agents and systemic antibiotics was linked to increased scar risk, while systemic isotretinoin had a protective effect.

CONCLUSIONS

Early identification of risk factors and timely intervention may help reduce the burden of acne scarring and improve patients' quality of life. Recognizing predictors of acne severity and scarring can guide clinicians in implementing preventive strategies and optimizing long-term outcomes.