Clinicians Should Consider Lifestyle Factor Changes Over Time in Acne Vulgaris Treatment, Study Reports

Age and medication use may correlate with lifestyle factors among patients with acne vulgaris, according to a study published in the Journal of the European Academy of Dermatology and Venereology.¹

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Background and Methods

Researchers cited numerous prior studies exploring the relationship between acne and diet while simultaneously considering general versus specific medication use. One such study, published in the Journal of the Academy of Nutrition and Dietetics, reported that participants with moderate to severe acne had higher intakes of dietary glycemic index, added sugars, total sugars, milk, saturated fats, and trans fats, while consuming fewer servings of fish compared to those with mild or no acne.²

The present study involved participants aged 12 to 24 who completed surveys covering demographics, diet, mental health, skin quality of life, physical activity, smoking, and medication use, at baseline and after 6 weeks. Recruitment took place from late November 2021 to mid-August 2022 at 3 primary dermatology clinics. Researchers assessed acne severity using the Investigator's Global Assessment (IGA) scale.

Findings

At baseline, the patient sample consisted of 127 individuals with acne and 63 acne-free controls. Individuals with acne were significantly younger (average age of 18.0 years) compared to acne-free controls (average age of 20.1 years). Additionally, a higher proportion of acne-free controls were Non-Hispanic White (92.1%) compared to patients with acne (75.6%).

Medication use was notably higher among individuals with acne, with 72.4% using some form of acne medication compared to 17.5% of acne-free controls. Topical medications were used by 52% of patients with acne, and systemic medication used was reported by 38.6%. In contrast, only 14.3% of acne-free controls used topical medications, and 9.5% used systemic medications.

Among the 61 participants who completed surveys, most individuals with acne reported improvement in their condition. A significant majority (94.4%) of patients with acne received medication at baseline, and most used it daily. Despite this, no worsening of acne was reported over the follow-up period.

In total, 69.4% of patients with acne noted improvement in their condition, and there was a reduction in skin-picking behavior among those who reported improvement.

Researchers also examined lifestyle factors and their correlation with acne severity and improvement, finding that patients with acne had a higher intake of soda and milk and lower fruit juice consumption compared to controls.

Levels of physical activity were higher among younger patients with acne, while emotional health indicators such as stress and depression showed mixed results. Patients with acne reported higher levels of stress and depression, particularly in older age groups.

Over the 6-week follow-up period, researchers observed a decrease in the use of makeup among patients with acne and an increase among controls. They also reported that changes in lifestyle factors such as diet and physical activity were minimal.

Conclusions

Potential limitations of the study, as noted by researchers, include its limited sample size and hindered patient retention.

"This exploratory study indicated that age and medication use may be related to lifestyle factors in acne patients," according to Snyder et al.

Researchers noted that further studies may consider the use of larger sample sizes in order to confirm and validate these findings.

"The current study indicates that combining knowledge of allopathic medications and lifestyle is more likely to provide sufficient evidence on lifestyle relationships," they wrote.

References

1. Snyder AM, Stone CJ, Ufkes N, et al. Lifestyle, medication use, and age considerations with acne vulgaris: a prospective study. August 15, 2024. https://doi.org/10.1002/jvc2.521
2. Burris J, Rietkerk W, Woolf K. Relationships of self-reported dietary factors and perceived acne severity in a cohort of New York young adults. J Acad Nutr Diet. 2014; 114(3): 384–392.