Epidemiology and extracutaneous comorbidities of severe acne in adolescence: a U.S. population-based study.

BACKGROUND

Little is known about the epidemiology of severe acne in the U.S.

OBJECTIVE

We sought to study the U.S. prevalence, determinants and comorbidities of severe acne in adolescence.

METHODS

We analysed data from the 2007 National Health Interview Survey, a cross-sectional questionnaire-based study of 9417 children ages 0-17 years. Prevalence of severe acne, demographics and comorbid disorders were determined.

RESULTS

The U.S. prevalence of severe acne was virtually nil in the first decade of life, but increased in a linear fashion from 11 years [1·7% (95% confidence interval (CI) 0·4-3·0%)] to 17 years of age [12·1% (95% CI 7·8-16·5%)] (Rao-Scott Chi-square, P < 0·0001). Severe acne was more common in Whites compared with other racial groups at age 14-15 years (P = 0·0004) and girls at age 11-13 (P = 0·02). Severe acne was associated with a number of comorbid disorders. Sinopulmonary disease included sinus infection (P = 0·0003), sore throat other than strep infection (P = 0·0003), asthma (P = 0·03) and nonasthmatic lung disease (P = 0·03). Upper gastrointestinal comorbidities included reflux/heartburn (P = 0·0003), abdominal pain (P = 0·03), nausea/vomiting (P = 0·0001) and food/digestive allergy (P = 0·01). Psychological comorbidities included depression (P = 0·02), anxiety (P < 0·0001), attention deficit disorder/attention deficit hyperactivity disorder (P = 0·01) and insomnia (P = 0·02).

CONCLUSIONS

In conclusion, severe acne was more prevalent in older age, Whites, female sex and higher socioeconomic status. Future studies are needed to confirm the associations with sinopulmonary, upper gastrointestinal and psychological disorders in adolescents.