A positive history of treatment of acne was significantly associated with moderate acne (n=12, 35.3%) than with mild acne (n=44, 16.6%, P=0.009). Among the students that reported the type of treatment they used for acne, 40.9% used creams containing potent steroids.
Our study revealed a significant association between family history of acne and presence of acne. However, this was no longer significant after the logistic regression. The association of family history of acne with acne has been reported in a previous study 22. The history of acne in the siblings of the students was higher than that for the parents, which may be a result of general increase in acne in the environment or inadequate knowledge of their parent’s medical histories. A history of acne in the mother was found to be high among our students with acne. Ghodsi et al.22 had reported a history of acne in the mother as the most influential family history of acne. Nevertheless, the exact pattern of inheritance has not been defined despite the documented evidence of familial tendency of acne. A previous study had suggested an association of family history of acne with an earlier age of onset of acne and an increased number of acne lesions 27. However, similar associations were not found in our study.
Our study, found that higher BMI was significantly associated with the presence of acne. The finding of increased BMI among adolescents with acne vulgaris has been reported in previous studies 29,30. High BMI is associated with peripheral hyperandrogenism, which may lead to the development of acne 31. The students from private schools had significantly higher BMI than those from public schools. This may explain the higher prevalence of acne in students from private schools found in our study. In south-west Nigeria, Fetuga et al.32 had reported a higher BMI among students from private schools than among students from public schools. In a developing nation like Nigeria, it is generally thought that students in private schools are likely from higher socioeconomic background. Socioeconomic status is an important factor in determining the BMI and dietary habits among Nigerians 32,33. The role of diet in this will require further investigation.
Most of the students had mild acne, whereas a few had moderate acne in our study. Mild acne had been reported as the most common grade of acne in previous community-based studies 9,27,38. However, hospital-based studies reported moderate/severe acne as the predominant grade of acne 39,40. This is expected as moderate/severe acne patients are likely to seek treatment in hospitals. Lesions were seen on forehead, nose, right cheek, left cheek, chin, perioral region, chest, and upper back in our students. Comedones were the most common type of lesions, followed by papules. This finding was similar to those previously reported 6,9. We found no difference as regards sex in the affection of the various parts of the body, unlike the report in Korea by Suh et al.41.
The limitations of this study were the absence of other possible risk factors for acne, such as dietary history of the students, menstrual history, and association of application of greases to hair. In addition, the use of topical steroids by some of the students with acne vulgaris could have altered the pattern and severity of the acne lesions. The prevalence of acne is increasing in sub-Saharan Africa. The association of high BMI with acne vulgaris may contribute to the differences in acne prevalence in developed and developing countries. Diet may play a significant role in this. Further studies are needed to clarify the role of diet in acne vulgaris.
There are no conflicts of interest.
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