Global Burden of Acne (1990–2021) and Projections for China's Disease Burden Over the Next 15 Years: A Comprehensive Study Based on Global Burden of Disease Data
Qian Zhang, Peixuan Wu, Chun Yang, Zijie He, Yanyan FengABSTRACT
Background
Acne vulgaris is a common chronic inflammatory skin disease with a significant impact on the global health burden. Although acne vulgaris is more prevalent among adolescents, the incidence of adult acne is gradually increasing, imposing a severe psychological and social burden, particularly on women of reproductive age. China accounts for 18% of the global population, yet previous GBD studies have paid insufficient attention to the evolving burden of acne in the country. With China's Socio‐demographic Index (SDI) rising rapidly, it serves as an ideal case for examining the relationship between socioeconomic transition and disease burden. This study aims to analyze trends in the global burden of acne vulgaris from 1990 to 2021, examine regional, national, age, and gender disparities, assess associations with sociodemographic indicators, and project future trends in China's acne vulgaris burden over the next 15 years. Prior studies have largely been confined to single continents or specific countries, with data typically limited to 2017 or earlier. In contrast, this study spans 204 countries and territories worldwide from 1990 to 2021, significantly expanding both temporal and spatial coverage. It is the first to systematically delineate nonlinear associations within the Socio‐demographic Index (SDI) framework, revealing a distinctive epidemiological curve characterized by an initial decline followed by a subsequent rise. Furthermore, by incorporating projections of China's disease burden over the next 15 years, this research provides robust empirical evidence to inform public health policymaking across the Asia‐Pacific region.
Methods
Using the Global Burden of Disease (GBD) 2021 database, we extracted data on acne vulgaris incidence, prevalence, disability‐adjusted life years (DALYs), and age‐standardized rates from 204 countries and regions worldwide between 1990 and 2021. Trend analysis employed age‐standardized rates, estimated annual percentage change (EAPC), and Bayesian modeling, with socioeconomic factors assessed using the Socio‐Demographic Index (SDI).
Results
In 2021, 239.7 million prevalent cases and 124.3 million incident cases of acne vulgaris were reported globally, accounting for 5.126 million DALYs. The global age‐standardized prevalence, incidence, and DALY rates for acne vulgaris were 3142.5 per 100 000 population (95% uncertainty interval: 2867.0 to 3500.6), 1645.2 (1459.7 to 1878.2), and 67.2 (42.3 to 105.8) per 100 000 population, representing increases of 12.2%, 14%, and 12.3% compared to 1990. In 2021, Germany (5688.4), Portugal (5475.1), and Luxembourg (5323.1) exhibited the highest age‐standardized prevalence rates for acne vulgaris. Over the entire study period, Sudan (25.3), Equatorial Guinea (25.2), Iraq (24.9), and Oman (24.7) recorded the largest increases in age‐standardized point prevalence rates. In 2021, Germany (2723) and Romania (821.7) had the highest and lowest age‐standardized incidence rates, respectively, while Germany (121) and Romania (32.2) had the highest and lowest age‐standardized DALY rates, respectively. Gender differences were pronounced, with women exhibiting higher standardized prevalence, incidence, and DALY rates than men. Among men, the global DALY rate for acne vulgaris increased between ages 15–19 and then declined with age, while for women, this rate also rose between ages 15–19. Regionally, a complex association exists between sociodemographic indices and the age‐standardized DALY rate for acne vulgaris, characterized by an overall plateau followed by a steep upward trajectory. China's burden of acne vulgaris exceeds the global average and is projected to continue rising over the next 15 years.
Conclusion
Acne vulgaris represents a significant global dermatological burden, particularly in high‐SDI regions, among children, and in female populations. Targeted prevention and treatment strategies are needed to mitigate its health impacts.