PS53 Impact of acne vulgaris severity, postinflammatory hyperpigmentation and scarring on peer bullying, school functioning and body appreciation in adolescents: a case–control study

Abstract

Acne vulgaris is a common dermatological condition among adolescents and includes inflammatory and noninflammatory lesions, as well as sequelae such as scarring and postinflammatory hyperpigmentation. While acne is known to be linked to psychosocial burden, not all adolescents are affected in the same way. This study aimed to compare peer bullying, body appreciation and school functioning between adolescents with acne vulgaris and healthy controls. This study also investigated the impacts of disease severity, scarring and postinflammatory hyperpigmentation to identify vulnerable patient subgroups. This multicentre, prospective, case–control study included adolescents aged 13–18 years with acne vulgaris and healthy controls. Investigator’s Global Assessment (IGA), Post-Acne Hyperpigmentation Index and Scale for Acne Scar Severity score were measured. Participants completed the Body Appreciation Scale-2, Pediatric Quality of Life Inventory School Functioning Subscale, Child-Adolescent Bullying Scale, and age-specific Dermatology Life Quality Index (DLQI or Children’s DLQI). Student’s t-tests, χ2-tests and multiple linear regression were performed. The study included 161 patients (111 female, 50 male; mean age 15.9 years, SD 1.5; mean IGA 2.32, SD 0.99) and 161 controls (101 female, 60 male; mean age 15.8 years, SD 1.3). No significant differences were found between groups in bullying, body appreciation or school functioning (P > 0.05). Within the patient group, bullying (β = 0.26, P < 0.001) and acne severity (β = 0.16, P = 0.05) predicted poorer quality of life, whereas body appreciation (β = −0.35, P < 0.001) and active treatment (β = −0.15, P = 0.03) were associated with better quality of life. Impaired quality of life predicted poorer school functioning (β = −0.30, P = 0.001). The overall similarity between the patient and healthy groups might be related to the patients’ mild-to-moderate severity profile and multiple factors influencing body appreciation, school functioning and bullying. However, some subgroups remain vulnerable, and impaired quality of life was found to predict poor school functioning. Future research should focus on populations with severe acne and potentially influencing factors.