Quality of life and acne in Scottish adolescent schoolchildren: use of the Children's Dermatology Life Quality Index© (CDLQI) and the Cardiff Acne Disability Index© (CADI)


*Corresponding author, tel. +1382 660111; fax +1382 633925; E-mail: nwalker@doctors.org.uk


Background  Acne vulgaris is known to adversely affect all aspects of quality of life. However, although acne is thought to occur in the majority of adolescents, there are few data currently available on the impact of acne in this age group.

Objectives  Measurement of the impairment of health-related quality of life (HRQoL) in teenage Scottish schoolchildren in a comparative study using two HRQoL questionnaires. A secondary objective was to collect data on the use and perceived efficacy of medical and over-the-counter (OTC) preparations.

Study design  An anonymous cross-sectional survey of 200 adolescent (15–18 years) Dundee schoolchildren was conducted by means of two self-reported questionnaires: the Children's Dermatology Life Quality Index© (CDLQI) and the Cardiff Acne Disability Index© (CADI). Data on demographics and therapeutic modalities and their perceived efficacy were also collected.

Analysis  Statistical analysis was performed using the package Stata 7.0.

Results  Self-reported acne was present in 83% of teenagers (147/178), with similar sex distribution (54% male, 46% female). The overall mean CDLQI score (max. 30) was low 1.7 {6% impairment} (CI −1 to 0), range 0–19. Nine pupils scored between 5 and 9 {17–30% impairment} suggesting moderate HRQoL impairment and three scored > 10 {> 33% impairment} indicating severe impairment. The overall mean CADI score (max. 15) of 1.9 {13% impairment}, CI 0 to 1 (range 0–15) was also low, but 12 pupils scored between 5 and 9 {33–60% impairment}, one scoring 10 + {> 67% impairment} and one scoring the maximum, 15 {100% impairment}. There was no significant difference in mean scores between the sexes in either questionnaire (P = 0.5). There was good correlation between the results from the two questionnaires (Spearman's rho = 0.62). Three-quarters (75%) had used OTC products, of which only a third (33%) felt they helped ‘a lot’. Fifteen per cent were receiving prescribed treatment from their doctors of which 66% found it helpful.

Conclusions  Self-reported acne occurred in 83% (147/178) of the Scottish teenagers involved in this study, which confirms previous reports of a high prevalence of acne in teenagers. Cross-validation of the CLDQI and CADI demonstrated good correlation and both scales were easy to administer and identified 11% (16/147) of teenagers who perceive their lives to be significantly affected by their acne (8% moderately to severely, 3% severely). It is important to identify and treat such teenagers early to reduce the future socio-economic burden of their acne.