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Self-Reported Acne Severity, Treatment, and Belief Patterns across Multiple Racial and Ethnic Groups in Adolescent Students


Address correspondence to Alexandra B. Kimball, M.D., M.P.H., Vice Chair, Dermatology, Massachusetts General Hospital, Associate Professor, Harvard Medical School, 50 Staniford Street, Suite 246, Boston, MA 02114, or e-mail:


Abstract:  Acne vulgaris is a common condition among adolescents regardless of age, gender, and race. We compare the frequency, severity, help-seeking behavior, treatment, and beliefs about acne among students based on race, ethnicity, gender, and age. Anonymous surveys were administered to 1,214 students aged 10–19 years of varied gender, race, and ethnicity in public middle and high schools in New Jersey. Results showed the frequency and severity of acne were high (76% and 65%, respectively) and more prevalent in white compared to non-white respondents (RR = 1.13, 95% CI = 1.04–1.24 and RR = 1.22, 95% CI = 1.09–1.37, respectively), and also in older compared to younger ages (RR = 1.24, 95% CI = 1.17–1.32 and RR = 1.43, 95% CI = 1.32–1.55, respectively). The majority of respondents (83%) reported never having seen a physician for their acne; however, those reporting acne of some severity were more likely to have seen a physician compared with those who did not report acne (21% vs. 8%, p < 0.001). Blacks who reported mild or moderate severity of acne were more likely to have seen a health professional compared to white respondents with same the acne severity (RR = 3.63, 95% CI = 2.06–6.37 and RR = 3.06, 95% CI = 2.02–4.65, respectively). Conversely, Hispanic respondents with mild or moderate acne were less likely to have seen a health professional compared to whites with the same acne severity (RR = 0.56, 95% CI = 0.35–0.89 and RR = 0.47, 95% CI = 0.26–0.86, respectively). Beliefs about external factors affecting acne also varied by race and ethnicity. In conclusion, the severity, frequency, and beliefs about acne all play a role in help-seeking behaviors, which vary to a significant extent by race and ethnicity.