Objective: To investigate the influence factors and manifestations between acne and psychological distress in university students, so as to reveal their social and psychological inter-reaction mechanism.
Methods: A survey of 2381 college and university students in was conducted using the professional survey website. Three questionnaires were included. The prevalence and the severity of acne was determined using the Pillsbury classification, the role of stress in acne formation was examined using the Adolescent Self-Rating Life Events Check List (ASLEC), and the psychological state of acne patients was determined using the Hospital Anxiety and Depression Scale (HADS).
Results: A total of 55.4% of university students reported suffering from acne and 19.7% of them were graded as having severe acne. Negative life events were found to exacerbate acne. The most frequently reported negative life event was academic stress or failure, which had a prevalence of 74%. This was followed by criticism or discrimination by others (66%), intra-family conflicts/conflicts with parents (29%) and peer bullying/interpersonal conflicts (26%). Acne-affected groups all had significantly higher HADS-A and HADS-D scores compared with controls (7.31 vs. 4.37, 7.28 vs. 3.85, respectively; P<0.01). The HADS-D score was particularly high in the group with severe acne.
Conclusion: Psychological stress has a negative effect on acne and lead to acne exacerbation. The internal relationship and influence mechanism between acne and psychological distress has been complex and affected by multiple social factors. The students, who suffered from academic and interpersonal pressure, are susceptible population to acne. At the stage of semi-matured, the students tend to sustain more psychological burden from acne. More attention and psychological support from school and society should be offered to the acne-attacked university students.