New study reveals the impact of ‘hidden acne’ on quality of life
- Around 60% of patients with facial acne also have truncal involvement1 however truncal acne is often overlooked in consultations2
- This study, which examined the quality of life of >1300 acne sufferers with either facial acne alone or combined truncal and facial acne, reported that combined truncal and facial acne was associated with a significantly greater impact on quality of life than facial acne alone
- People with combined truncal and facial acne were almost twice as likely to report a ‘very large’ or ‘extremely large’ impact on quality of life*
- For children (aged 13 to <16 years) with combined truncal and facial acne, a significant difference in quality of life was noted in relation to sports, schoolwork/holiday enjoyment and sleep†
- In teenagers and adults (aged ≥16–40 years), a significant impact was reported in relation to daily activities, clothing choice, sport and treatment†
*odds ratio was 1.86 (95% CI 1.10–3.14, p=0.028) in children and 1.61 (95% CI 1.02–2.54, p=0.042) in adults
†significance demonstrated by p<0.05 in individual domains of the Children’s Dermatology Life Quality Index score in children and the Dermatology Life Quality Index score in adolescents and adults. Data not shown in publication.
Lausanne, May 6, 2021 – Results of a study revealing the additional burden of combined facial and truncal acne on patients compared with facial acne alone has been published this month in JAAD International.3
Professor Jerry Tan, co-chair of the burden survey project, said, “While facial acne is readily visible and the primary focus of prior research and treatment, truncal acne is largely hidden and thus neglected.” Indeed, this study shines a spotlight on the additional burden that truncal acne adds to facial acne sufferers, whereas previous quality-of-life studies in patients with only facial acne may have overlooked and underestimated this.
"While facial acne is readily visible and the primary focus of prior research and treatment, truncal acne is largely hidden and thus neglected.”
Professor Jerry Tan
Burden survey project co-chair, Western University, CANADA
The findings highlighted a number of detrimental effects, including the impact on emotional wellbeing of combined truncal and facial acne sufferers in everyday life and social activities. The majority of respondents in both the combined truncal and facial group (86.4%) and the facial-only group (91.5%) reported being self-conscious because of their acne.
Increasing severity of truncal acne was found to increase the adverse impact on health-related quality of life irrespective of the severity of facial acne, highlighting that the impact of truncal acne is much larger than originally thought. This was emphasized by Professor Brigitte Dréno, also a study co-chair: “Assurance and counselling, combined with early treatment of truncal acne, are important to reduce disease-related psychosocial sequelae and increase the efficacy of treatment. In addition, it may prevent the development of scarring.”
"Assurance and counselling, combined with early treatment of truncal acne, are important to reduce disease-related psychosocial sequelae and increase the efficacy of treatment. In addition, it may prevent the development of scarring.”
Professor Brigitte Dréno
Burden survey project co-chair, University of Nantes, FRANCE
The data come from a web-based quantitative survey of 694 people with combined truncal and facial acne and 615 people with facial acne alone in Europe, Canada and the USA. Survey participants included children 13 to <16 years and teenagers and adults ≥16–40 years. Demographic and clinical characteristics were similar between groups.
This study was one of four recently conducted studies investigating the burden of truncal and facial acne and acne scarring on acne sufferers. The goal of this study was to determine to what extent acne location affects health-related quality of life.
This study highlights the need to treat facial and truncal acne with equal importance. Dr Kamel Chaouche, Head of Global Medical Affairs Prescription at Galderma, said, “I believe these findings will be of great value in improving the management of truncal and facial acne. Galderma is proud to have supported the study, as part of our continuing commitment to reducing the burden for acne sufferers and helping doctors to optimize the treatment of truncal and facial acne.”
"I believe these findings will be of great value in improving the management of truncal and facial acne. Galderma is proud to have supported the study, as part of our continuing commitment to reducing burden for acne sufferers and helping doctors to optimize the treatment of truncal and facial acne.”
Doctor Kamel Chaouche
Head of Global Medical Affairs, Prescription, GALDERMA
Acne is a common skin disease that consists of lumps under the skin’s surface (comedones, or blackheads) and inflamed lesions (pustules, or zits/pimples/spots). It is estimated to affect up to 85% of people aged 12–24 years, however, it can also affect a significant proportion of individuals outside this age bracket.4,5 Acne is primarily known to affect the face, although up to 60% of those with facial acne are also affected on their shoulders, chest and back (known as truncal acne).1,6 If acne is not adequately controlled, or if an individual has certain risk factors, it can lead to long-term physical effects including scarring and pigment changes (known as acne sequelae).7
Both active acne and its sequelae can lead to emotional distress, a negative impact on acne sufferers’ school, work and social lives, and poor mental health.7 Although facial acne is well researched and is addressed in clinical management guidelines, some aspects of acne – such as truncal acne, acne sequelae and long-term management – need more attention. As a result, it could be that acne sufferers are not receiving appropriate care and so are suffering an unnecessary burden from their acne.
About the acne burden surveys
Four acne burden surveys were conducted between November 2019 and January 2020, aiming to help us better understand what it means for people to live with acne scarring and combined truncal and facial acne in order to improve patient outcomes. In total across all four surveys, over 2000 adults and adolescents with combined truncal and facial acne, facial acne alone, or acne scarring were recruited as representative samples from general population panels in Brazil, Canada, France, Germany, Italy, the UK and the USA. The surveys consisted of a qualitative phase, based on 60-minute in-depth telephone interviews, and a quantitative phase, in which participants completed an online questionnaire. The quantitative phases also recruited over 900 dermatologists and general practitioners who frequently prescribe therapies for acne – these data are currently under analysis.
The acne burden surveys were funded by Galderma.
Galderma is the world’s largest independent dermatology company, present in approximately 100 countries. Since our inception in 1981, we have been driven by a complete dedication to dermatology. We deliver an innovative, science-based portfolio of sophisticated brands and services across Aesthetics, Consumer Care and Prescription Medicine. Focused on the needs of consumers and patients, we work in partnership with healthcare professionals to ensure superior outcomes. Because we understand that the skin we’re in shapes our life stories, we are advancing dermatology for every skin story. For more information: www.galderma.com.
Head of Franchise Communications
+41 79 771 52 45
Tan J, et al. Prevalence and severity of facial and truncal acne in a referral cohort. J Drugs Dermatol. 2008;7(6):551–6.
Del Rosso JQ, et al. Truncal Acne: A Neglected Entity. J Drugs Dermatol. 2019;18(12):205–1208.
Tan J, et al. Impact of facial and truncal acne on quality of life: A multi-country population-based survey. JAAD Int 2021;3:102–110.
Bhate K, Williams HC. Epidemiology of acne vulgaris. Br J Dermatol 2013;168:474–85.
Hay RJ, et al. The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions. J Invest Dermatol 2014;134:1527–34.
Del Rosso JQ, et al. A closer look at truncal acne vulgaris: prevalence, severity, and clinical significance. J Drugs Dermatol 2007;6:597–600.
Layton AM, et al. Reviewing the global burden of acne: how could we improve care to reduce the burden? Br J Dermatol 2021;184:219–225.