Acne Is More Common in Preadolescent Girls and Increases With Age

Preadolescent girls are more likely to have acne than boys, and preadolescents with acne are more likely to be obese.

The incidence of acne is higher in preadolescent girls than in boys, and preadolescents with acne are more likely to be obese, according to findings from a study published in Pediatric Dermatology.

Researchers assessed acne incidence in children 7 to 12 years of age and evaluated the relationship between body mass index (BMI) and acne. They used the Rochester Epidemiology Project to identify all residents in Olmsted County, Minnesota, who were initially diagnosed with acne between the ages of 7 and 12 years from January 2, 2010, through December 31, 2018.

For each patient with acne without a preexisting acne-related endocrine disorder, 2 age- and sex-matched (±1 year) control individuals residing in Olmsted County at the time of the patient’s acne diagnosis (index date) were randomly selected.

A total of 643 confirmed acne cases (482 female; 74.2% White) were included. The overall annual age- and sex-adjusted incidence rate for children 7 to 12 years of age combined was 58.0 (95% CI, 53.5-62.5) per 10,000 person-years. Female children had a significantly higher annual incidence compared with male children (89.2 vs 28.2, respectively; P <.001). The annual incidence was significantly increased with age, with incidence rates of 4.3, 24.4, and 144.3 found in children 7 to 8, 9 to 10, and 11 to 12 years of age, respectively.

Increasing understanding of preadolescent acne epidemiology and risk factors may allow earlier intervention and prevent undesirable sequelae.

The median follow-up after an initial acne diagnosis was 4.9 (interquartile range [IQR], 3.1-7.4) years, with a median age at last follow-up of 16.8 (IQR, 14.8-19.4) years.

Before BMI was compared in patients and control individuals, 27 acne patients with a preexisting acne-related endocrine disorder were excluded, and BMI data were available within 8 months of acne diagnosis for 581 patients (73.5% female). The mean (SD) age when BMI was recorded was 11.9 (1.0) years for the 581 patients and 11.7 (1.2) years for the 1162 matched controls. The children with acne had a significantly higher median age- and sex-specific BMI percentile compared with the control group (median [IQR], 75.0 [51.2-91.2] vs 65.0 [36.4-87.4]; P <.001). In addition, 16.7% of children with acne had a BMI in the 95th percentile or higher vs 12.2% of the control individuals (P =.01).

The use of prescription systemic medication increased in groups with higher BMI, with 5.4% use observed in children who were underweight or of normal weight, 8.1% in those who were overweight, and 10.3% in those who were obese. The difference in rates was not significant among the BMI groups (P =.18), although the odds of using prescription systemic medications was significantly associated with a higher BMI (odds ratio, 1.43 per 5 kg/m2 increase in BMI; 95% CI, 1.07-1.92; P =.015).

Study limitations include the retrospective design, and all patients with acne may not have been identified. Also, menarche age was unavailable, some patients may not have visited a physician for acne and subsequently were not included, and residents in Olmsted County, Minnesota, were mostly non-Hispanic White.

“There is a potential association with precocious puberty which should be considered, especially among those presenting under 8 or 9 years old,” stated the researchers. “Increasing understanding of preadolescent acne epidemiology and risk factors may allow earlier intervention and prevent undesirable sequelae.”

References:

Rodriguez Baisi KE, Weaver AL, Shakshouk H, Tollefson MM. Acne incidence in preadolescents and association with increased body mass index: a population-based retrospective cohort study of 643 cases with age- and sex-matched community controls. Pediatr Dermatol. Published online January 3, 2023. doi:10.1111/pde.15223