Acne Vulgaris Burden Rate Increases Globally, Differing by Population-Based Trends

The burden rate of acne vulgaris has increased globally since 1990, except in the United States, Poland, Germany, and New Zealand, according to a study in the British Journal of Dermatology.

For the study, researchers sourced data from the Global Burden of Disease (GBD) Study 2019. The investigators summarized the incidence, prevalence, disability-adjusted life years (DALYs), and corresponding secular trends of acne vulgaris according to sex and age group in 204 countries from 1990 to 2019.

Over the 29-year span, the number of incident cases of acne vulgaris increased by 47.9% globally. In 1990, cases measured 79.7 (95% uncertainty interval [UI], 67.0-91.1) million and rose to 117.4 (95% UI, 103.0-133.7) million by 2019. The age-standardized incidence rate (ASIR) of acne vulgaris increased from 13.5 (95% UI, 11.8-15.4) to 15.9 (95% UI, 13.9, 18.2) per 1000 person-years in the past 30 years, with an average annual percentage change (AAPC) of 0.58 (95% CI, 0.57-0.60).

From 1990 to 2019, the same 29-year span, the number of prevalent cases of acne vulgaris increased from 156.7 (95% UI, 140.2-174.5) million to 231.2 (95% UI 208.2-255.5) million. The AAPC increased in age-standardized prevalence rate (ASPR) by 0.55 (95% CI, 0.53-0.56) from 26.4 (95% UI, 23.8-29.4) in 1990 to 30.7 (95% UI, 27.6-34.0) in 2019 per 1000 person-years.

The ASPR increased significantly in all sociodemographic index (SDI) regions from 1990 to 2019, particularly in the high-middle to low SDI regions. Of the GBD regions, Western Europe, high-income Asia Pacific, and East Asia were in the top 3 regions for the highest ASPR in 2019 (from 41.1 per 1000 persons to 55.8 per 1000 persons).

The ASPR of acne vulgaris increased in 200 of 204 countries and territories from 1990 to 2019, except in the United States, Poland, Germany, and New Zealand.

The ASR of acne vulgaris in women was about 1.3 times the rate in men (34.9 per 1000 persons vs 26.8 per 1000 persons for ASPR in 2019), although the sex difference in ASR has reduced slightly during the past 30 years due to the pronounced upward trend in male patients.

Age-specific prevalent cases of acne vulgaris were increasing steadily from 1990 to 2019 in all SDI regions for most age groups, except in children and young adults in the higher SDI regions.

The study authors noted that they may have underestimated the acne vulgaris burden, owing to the probability of undiagnosed and untreated acne vulgaris in developing countries. Also, the acne vulgaris burden in the GBD study was determined with use of robust mathematical models based on all available data sources, with different origins and qualities, which may lead to deviations from the actual data.

“This study reveals that the overall burden of acne vulgaris is staggering and has continued to increase, together with substantial inequalities in age, sex, geographical location, and socioeconomic status, over the past 3 decades,” the investigators wrote.

Reference

Chen H, Zhang TC, Yin XL, Man JY, Yang XR, Lu M. Magnitude and temporal trend of acne vulgaris burden in 204 countries and territories from 1990 to 2019: an analysis from the Global Burden of Disease Study 2019. Br J Dermatol. Published online November 10, 2021. doi:10.1111/bjd.20882