Improved Quality of Life in Adolescents With Acne After Educational Initiative

girl with acne cream
girl with acne cream
The researchers theorized that education aimed at adolescents and delivered in a socially normalized group setting would be associated with durable QoL improvements.

Short-term quality-of-life (QoL) improvements have been reported in adolescents who participated in a slide-based educational initiative on skin health and care, according to the results of a prospective, longitudinal cohort survey study conducted in Canada and published in the Journal of the American Academy of Dermatology.1

The investigators developed an educational initiative called Skin Confident (the intervention) and measured its benefits with the use of standardized rating scales. They used the Acne-QoL scale in their analysis, which assesses 4 separate domains: self-perception, social roles, emotional roles, and acne symptoms.2 The researchers theorized that education aimed at adolescents and delivered in a socially normalized group setting would be associated with durable QoL improvements.

In the study, surveys were performed at baseline and 4 weeks postintervention in 2 independent settings (high school and community). The intervention was presented to 5 high school classrooms (57 respondents per survey; 55.3% response rate). A total of 5 Girl Guides of Canada Pathfinders groups participated in the community setting survey (23 respondents; 47.9% response rate). These groups were selected because they were routinely available for the administration of special presentations.

The intervention included a 45-minute standardized slide presentation on skin health, acne, self-esteem, and evidence-based skin care (accessible at The survey encompassed the Acne-QoL scale, self-reported global acne severity, and skin care practices. Acne-QoL domain scores were calculated by totaling the numeric responses for all items within a specific domain.

At baseline, average combined Acne-QoL scores were higher in the high school cohort (37.3±27.2) than in the community cohort (22.6±16.0). In both groups, Acne-QoL scores decreased 4 weeks’ postintervention, which was indicative of an improvement in acne-related QoL (high school cohort: 28.5±24.3; community cohort: 14.8±9.9).

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A postintervention analysis of each of the 4 subdomains demonstrated a statistically significant improvement in the high school and community cohorts with respect to self-perception (P =.003 and P =.005, respectively), emotional roles (P =.0001 and P =.013, respectively), and acne symptoms (P <.0001 and P =.013, respectively). Moreover, a significant improvement in global acne severity assessments was reported 4 weeks after the intervention in the high school group (self-reported moderate to severe acne in 19.3% of participants at baseline and 10.5% of participants postintervention; P =.049). No change in the community group was reported, potentially because of the younger age of the participants and the correspondingly lower prevalence of acne.

Limitations of the current study include delivery in a geographically restricted area with a single presenter as well as the short interval between the preintervention and postintervention evaluations.

The investigators concluded that the standardized format of their intervention renders it amenable to delivery on a larger scale and adaptation among other patient populations.


1. Burleigh A, Yousefi M, Humphrey S. Skin Confident: a skin health and acne educational intervention to improve acne quality of life measures in adolescents [published online July 4, 2018]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2018.06.052

2. Martin AR, Lookingbill DP, Botek A, Light J, Thiboutot D, Girman CJ. Health-related quality of life among patients with facial acne — assessment of a new acne-specific questionnaire. Clin Exp Dermatol. 2001;26(5):380-385.