High Body Mass Index is a Risk Factor for Acne Severity in Adolescents: A Preliminary Report

Acne vulgaris is one of the most common chronic dermatological diseases among adolescents. Recent data indicated that a specific diet may affect the course and appearance of acne. The aim of the study was to analyze the relationship between body mass index (BMI) and acne prevalence and severity. This cross-sectional study was conducted among 143 consecutively recruited adolescents aged between 12 and 18. All participants were physically examined, including measurement of weight and height and type and severity of acne. Acne lesions were evaluated as not present (0), mild (1), moderate (2), and severe (3). The predominant type of acne lesions was used to classify the acne into one of the following subtypes: comedonic acne, papulo-pustular acne, and nodulo-cystic acne. Acne was present in 123 adolescents (86.0%) being more prevalent in teenagers ≥15 years old than in those between 12 and 14 years old (97.1% vs. 76.0%, respectively, P<0.001). The prevalence of acne did not differ significantly between teenagers with different BMI. However, those teenagers who were overweight or obese suffer from the inflammatory type of acne (papulo-pustular or nodulo-cystic) more often compared with underweight, slim, or normal-weight teenagers (P=0.03). The mean BMI value in patients with comedonic acne was significantly lower (mean BMI ± Standard Deviation (SD): 20.0±3.5 kg/m2) when compared with papulo-pustular acne (22.2±3.8 kg/m2, P=0.04) or nodulo-cystic acne (23.9±5.1 kg/m2, P<0.01). The BMI value correlated significantly with the severity of acne (ρ=0.33, P<0.001) and with higher number of skin areas involved with acne (ρ=0.23, P<0.01). Our findings clearly indicate the association between overweight/obesity and acne. Such a relationship has a significant impact on the treatment of patients with acne, as therapy should focus not only on proper selection of medications but also take into account modification of the patient's dietary habits, physical activity, and, if necessary, reduction of body weight.