Acne vulgaris is an extremely common disorder. Prevalence of acne varies among different populations in different studies from 50% [
Few studies are interested in exploring knowledge and experiences of acne patients towards acne [
Treatment of acne is usually postponed that patients may wait more than one year before seeking medical advice [
Psychological and social consequences of acne vulgaris are considerable although it is not causing severe morbidity or physical disability [
This cross-sectional study was conducted to assess knowledge, beliefs, and psychosocial effects of acne among acne vulgaris patients attending dermatology referral clinics, Al-Khobar Governmental Hospital, Al-Khobar, Saudi Arabia.
A cross-sectional study was conducted to assess knowledge, beliefs, and psychosocial effects of acne among acne vulgaris patients attending Al-Khobar Governmental Hospital, Dermatology Referral Clinics, Eastern Province, Saudi Arabia. All acne patients (males and females) attending Al-Khobar Governmental Referral Dermatology Clinic during the period from November 2012 to the end of December 2012 were involved. Data were collected using structured, self-administered questionnaire which was designed after reviewing the recent literature and similar questionnaires and based on the objectives of the study putting in consideration sociocultural backgrounds. The questionnaire was divided into two parts. The first part includes sociodemographic data like age, gender, and marital status. The second part includes questions to assess: (1) knowledge and beliefs about causes and aggravating factors, (2) knowledge and beliefs about treatment, and (3) the perceived psychological effects of acne. Questionnaire was validated and modified in the light of pilot study. The questionnaire was reviewed by 2 faculty, one of whom has Saudi Arabian slang; revised questionnaires were compared and necessary modifications were made before finally approved by the reviewers. The questionnaire was then reviewed by researchers again, one of whom has Saudi Arabian slang before and after pilot study with minor linguistic modifications of some confusing words. The participants were approached in their clinics (male and female dermatology clinics). The questionnaires were distributed and explained to them after obtaining their verbal consent. Questionnaires were collected after being completed. A pilot study was conducted on 38 patients—different from the target group—to check the understanding and clarity of the questionnaire. Based on the results, some linguistic modifications of questions were made to avoid confusion about questions and make easier understanding and interpretation by participants. The data were entered and analyzed in a personal computer using statistical package for social sciences (SPSS) software version 16. Data were presented using descriptive statistics in the form of frequencies and percentages for qualitative variables and mean and standard deviation (SD) for quantitative variables. Chi-square test was used as appropriate to determine association. The level of statistical significance was set to be less than 0.05. The study was approved by the Ethical Committee of Postgraduate Saudi Board Program, Eastern Province. Verbal consent was obtained from the participants after explaining the objectives of the study to them. All questionnaires were anonymous, and collected data were kept confidential and not used except for the study purpose.
In this study, 200 questionnaires were distributed, 180 acne patient completed the questionnaire, and 20 patients were excluded (18 patients of them did not complete the questionnaire and 2 were non-Saudi). Males accounted for 40% of the sample and females were 60%.
Table
Sociodemographic characteristics of study population.
Variable | Frequency (total sample number = 180) | |
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No. | % | |
Age | ||
≤14 years old males | 4 | 2.2% |
≤14 years old females | 15 | 8.4% |
14–21 years old males | 52 | 28.9% |
14–21 years old females | 60 | 33.3% |
>21 years old males | 24 | 13.3% |
>21 years old females | 25 | 13.9% |
Gender | ||
Males | 72 | 40% |
Females | 108 | 60% |
Marital status | ||
Single | 150 | 83.3% |
Married | 28 | 15.5% |
Divorced | 1 | 0.6% |
Widow (er) | 1 | 0.6% |
Education | ||
Illiterate | 5 | 2.8% |
Primary school | 2 | 1.1% |
Intermediate school | 29 | 16.1% |
Secondary school | 95 | 52.8% |
Bachelor or more | 49 | 27.2% |
Occupation | ||
Student | 101 | 56.1% |
Governmental job | 15 | 8.3% |
Nongovernmental | 20 | 11.1% |
Housewife | 16 | 8.9% |
Jobless | 28 | 15.6% |
Income | ||
<5000 Saudi Riyals | 54 | 30% |
5000–10000 Saudi Riyals | 82 | 45.6% |
>10000 Saudi Riyals | 44 | 24.4% |
Knowledge about causes and aggravating factors among acne patients.
Factors | Yes | No | Do not know | |||
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No. | % | No. | % | No. | ||
Inheritance (genetics) | 57 | 31.7 | 81 | 45 | 42 | 23.3 |
Consuming fatty food* | 97 | 53.9 | 53 | 29.4 | 30 | 16.7 |
Consuming chocolate* | 143 | 79.4 | 27 | 15 | 10 | 5.6 |
Consuming spicy food* | 53 | 29.4 | 83 | 46.1 | 44 | 24.4 |
Consuming potato chips* | 97 | 53.9 | 52 | 28.9 | 31 | 17.2 |
Obesity* | 61 | 33.9 | 67 | 37.2 | 52 | 28.9 |
Poor hygiene* | 122 | 67.8 | 37 | 20.6 | 21 | 11.7 |
Tension | 118 | 65.6 | 32 | 17.8 | 30 | 16.7 |
Using cosmetics | 96 | 53.3 | 33 | 18.3 | 51 | 28.3 |
Menses | 98 | 54.4 | 23 | 12.8 | 59 | 32.8 |
Exposure to sun* | 63 | 35 | 62 | 34.4 | 55 | 30.6 |
Contagious* | 56 | 31.1 | 68 | 37.8 | 56 | 31.1 |
Factors affecting total knowledge score about causes and aggravating factors of acne among study sample.
Poor | Good | Total |
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No. | % | No. | % | ||||
Knowledge versus age | |||||||
Childhood | 14 | 73.7% | 5 | 26.3% | 19 | 100.0 |
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Teenagers | 69 | 61.6% | 43 | 38.4% | 112 | 100.0 | |
Adulthood | 22 | 44.9% | 27 | 55.1% | 49 | 100.0 | |
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Knowledge versus gender | |||||||
Males | 49 | 68.1 | 23 | 31.9 | 72 | 100.0 |
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Females | 56 | 51.9 | 48.1 | 48.1 | 108 | 100.0 | |
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Knowledge versus marital status | |||||||
Single | 90 | 60 | 60 | 40 | 150 | 100.0 |
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Married | 13 | 46.4 | 15 | 53.6 | 15 | 100.0 | |
Divorced | 1 | 100 | 0 | 0 | 1 | 100.0 | |
Widow (er) | 1 | 100 | 0 | 0 | 1 | 100.0 | |
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Knowledge versus education | |||||||
Illiterate | 4 | 80 | 1 | 20 | 5 | 100.0 |
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Primary school | 2 | 100 | 0 | 0 | 2 | 100.0 | |
Intermediate | 20 | 69 | 9 | 31 | 29 | 100.0 | |
Secondary | 54 | 56.8 | 41 | 43.2 | 95 | 100.0 | |
Bachelor and more | 25 | 51 | 24 | 49 | 49 | 100.0 | |
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Knowledge versus income | |||||||
<5000 RS | 33 | 61.1% | 21 | 38.9% | 54 | 100.0 |
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5000–10000 |
51 | 62.2% | 31 | 37.8% | 82 | 100.0 | |
>10000 RS count | 21 | 47.7% | 23 | 52.3% | 44 | 100.0 |
Perceived stress due to acne in patients according to gender.
Not affected | Affected | Total |
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No. | % | No. | % | ||||
Male | 43 | 59.7% | 29 | 40.3% | 72 | 100% |
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Female | 39 | 36.1% | 69 | 63.9% | 108 | 100% |
Self-reported social effects of acne.
Life activity | Total ( |
% |
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School performance | 24 | 13.3% |
Work performance | 19 | 10.6% |
Spouse relationship | 38 | 21.1% |
Willing to get married | 55 | 30.6% |
Friendship affected | 31 | 17.2% |
Thirty-two percent of our patients believed that acne is inherited or having genetic factors. These results were better than other studies; for example, in Poli et al. study, 25.2% perceived acne to be inherited from parents [
Tension was believed to be related to acne by 65.6% of our patients. Almost the same result was found in Tallab study (65% of his sample) [
Regarding general knowledge score, 41.7% of our study population showed good knowledge in contrast to study of Brajac et al. (2004), where only 11% have the overall score of correct answers [
These study results showed that poor knowledge, false beliefs, and many misconceptions are prevalent among Saudi acne patients in a way comparable to previous studies in other populations which include acne patients and/or normal populations of different cultures. This may reflect deficient acne patient education during their follow-up in their dermatology clinics.
Perceived stress was self-reported by 98 patients, that is, 54.4% of total sample. There was statistically significant correlation of self-reported being stressed due to acne with gender, (40.3% and 63.9% of males and females. resp. (
Regarding seeking medical advice, twenty-two percent, 16.7%, 23.9%, and 37.8% of total sample visited their doctors within 3 months, 3–6 months, and 6–12 months and after 1 year from symptoms appearance, respectively. Similar results were found in Poli et al. study (2011), twenty-two percent, 14.2%, 12.4%, and 49.6% of their sample, but their sample consisted of acne patients and others who never had acne [
These study results showed that poor knowledge, false beliefs, and many misconceptions are prevalent among Saudi acne patients in a way comparable to the previous studies in other populations and cultures. This in spite of the fact that our study population consisted only of acne patients followed up in dermatology clinics. Seeking medical advice behavior and expectation from treatment modalities among acne patients in this study are also similar to other studies and appear to reflect the poor knowledge and misconceptions about the disease. More effort for health education in general and selective patient education in particular is needed to improve patients’ knowledge about acne and its modalities of treatment and to encourage early medical consultation behavior and improve patient adherence to treatment. Considering psychological effect, it appears to be high as it has been proved in other cultures and needs always to be considered and addressed early in the course of patient management.
The authors declare that they have no conflict of interests.