A study on the quality of life and adjustment of adolescents with acne vulgaris


  • James Joseph Karappally St. Antony’s Skin Clinic, Pala, Kerala
  • Razeena Padmam School of Behavioural Sciences, MG University, Kerala, India
  • George Kurien Department of Dermatology, Travancore Medical college, Kollam, Kerala




Quality of life, Adjustment, Acne vulgaris


Background: Acne vulgaris is a seemingly harmless disease affecting majority of adolescents. It is actually a psycho-dermatological disorder associated with psychological trauma. The impact of acne on the quality of life of Indian patients remains undocumented. A study is undertaken to assess the impact of acne on health, family, emotional and social wellbeing of acne patients.

Methods: 100 patients between age group of 13 to 19 years with acne vulgaris, attending St. Antony’s Skin Clinic, Pala, Kerala, between April 2010 and March 2012 were selected for study. The control group consisted of 100 adolescents without acne. Both groups had no other dermatological or systemic disease. Acne cases were graded using global acne grading system. Quality of life was assessed using WHO QOL BREF.Four domains were derived from this, physical and psychological health, social relationship and environment. Adjustment levels were assessed using adapted version of bell adjustment inventory.

Results: The parameters assessed were quality of life, family, social, emotional, health related and overall adjustments in those with and without acne and severity of acne in relation to quality of life and all values were significantly in favour of those without acne.

Conclusions: Acne affects personality, self-esteem and self-image of patients. It affects social interaction. Adolescents with acne report low quality of life and resultant poor psychosocial adjustment. There is an inverse relation between severity of acne and quality of life. The severity levels and adjustment also has an inverse relationship.

Author Biographies

James Joseph Karappally, St. Antony’s Skin Clinic, Pala, Kerala

Sr. Consultant Dermatologist

Razeena Padmam, School of Behavioural Sciences, MG University, Kerala, India

Director & Professor

George Kurien, Department of Dermatology, Travancore Medical college, Kollam, Kerala

Dept.of Dermatology & Venereology. Professor & Head


American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. 4th Edn. Text Revision, Washington DC: Americ Psyc; 2000.

Jancovic S, Vukicevic J, Jordjevic SD, Jancovic J, Marikovic J. Quality of life among school children with acne. Ind J Dermatol Venereol Leprol. 2012;78(4):454-8.

Doshy A, Zaheer A, Stiller MJ. A comparison of current acne grading systems and proposal of a novel system. Int J Dermatol. 1997;36:416-8.

Introduction, administration, scoring and generic version of the assessment-Field trial version, WHOQOL-BREF, WHO, Geneva 1996.

Raju S, Sam Sadananda Raj H. Adapted version of Bell Adjustment Inventory, Dept.of Psychology, University of Kerala, Trivandrum. 1988.

Hanish A, Omar K, Shah SA. Prevalence of acne and its impact on the quality of life in school aged adolescents in Malaysia. J Primary Health Care. 2009;1(1):20-5.

Kubba R, Bajaj AK. Acne in India: Guidelines for management-IAA Consensus document:Acne and quality of life. Ind J Dermatol Venereol Leprol. 2009;75(7):4-5.

Picardi AI, Aberi D, Melchi AI. Psychiatric morbidity in dermatology outpatients, an issue to be recognized. Br J Dermatol. 2000;143:983-91.

Ismail KH, Ali M. Quality of life in patients with acne in Erbil city. Health Qual Life Outcomes. 2012;10:60,1-4.

Parameswaran EG, Beena C. Adjustment, Maladjustment and Readjustment. In: An Invitation to Psychology. Hyderabad: Neelkamal Publications Pvt Ltd.

Jowett S, Ryan T. Skin Diseases and the handicap Analysis of the impact of Skin Condition. Soc Sci Med. 1985;20:425-9.

Mallon E, Newton JN, Klassen A, Stewart Brown SL, Ryan TJ, Finlay AY. The quality of life in acne:a comparison with general medical conditions using generic questionnaires. Brit J Dermatol. 1999;140:672-6.

Barankin B, De Koven J. Psychosocial effect of common skin diseases. Can Fam Physician. 2002;48:712-6.






Original Research Articles