Predictors Onset Persistence and Psychological Impact of Acne (POPPIA)

Rationale
Acne is an inflammatory skin disorder comprising papules/pustules, comedones, hyper-pigmentation and scarring. Almost all teenagers are affected to some degree, with 20% being moderately-to-severely affected. There is accompanying psychosocial morbidity and the physical impairment/disfigurement caused by hyper-pigmentation or scarring can be permanent. Attendance in both primary and secondary care consume considerable NHS resources. However, there little is published on natural history and conflicting evidence surrounding the relationships between acne and diet, psychological-stress and obesity.

Further research is needed to better understand both risk factors for the development and persistence of acne; and the psychological consequences of having acne. This work could provide evidence-leading to healthcare improvements and better understanding of the link between acne and mental health in adolescence, which is a vulnerable period for mental health disorders.

Aims & Objectives
This study has three aims:
1. To investigate how common acne is
2. To investigate risk factors for acne onset and persistence
3. To study the psychosocial consequences of having acne

Methods
Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, first the prevalence, incidence-rate and cumulative-incidence of acne between will be estimated using data from study clinics where acne was examined in detail by trained healthcare professionals. The sex, age, ethnic-group and socioeconomic distributions of young people with acne according to disease severity and comparing with those who do not have acne will be described. Persistence of acne across examinations at ages 9-13 will be described.

Data will be used to test hypotheses that: dietary factors such as dairy-rich or high glycaemic-index diets, psychological- stress and obesity early in childhood are positively associated with early onset of acne, and the progression and severity of acne; and the risk of depression, low self-esteem and time-off-school are increased in those patients who have had acne.