Risk factors for acne scarring in Ecuador

Background Acne is a common disease that causes a large global disease burden. The Global Burden of Skin Disease reported that in 188 countries the burden from acne as measured by disability-adjusted life years (DALYs), years lived with disability and years of life lost is greatest in Western Europe, high-income North America and Southern Latin America. This paper aims to identify risk factors for acne scarring specific to the Ecuadorian population in order to adapt the 4-ASRAT tool accordingly. Methods This was an observational prospective study. Participants were recruited to complete a survey that was developed based on the potential risk factors for acne scarring and had facial photographs taken. To determine risk factors and their respective weighting, a logistic regression was performed. Results The study included 404 participants. Results from univariate analyses indicated that male sex (OR=2.76 95%CI [1.72; 4.43]), severe or very severe acne scarring (OR=4.28 95%CI [1.24; 14.79]), acne duration over 1 year (OR=1.71 95%CI [1.12; 2.60]), oily skin (OR=2.02 95%CI [1.27; 3.22]) and the presence of acne on the neck (OR=2.26 95%CI [1.30; 3.92]), were all significantly associated with the presence of acne scarring. Male sex (2.56 95%CI [1.58;4.17]), oily skin (1.96 95%CI [1.20;3.20]) and severe or very severe acne (3.75 95%CI [1.05;13.37]) remained significant risk factors for acne scarring in the multivariate analysis. Conclusion By identifying acne scarring risk factors and applying the tool in everyday dermatology visits, we can reduce the physical and psychological burden that acne scarring causes in the adolescent and adult population. Further research should be performed to reassess potential risk factors and complete the adaptation of the tool for the Ecuadorian population, with a larger and more representative study population.