The impact of acne and facial post-inflammatory hyperpigmentation on quality of life and self-esteem of newly admitted Nigerian undergraduates

Figures & data

Table 1 Clinical characteristics of the study participants in terms of gender and facial post-inflammatory hyperpigmentation

Variables	Total (%) N=200	Gender			Facial PIH
		Male (%)	Female (%)	p-value	Acne with facial PIH	Acne without facial PIH	p-value
Acne presentation
Mean age ± SD (years)	23.90±3.34	24.35±3.49	23.48±3.17	0.065	24.14±2.97	23.59±3.26	0.245
Mean age of onset ± SD (years)	16.24±3.32	16.15±3.04	16.32±3.58	0.771	16.40±3.26	15.76±3.51	0.335
Facial pruritus	47 (23.5)	15 (15.6)	32 (30.8)	0.012	31 (27.4)	16 (18.4)	0.135
Painful eruptions	69 (34.5)	31 (32.3)	38 (36.5)	0.528	56 (49.6)	13 (14.9)	<0.001
Purulent eruptions	45 (22.5)	19 (19.8)	26 (25.0)	0.378	38 (33.6)	7 (8.0)	<0.001
Facial scars	70 (35.0)	27 (28.1)	43 (41.3)	0.050	60 (53.1)	10 (11.5)	<0.001
Family history of acne	94 (47.0)	50 (52.1)	44 (42.3)	0.166	67 (59.3)	27 (31.0)	<0.001
Psychological feelings
Stigmatized	15 (7.5)	10 (10.4)	5 (4.8)	0.670	7 (6.2)	8 (9.2)	0.424
Socially unacceptable	17 (8.5)	9 (9.4)	8 (7.7)	0.517	12 (10.6)	5 (5.7)	0.221
Being judged	25 (12.5)	13 (13.5)	12 (11.5)	0.669	15 (13.3)	10 (11.5)	0.706
Loss of self-esteem	12 (6.0)	8 (8.3)	4 (3.8)	0.182	10 (8.8)	2 (2.3)	0.071
Depression	29 (14.5)	15 (15.6)	14 (13.5)	0.664	17 (15.0)	12 (13.8)	0.803
Feelings of shame	21 (10.5)	11 (11.5)	10 (9.6)	0.671	11 (9.7)	10 (11.5)	0.687
Anxiety	39 (19.2)	18 (18.8)	21 (20.2)	0.874	30 (26.5)	9 (10.3)	0.004
Emotionally upset	49 (24.5)	24 (25.0)	25 (24.0)	0.241	40 (35.4)	9 (10.3)	<0.001

Abbreviation: PIH, post-inflammatory hyperpigmentation.

Figure 1 The severity of acne vulgaris among LAUTECH undergraduates according to the US Food and Drug Administration 5-category global system of acne classification.

Note: The pie chart was created using US Food and Drug Administration classification system.¹⁷

Table 2 The pattern of Cardiff Acne Disability Index and Rosenberg self-esteem scale scores among study participants in relation to gender and facial post-inflammatory hyperpigmentation

Variables		Total (%) N=200	Gender			Facial PIH
			Male (%	Female (%)	p-value	Acne with facial PIH	Acne without facial PIH	p-value
Mean total CADI ± SD		1.47±1.42	1.41±1.35	1.52±1.49	0.576	1.77±1.60	1.07±1.02	<0.001
CADI group [impairment]
0	[0]	72 (36.0)	35 (36.5)	37 (35.6)	0.922	34 (30.1)	38 (43.7)	0.006
1–3	[7–20%]	114 (57.0)	55 (57.3)	59 (56.7)		66 (58.4)	48 (55.2)
4–9	[27–60%]	14 (7.0)	6 (6.2)	8 (7.7)		13 (11.5)	1 (1.1)
10–15	[67–100%]	–	–	–
Mean total RSES ± SD		24.90±3.67	24.96±3.70	24.85±3.66	0.830	24.90±3.73	25.90±3.62	0.991
RSES group [esteem level]
10–15	[normal SE]	197 (98.5)	93 (96.9)	104 (100.0)	0.109	111 (98.2)	86 (98.9)	0.720
>15	[low SE]	3 (1.5)	3 (3.1)	0 (0.0)		2 (1.8)	1 (1.1)

Abbreviations: PIH, post-inflammatory hyperpigmentation; RSES, Rosenberg self-esteem scale; SE, self-esteem; CADI, Cardiff Acne Disability Index.

Table 3 The correlation of patients’ and physicians’ assessed severity of acne, and the Cardiff Acne Disability Index and Rosenberg self-esteem scale

Variables CADI	Patients’ assessed severity of acne		Physicians’ assessed (US-FDA) severity of acne
	Correlation (r)	p-value	Correlation (r)	p-value
Aggressive, frustrated or embarrassed	0.251**	<0.001	0.137	0.051
Interfered with social life	0.201**	0.004	0.125	0.075
Avoidance of public facilities	0.158*	0.002	0.083	0.237
Feelings about appearance of skin	0.286**	<0.001	0.202	0.004
How bad is your acne now?	0.119	0.090	0.044	0.530
Total CADI	0.273*	<0.001	0.152*	0.030
RSES
Do not feel that I am a person of worth	−0.171*	0.015	−0.194**	0.005
Do not feel that I have good qualities*	−0.084	0.233	−0.111	0.115
Inclined to feel that I am a failure	−0.113	0.109	−0.051	0.473
Unable to do things like other people	0.000	0.991	0.020	0.778
Do not have much to be proud of*	−0.002	0.982	0.039	0.579
No positive attitude towards myself*	−0.124	0.078	−0.120	0.088
I am not satisfied with myself	−0.099	0.107	0.066	0.350
Wish for more respect for myself *	0.107	0.128	0.117	0.095
I certainly feel useless at times*	−0.177*	0.012	0.265**	<0.001
At times I think I am no good at all	0.024	0.733	−0.037	0.600
Total self-esteem	−0.042	0.549	−0.040	0.574

Notes:

** Correlation significant at 0.01 (2 tailed);

* Correlation significant at 0.05 (2 tailed)

Abbreviations: CADI, Cardiff Acne Disability Index; RSES, Rosenberg self-esteem scale; US-FDA, US Food and Drug Administration; r = Spearman’s rho.

Table 4 The relationship between the mean ranks of Cardiff Acne Disability Index (CADI) and Rosenberg self-esteem scale (RSES) scores in relation to gender and acne with and without facial post-inflammatory hyperpigmentation

Variables CADI	Mean rank of scores		p-value	Mean rank of scores		p-value
	Male	Female		Acne with facial PIH	Acne without facial PIH
Aggressive, frustrated or embarrassed?	103.56	100.54	0.528	110.19	91.30	<0.001
Interfered with social life	102.10	101.90	0.943	105.06	98.00	0.012
Avoidance of public facilities	102.70	101.35	0.646	104.57	98.65	0.046
Feelings about appearance of skin	100.19	103.69	0.638	109.70	91.94	0.018
How bad is your acne now?	103.19	100.89	0.751	108.61	93.36	0.038
Total CADI	101.90	102.10	0.980	113.19	87.38	<0.001
RSES
Do not feel that I am a person of worth	102.10	101.91	0.967	100.42	104.06	0.426
Do not feel that I have good qualities	102.76	101.30	0.719	99.50	105.26	0.160
Inclined to feel that I am a failure	101.98	102.01	0.996	98.69	106.32	0.189
Unable to do things like other people	106.45	97.84	0.130	105.27	97.73	0.189
Do not have much to be proud of	110.83	93.76	0.027	98.36	106.76	0.280
No positive attitude towards myself	102.50	101.53	0.865	100.88	103.47	0.652
I am not satisfied with myself	100.14	103.73	0.585	97.76	107.55	0.140
Wish for more respect for myself	94.79	108.73	0.071	110.19	91.30	0.165
I certainly feel useless at times	98.87	104.92	0.376	99.91	104.73	0.484
At times I think I am no good at all	101.64	102.34	0.917	102.75	101.02	0.797
Total self-esteem	103.47	100.62	0.728	101.54	102.60	0.899

Abbreviations: PIH, post-inflammatory hyperpigmentation; RSES, Rosenberg self-esteem scale; CADI, Cardiff Acne Disability Index.

US Department of Health and Human ServicesFood and Drug AdministrationCenter for Drug Evaluation and Research (CDER)Guidance for Industry; Acne Vulgaris: Developing Drugs for Treatment2005

 Google Scholar