ACNE incidence has been linked to age and BMI in children and adolescents, leading to a higher number of prescriptions for systemic medications among those with a higher BMI compared to those with a normal or low BMI.
A population-based retrospective cohort study, conducted by Katinna Rodriguez Baisi, Ponce Health Sciences University, Puerto Rico, and colleagues, analysed data on children and adolescents between the ages of 1–12 years, diagnosed with initial acne from 2010–2018. In total, 643 patients were included, and for each case, two age- and sex-matched controls were selected. The annual incidence rate of acne was of 58 per 10,000 person years, adjusted for age and sex, and females were more likely to experience acne than males (89.2 versus 28.2 per 10,000 person-years, respectively; p=0.001). Furthermore, the team noted that acne was age dependent. While the incidence rate for children from 7–8 years old was 4.3 per 10,000 person-years, in 9–10-year-old patients this was 24.4 per 10,000 person years, and in 11–12-year-old patients incidence was 144.3 per 10,000 person-years.
While median BMI percentile in the control group was of 65%, those with acne had a median of 75% in BMI percentile. Furthermore, 16.7% of those with acne were in the 95th or greater percentile compared to 12.2% in the control group. Of those with acne, 99.0% used a type of acne therapy, including 47.7% using over the counter medication, 75.1% using prescription topical medications, and 8.2% using prescription systemic medications. The likelihood of receiving systemic medication increased as BMI increased (odds ratio: 1.43 per 5 kg/m2 increase in BMI; 95% confidence interval: 1.07–1.92), with 5.4% of those underweight or of normal weight receiving prescriptions for systemic acne medication, compared to 8.1% of those who were overweight, and 10.3% of those with obesity.
The team hopes that future research will investigate whether measures to improve BMI affects acne. They wrote: “Increasing understanding of preadolescent acne epidemiology and risk factors may allow earlier intervention and prevent undesirable sequelae.”