The impact of acne treatment on quality of life and self-esteem: a prospective cohort study from Lebanon

Abstract Background : Acne is highly prevalent among teenagers and young adults with proven negative psychological and emotional impact. To our knowledge, no study has been conducted to quantify the repercussions of acne on quality of life (QoL) and self-esteem in Lebanon. Accordingly, this study aimed to highlight the effect of acne treatment on QoL and self-esteem of Lebanese adolescents and young adults. Methods : In this observational prospective study, patients between 15 and 40 years old with moderate to severe acne were allocated to one of two treatment groups (isotretinoin versus systemic antibiotics combined with topical treatments) and followed over a period of 6 months. The effect of acne on QoL was measured using the Dermatology Life Quality Index (DLQI), the Cardiff Acne Disability Index (CADI), and the Rosenberg Self Esteem Scale (RSES) before treatment initiation (T1), after 3 months (T2), and 6 months (T3). A multivariate analysis of covariance model (MANCOVA) was used. Results : Sixty-two patients were included, 79% were female, and 61.3% had moderate acne. Fifty five percent were treated with systemic antibiotics combined with topical treatments and 45% received isotretinoin. Mean scores of CADI, DLQI and RSES at T1 were comparable between the two groups. A significant improvement was noticed in both groups at T2 and T3. MANCOVA showed an interaction of time and age that concerns 25- to 40-year-old patients of both groups, who were the most negatively affected by acne at T1 and improved the most at T3. Conclusion : This study demonstrated the equivalence between acne treatments in improving QoL, and revealed the social obstacle that acne creates and its recrudescence in the subgroup of women in childbearing age.