Association Between Acne Severity and Quality of Life Among Young Adults with Acne Vulgaris: A Cross-Sectional Study

Abstract

Background: Acne vulgaris is a common inflammatory dermatological disorder predominantly affecting adolescents and young adults. Beyond its physical manifestations, acne may substantially affect psychological well-being, social functioning and daily activities. Although clinical severity is an important component of disease assessment, the patient's perceived quality-of-life burden may not always correspond directly to the visible severity of acne. Evaluating both clinical severity and quality of life may therefore provide a more comprehensive assessment of disease burden.

Objectives: To assess the association between clinical acne severity and dermatology-specific quality of life among young adults with acne vulgaris attending a tertiary care hospital in North India.

Methods: A hospital-based cross-sectional observational study was conducted in the Department of Dermatology of a tertiary care hospital in North India from December 2025 to March 2026. A total of 420 young adults aged 18–30 years with clinically diagnosed acne vulgaris were recruited using consecutive sampling. Demographic and clinical characteristics were recorded using a structured data collection form. Acne severity was assessed using the Global Acne Grading System (GAGS), while dermatology-specific quality of life was assessed using the Dermatology Life Quality Index (DLQI). Continuous variables were summarized using mean and standard deviation or median and interquartile range, as appropriate, while categorical variables were expressed as frequencies and percentages. Differences in DLQI scores across acne-severity categories were assessed using one-way analysis of variance, with the Kruskal–Wallis test used as a non-parametric sensitivity analysis. The relationship between GAGS and DLQI scores was assessed using Spearman's correlation coefficient. Statistical tests were two-sided, with p<0.05 considered statistically significant.

Results: The mean age of participants was 23.3±3.0 years; 233 (55.5%) were male and 187 (44.5%) were female. Mild, moderate, severe and very severe acne were present in 109 (26.0%), 145 (34.5%), 122 (29.0%) and 44 (10.5%) participants, respectively. The overall mean GAGS score was 27.6±10.0 and the mean DLQI score was 8.3±4.5. Mean DLQI scores increased progressively with acne severity, from 3.6±2.3 in mild acne to 7.0±2.5, 11.3±2.4 and 15.4±2.5 in moderate, severe and very severe acne, respectively. The difference across severity groups was statistically significant (F=340.82; p<0.001). A strong positive correlation was observed between GAGS and DLQI scores (Spearman's ρ=0.832; p<0.001).