Risk factors of severe acne vulgaris: Systematic review and meta-analysis

Abstract

Severe forms of acne vulgaris are accompanied by a pronounced decrease in the quality of life and lead to scarring. Early and effective acne therapy is the prevention of the formation of persistent cosmetic defects.Aim. To identify risk factors and predictors for the development of severe forms of acne vulgaris.Materials and methods. Article searches were performed in PubMed, Google Scholar and the Cochrane Central Registry of Controlled Trials over the period from 15 years to 10/25/2021 for the keywords ‘severe acne’, ‘predictors’ and ‘risk factors’. A meta-analysis was prepared using the Review Manager software (RevMan 5.4.1), The Cochrane Collaboration (2020) in line with international guidelines for systematic reviews and meta-analyzes (PRISMA).Results. 38 publications were included in the review. Risk factors for the development of severe forms of acne vulgaris can be divided into nonmodifable (presence of acne in close relatives, male gender, oily skin type, changes in genes) and modifable (increased BMI, consumption of dairy products, Fast digesting carbohydrates, etc.) In the meta-analysis, a statistically signifcant increase in the risk of severe forms of acne vulgaris in the presence of a history of acne in a close family member was found to be 2.54 times (95 % CI [1.63, 3.91]). It was also found that men have a higher risk of developing severe forms than women (1.16 times {95 % CI [1.04, 1.30]}). People with a BMI higher than 25 (2.54 times {95 % CI [1.63, 3.91]}) and those who consume dairy products 1.59 times more often than three times a week (95 % CI [1.37, 1.85]).Conclusion. Understanding the main risk factors for the development of deep forms of acne vulgaris will help to suspect a severe course of the disease in the early stages and to prescribe effective therapy in time. Male gender, family history, elevated BMI, and dairy consumption suggest a high likelihood of early development of severe acne.