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Cited by 40Acne and Rosacea Treatments and EffectsDermatologic Treatments and ResearchDermatology and Skin Diseases

Modifiable and non-modifiable epidemiological risk factors for acne, acne severity and acne scarring among Malaysian Chinese: a cross-sectional study

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Say, Yee-How, Heng, Anna Hwee Sing, Reginald, Kavita, Wong, Yi Ru, Teh, Keng Foo, Rawanan Shah, Smyrna Moti, Sio, Yang Yie, Ng, Yu Ting +3 more·2021·BMC Public Health
DOI 10.1186/s12889-021-10681-4PMC PMC8005239
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Abstract

Background: Acne vulgaris, a highly prevalent multifactorial inflammatory skin disease, can be categorised into different severity and scarring grades based on the type, number, and severity of lesions. While many epidemiology studies have investigated the risk factors for acne presentation, fewer studies have specifically studied the risk factors for acne severity and scarring. Therefore, this study investigated the prevalence of acne, acne severity and scarring grades, and their associated non-modifiable and modifiable epidemiological risk factors among Malaysian Chinese. Methods: A total of 1840 subjects (1117 cases/723 controls) completed an investigator-administered questionnaire as part of a cross-sectional study, which include socio-demographics, familial history, lifestyle factors, dietary habits, and acne history. Acne cases were further evaluated for their severity (n = 1051) and scarring (n = 1052) grades by a trained personnel. Results: Majority of the acne cases (up to 69%) had mild acne or Grade 1/2 scarring, while 21.6% had moderate/severe acne and 5.5% had Grade 3/4 scarring. Males had significantly higher risk of presenting with higher grades of acne scarring. Those who had acne, regardless of severity and scarring grades, had strong positive familial history (either in parents and/or sibling). Frequent consumption (most or all days) of foods that are commonly consumed during breakfast (butter, probiotic drinks, cereals and milk) decreased the risk for acne presentation and higher acne scarring, while periodic consumption (once/twice per week) of nuts and burgers/fast food decreased the risk for higher acne severity. Alcohol drinking was significantly associated with increased risk for acne presentation, while paternal, parental and household smoking were associated with reduced risk of more severe acne. Conclusions: In conclusion, positive familial history is a strong predisposing factor in influencing acne presentation, severity and scarring. Frequent consumption of foods that are commonly consumed during breakfast is protective against acne presentation.

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  • 35.7% (10/28) of observational studies exclusively commented on the association between dairy and acne.

    “Overall, 35.7% (10/28) exclusively commented on the association between dairy and acne (Table II),24, 25, 26, 27, 28, 29, 30, 31, 32, 33”

    From Diet and acne: A systematic review (2022) · cites this paper as [33]

    The Methods and Discussion describe a cross-sectional study of familial history, lifestyle, multiple dietary habits, acne severity, and scarring—not a study exclusively about dairy and acne. The paper does examine milk consumption, but its stated scope contradicts its inclusion as a dairy-only study. The 10/28 tally appears to be the citing authors’ own count, not a result reported by this source. (LLM, conf=0.86)

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Cited by

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Authors
Say, Y.-H., Heng, A. H. S., Reginald, K., Wong, Y. R., Teh, K. F., Rawanan Shah, S. M., Sio, Y. Y., Ng, Y. T., Matta, S. A., Pang, S. L., & Chew, F. T.
Affiliations
  • National University of Singapore (SG)
  • Sunway University (MY)
Corresponding author
Chew, Fook Tim
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2021-03-27
Volume
21
Issue
1
Pages
601-601
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/s12889-021-10681-4
PMC
PMC8005239
OpenAlex
W3142470994
Cited by
40
References
1
Citations by year
2026: 9 · 2025: 8 · 2024: 9 · 2023: 8 · 2022: 6
FWCI
5.01
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • National University of Singapore (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
  • Health Sciences › Medicine › Dermatology › Dermatologic Treatments and Research
  • Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
Keywords
acne, acne severity, acne scars, risk factors, family history (medicine), dietary habits, alcohol consumption, smoking, Malaysian Chinese, skin disease epidemiology
MeSH terms
Acne Vulgaris, Animals, China, Cicatrix, Cross-Sectional Studies, Humans, Male, Risk Factors, Severity of Illness Index

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