acnes, since humidity favours bacterial
growth. Stress contributed to increase in
severity of acne in 93.1% of the subjects.
Chiu et al15 had earlier reported a similar
finding in a Chinese population. It could be
that stress triggers off the mechanism
involved in the formation of acne vulgaris
comedons.
However, our study on belief and
perceptions of acne among its sufferers
revealed that 74.7% of subjects believed that
it is caused by oily/fatty diet, and 40.8%
believed that it is hereditary. Only 5.2% of
its sufferers had sought doctor’s attention
and majority used non-prescription
products like creams/lotion (59.8%) and
cleansers (32.8%). This corroborates a
previous report16 in Caucasian population
that acne is believed to be caused by
hormonal and genetic factors, diet, poor skin
hygiene and infection. The non-prescription
products used by the Caucasian population
were cleansers, acne pads and lotions.16 Also
a study in Hongkong revealed that only
2.4% of 522 acne sufferers sought medical
attention.17 We may conclude that both
Caucasian and Nigerian-Black population
express similar beliefs and perceptions
about acne vulgaris.
This study shows that the psychological
abnormalities expressed by acne sufferers
includes: social inhibition in 20.7%, anxiety
in 17.2% and depression occurring in 9.2%
of the acne sufferers. The belief that the
disorder has disfigured the face with scars,
lesions and some times keloids and thus a
tendency to withdraw from social gathering
may contribute to these psychological
problems in acne sufferers. It was observed
in this study that 30.5% of the acne sufferers
experienced pain, 29.9% had discomfort
while 13% had both as psychosomatic
symptoms. The pain and discomfort may be
due to the reddening and swelling of the
comedons. These findings are in line with a
previous Caucasians report.18
We conclude that stress, seasonal variation
(rainy season) and pre-menstrual period
may affect the severity of acne vulgaris.
Females had higher prevalence than males,
while ethnicity may not be a determining
factor. Nigerians share similar beliefs,
perception and misconceptions with the
Caucasians regarding acne vulgaris. Health
education programme on acne is needed to
improve the understanding of this disorder
in Nigeria.
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