Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit characterized by comedones, papules, pustules, nodules, and possible scarring. It commonly affects adolescents due to hormonal changes during puberty and may cause significant psychosocial distress.

Globally, acne is among the most prevalent skin diseases in teenagers and young adults. Although androgenic stimulation and follicular hyperkeratinization are established mechanisms, several lifestyle factors such as diet, stress, inadequate sleep, obesity, cosmetic products, and sedentary behavior are increasingly recognized contributors.

Adolescence is a vulnerable period where body image concerns and peer interactions amplify the emotional burden of acne. Identifying modifiable risk factors can support holistic management.

This study was undertaken to evaluate the clinical pattern of acne vulgaris and its association with lifestyle factors among adolescents attending a tertiary care hospital.

Study Design and Setting Hospital-based cross-sectional observational study conducted in the Department of Dermatology of a tertiary care teaching hospital. Study Duration 12 months. Study Population Adolescents aged 10–19 years attending dermatology OPD with acne vulgaris. Sample Size 220 patients. Inclusion Criteria • Age 10–19 years • Clinical diagnosis of acne vulgaris • Willingness to participate with assent/guardian consent where required Exclusion Criteria • Patients on systemic retinoids in previous 6 months • Drug-induced acneiform eruptions • Endocrine disorders already on treatment Data Collection A structured proforma was used to collect: • Age, sex, residence • Duration of acne • Family history • Dietary pattern • Junk food frequency • Sleep duration • Stress (self-reported academic/social stress) • Cosmetic use • Physical activity Clinical Assessment Acne severity graded as: • Mild • Moderate • Severe Statistical Analysis Data analyzed using SPSS. Chi-square test applied. p < 0.05 considered statistically significant.

Demographic Profile

Among 220 adolescents, the mean age was 16.1 ± 2.1 years. Females constituted 58.2% and males 41.8%. Most patients belonged to the 15–19 years age group (63.6%).

Clinical Pattern of Acne

Moderate acne was the most common pattern seen in 46.4% of patients, followed by mild acne in 34.1% and severe acne in 19.5%.

Site of Involvement

Facial lesions were present in all patients (100%). Back involvement was observed in 28.6% and chest involvement in 16.8%. Mixed site involvement was more common in severe acne.

Lesion Morphology

Comedones were present in 82.7%, inflammatory papules in 71.8%, pustules in 42.3%, nodules in 14.5%, and post-acne scarring in 22.7%.

Lifestyle Factors Associated with Acne Severity

The following factors were significantly associated with moderate-to-severe acne:

• Frequent junk food intake: 54.5%
• High glycemic diet: 49.1%
• Sleep duration <6 hours/day: 44.1%
• High stress levels: 47.3%
• Regular cosmetic use: 39.5%
• Sedentary lifestyle: 36.8%
• Positive family history: 41.4%

(p < 0.05 for all significant variables)

The present study demonstrates that moderate acne is the most common presentation among adolescents, consistent with previous hospital-based studies. Female predominance may reflect greater health-seeking behavior and cosmetic concern.

Facial involvement was universal, while truncal acne was more frequent in severe disease. This pattern has been reported in earlier dermatology literature.

Dietary factors such as frequent junk food consumption and high glycemic load were significantly associated with acne severity. Such diets may increase insulin-like growth factor activity and sebum production.

Sleep deprivation and psychological stress also showed significant correlation. Stress may worsen acne through neuroendocrine pathways, while poor sleep contributes to hormonal imbalance and inflammation.

Positive family history supports a genetic predisposition. Cosmetic use, especially occlusive or comedogenic products, may aggravate acne.

These findings emphasize the importance of combining pharmacological treatment with lifestyle counseling.

Acne vulgaris is highly prevalent among adolescents, with moderate acne being the most common clinical form. Lifestyle factors including unhealthy diet, inadequate sleep, stress, sedentary behavior, and cosmetic use are significantly associated with disease severity. Addressing these modifiable factors can improve clinical outcomes and quality of life. Limitations • Single-center study • Self-reported lifestyle variables may introduce recall bias • Cross-sectional design cannot establish causality Recommendations • Routine counseling on diet and sleep hygiene • Stress management strategies for adolescents • Awareness regarding appropriate cosmetic products Early dermatology consultation to prevent scarring

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