Epidemiology and Perception of Acne Among Adolescents in Jos, Nigeria: Cross-Sectional School-Based Study

BACKGROUND: Adolescents who make up a vast majority of the secondary school population are at a stage at which they are largely affected by acne. This condition, which is widely visible and easily recognized by peers, has numerous misperceptions surrounding it, which may influence attitudes toward people affected by it. There is a paucity of information on the prevalence of acne and how adolescents in Jos, Nigeria, view the condition. OBJECTIVE: This study aimed to determine the prevalence of acne, perceived risk factors, and the accuracy of self-report among adolescents in Jos, Nigeria. The study also sought to understand perceptions surrounding acne in this age group. METHODS: This descriptive cross-sectional study was conducted among adolescents attending private and public secondary schools in Jos, Nigeria. In total, 482 students were recruited through a multistaged stratified random sampling method. A self-administered semistructured questionnaire was used to collect information on history of acne, perceptions of causes, and the attitude toward those who have the condition. All participants were examined for the presence of acne. Univariate, bivariate, and multivariate analysis were conducted using SPSS (version 26; IBM Corp). RESULTS: The self-reported prevalence of acne was 44% and that upon clinical examination was 55%. Self-report showed a moderate degree of agreement with clinical diagnosis (Cohen κ=57.3%; P<.001). Predictive factors for the presence of acne in general were age of ≥15 years (odds ratio [OR] 1.79, 95% CI 1.12-2.87; P=.02), being in a private school (OR 2.17, 95% CI 1.38-3.42; P=.001), and being in a senior secondary class (OR 2.14, 95% CI 1.32-3.47; P=.002). The female gender (OR 3.03, 95% CI 1.64-5.61; P=.001) and religion (OR 3.24, 95% CI 1.27-8.24; P=.02) were predictive for acne only among adolescents aged <15 years, while a positive family history was predictive in those aged ≥15 years (OR 2.04, 95% CI 1.15-3.61; P=.02). A distinct perception and attitude pattern surrounding acne was observed, as a significant proportion (84/131, 64.1% vs 47/131, 35.9%; P=.02) of those who related acne to a biological phenomenon had acne themselves; however, the belief that acne is caused by skin lightening practices was significantly more common in those without acne (19/28, 67.9%) than in those with acne (9/28, 32.1%; P=.01). One-fourth of the adolescents (n=122, 25.3%) had no idea of the possible causes of acne. CONCLUSIONS: Though acne is a prevalent skin condition among Nigerian adolescents, many misperceptions and unfavorable attitudes surround acne and persons affected by the condition. Our findings have revealed the need to work with the school health program to educate the general adolescent population about acne, to refer and manage teenagers with acne.