Correlation Between Stress Scale and Serum Substance P Level in Acne Vulgaris

INTRODUCTION: Acne vulgaris is a chronic inflammatory disease of pilosebaceous follicles with polymorphic lesions, consisting of comedones, papules, pustules and nodules with varying degrees of severity. Stress is one of the triggers of acne vulgaris. Peripheral nerves release substance P in response to stress. Substance P causes proliferation and differentiation of sebaceous glands and increases lipid synthesis in sebocytes. PURPOSE: To determine the correlation between stress scale and serum substance P level in acne vulgaris. PATIENTS AND METHODS: This study was an observational analytic study with a cross-sectional design involving 30 patients with acne vulgaris and 30 controls. History taking, dermatological examination and the Holmes−Rahe stress scale questionnaire were performed with each patient to evaluate stress scale, followed by taking blood samples to assess substance P serum levels using the ELISA test. The collected data were analyzed using the Spearman correlation test. RESULTS: In both groups, the majority of subjects were 23–27 years old (36.7%) and most of them were female (76.7%). The majority in the acne vulgaris group had low scores on the stress scale, represented by 17 patients (56.7%). The main cause of stress in the acne vulgaris group was a major change in sleeping habits (66.7%). In the acne vulgaris group, the highest mean value of serum substance P level in high stress scale group was 168.2 pg/mL. There was a positive correlation between stress scale and serum substance P level in acne vulgaris with moderate strength and this was statistically significant (r = 0.446; p = 0.014). Meanwhile, stress scale and serum substance P level in controls were not correlated and this was not statistically significant (r = −0.090; p = 0.636). CONCLUSION: There was a correlation between stress scale and serum substance P level in acne vulgaris.