title: How People with Facial Acne Scars are Perceived in Society: an Online Survey.
abstract: BACKGROUND
  Atrophic scarring occurs throughout the course of inflammatory acne and across the spectrum of severity. This study evaluates perceptions of the general population toward individuals with clear skin and acne scars.
  
  
  METHODS
  An online survey administered in the USA, UK, Japan, Germany, France and Brazil to respondents 18 years and over presented three facial pictures of clear skin or digitally superimposed acne scars (but no active acne lesions) in a random fashion. At least one clear and one scar picture were presented to each participant.
  
  
  RESULTS
  Among the 4618 responders, 33% themselves had facial acne scars. The skin was the first thing noticed about the face by 41% when viewing pictures with scars vs 8% viewing clear skin (p < 0.05). Those with scars were less likely to be considered attractive (17% vs 25%), confident (25% vs 33%), happy (23% vs 30%), healthy (21% vs 31%) and successful (17% vs 24%), and more likely to be perceived as insecure (15% vs 8%) and shy (23% vs 14%) compared with those with clear skin (all p < 0.05). The significance of the responses obtained varied according to the acne and scar status of the respondent. Skin care was cited as the habit most in need of improvement by 59% vs 13% of respondents viewing pictures with scars vs clear skin, respectively (p < 0.05). All respondent subgroups cited skin care irrespective of their own acne and scar status (all p < 0.05 vs pictures with clear skin). Those with scars were thought less likely to have a promising future (78% vs 84%) than those with clear skin (p < 0.05). The majority of respondents reported willingness to pay money to eradicate scars.
  
  
  CONCLUSIONS
  The results of this multi-national survey demonstrate that facial acne scars are perceived negatively by society, confirming the importance of preventing acne scars with early treatment of inflammatory acne.
  
  
  BACKGROUND
  Galderma International S.A.S France.
authors.affiliation: Department of Dermato Cancerology, Nantes University, Nantes, France. brigitte.dreno@wanadoo.fr.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Dréno
authors.affiliation: University of Western Ontario and Windsor Clinical Research Inc, Windsor, ON, Canada.
authors.forename: Jerry
authors.initials: J
authors.lastname: Tan
authors.affiliation: Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, USA.
authors.forename: Sewon
authors.initials: S
authors.lastname: Kang
authors.affiliation: Galderma Laboratories, L.P., Fort Worth, TX, USA.
authors.forename: Maria-José
authors.initials: MJ
authors.lastname: Rueda
authors.affiliation: Department of Dermatology, Juarez Hospital, Mexico City, Mexico.
authors.forename: Vicente
authors.initials: V
authors.lastname: Torres Lozada
authors.affiliation: Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bettoli
authors.affiliation: Harrogate and District NHS Foundation Trust, Harrogate, UK.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Layton
keywords: Acne; Negative; Perception; Quality of life; Scars; Society; Treatment