title: Acne scars in 18-year-old male adolescents: a population-based study of prevalence and associated factors.
abstract: BACKGROUND
  Acne vulgaris is a pilosebaceous follicle disorder affecting over 85% of adolescents to some degree. It frequently causes psychological distress that may persist into adulthood due to scarring. Little information about post-acne scarring epidemiology is available.
  
  
  OBJECTIVE
  To describe prevalence, distribution patterns and associated factors of acne scarring in young males, drawing on a representative population sample from a southern Brazilian city.
  
  
  METHODS
  A cross-sectional study was undertaken during presentation for military service, which is compulsory for all 18-year-old males. A questionnaire was applied, covering topics like diet, smoking habits, ethnicity, family structure, socio-economic level, as well as specific questions about active acne and resulting scars. Dermatologists conducted the clinical examination.
  
  
  RESULTS
  A total of 2,201 male adolescents were interviewed and examined. The overall prevalence of acne scarring was 22%. The malar region was the most frequently involved, present in 80% of affected individuals, followed by the frontal region (31.5%), back (17%), anterior chest (8.2%) and mentonian region (6.4%). Correlation between the intensity of clinical acne and the presence of scars was found, but no association was observed with educational level, smoking, ethnicity, obesity or socio-economic status.
  
  
  CONCLUSIONS
  There is a high prevalence of acne scars among this population. This is the first study to ascertain a correlation between acne scarring and factors such as socio-economic status and educational level. The direct relation between acne severity and scarring indicates that prompt and effective treatment is the best way to reduce scarring.
authors.affiliation: Universidade Católica de Pelotas (UCPel) - Pelotas (RS), Brazil.
authors.forename: Fernanda Tcatch
authors.initials: FT
authors.lastname: Lauermann
authors.affiliation: Universidade Federal de Pelotas (UFPel) - Pelotas (RS), Brazil.
authors.forename: Hiram Larangeira de
authors.initials: HL
authors.lastname: Almeida
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) - Porto Alegre (RS), Brazil.
authors.forename: Rodrigo Pereira
authors.initials: RP
authors.lastname: Duquia
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul (PUC-RS) - Porto Alegre (RS), Brazil.
authors.forename: Paulo Ricardo Martins de
authors.initials: PR
authors.lastname: Souza
authors.affiliation: Universidade de Santa Cruz do Sul (UNISC) - Santa Cruz do Sul (RS), Brazil.
authors.forename: Juliano de Avelar
authors.initials: Jde A
authors.lastname: Breunig
mesh_terms: D000152:Acne Vulgaris / Q000150:complications / Q000453:epidemiology*; D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D002921:Cicatrix / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D005145:Face; D006801:Humans; D008297:Male; D015995:Prevalence; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires