title: Epidemiology of acne vulgaris in adolescent male students in Arar, Kingdom of Saudi Arabia.
abstract: BACKGROUND
  Acne vulgaris is the most common cutaneous disorder affecting adolescents and young adults. Small, noninflamed acne lesions may not be more than a slight nuisance, but, in individuals with more severe inflammatory disease, pain, social embarrassment, and both physical and psychological scarring can be life altering. Despite its high prevalence, no previous community-based studies have been conducted in Arar, northern border of Kingdom of Saudi Arabia, addressing this issue.
  
  
  OBJECTIVE
  The aim of this study was to estimate the prevalence of acne vulgaris, to describe the sociodemographic characteristics of cases, and to determine the aggravating factors and the psychological impact of acne vulgaris in a representative sample of secondary school male students in Arar city, Kingdom of Saudi Arabia.
  
  
  METHODS
  This was a cross-sectional study. A multistage systematic random sampling technique was followed. A total of 400 male students during the academic year 2015-2016 were included in the study. Data were collected by means of personal interview and filling-in a questionnaire.
  
  
  RESULTS
  The overall prevalence of acne vulgaris was 53.5%. The mean age of onset was 15.0±1.2 years. Positive family history of acne vulgaris was found in 46.7% of cases. The skin was greasy in 61.7% of cases. Acne site was the face in 67.3%, the back in 4.7%, and both in 28% of the cases. More than half (54.2%) of the cases had first-degree acne. Students mentioned several factors affecting the appearance of acne; 59.8% of cases reported a relation of increased acne appearance with the cleanliness of the skin, 35.5% reported relation with consumption of fatty meals, 24.2% with eating chocolate, 23.3% with consumption of spicy food, 12.1% with excess intake of cola drinks, 31.8% with heavy smoking, and 60.7% reported increased acne appearance in summer months.
  
  
  CONCLUSIONS
  Acne was highly prevalent among secondary school male students in Arar city, Kingdom of Saudi Arabia. Several risk factors increased the appearance of acne, including, skin cleanliness, certain diets, and smoking. There was clear seasonal variation, with a higher prevalence mainly in summer. Therefore, community-based multiple strategies are required to combat with increasing rate of acne vulgaris and its subsequent complications among adolescents in Arar city and to educate them about its causes and the risk factors for its development.
authors.affiliation: aDepartment of Public Health and Community Medicine, Faculty of Medicine, Sohag University, Sohag, Egypt bFaculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia.
authors.forename: Nagah M
authors.initials: NM
authors.lastname: Abo El-Fetoh
authors.forename: Naif G
authors.initials: NG
authors.lastname: Alenezi
authors.forename: Nasser G
authors.initials: NG
authors.lastname: Alshamari
authors.forename: Omar G
authors.initials: OG
authors.lastname: Alenezi
mesh_terms: D000152:Acne Vulgaris / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D000293:Adolescent; D003430:Cross-Sectional Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012959:Socioeconomic Factors; D013334:Students