Introduction and Aim: Acne has adverse effects on the individual’s self-image and quality of life, and also causes a variety of psychological and psychiatric complications. This study aimed to determine the prevalence of acne among university students and also assess the effects of acne on quality of life, social appearance anxiety, and use of conventional, complementary, and alternative treatment methods.

Materials and Methods: This cross-sectional study was conducted on the students of a university located in the Central Anatolian Region of Turkey, in 2018. The study sample was computed to be 1025 with a confidence interval of 95% and 3% margin of error. The study was concluded with 1007 students (98.24%) Individuals constituting the study sample were selected using proportional cluster sampling. The study used “the Acne Quality-of-Life (AQOL) Scale” to investigate students’ quality of life and “the Social Appearance Anxiety Scale” to measure their social anxiety, along with a questionnaire that asked about some acne-related characteristics and conventional, complementary, and alternative treatment methods. The questionnaires were filled out by students under supervision of researchers. This process took between 10-15 minutes. The study was conducted with permission from the Non-interventional Clinical Research Ethics Board (Approval date:05.06.2018; Number:10), and the questionnaire was administered with permission from the university management (Approval date:24.04.2018; Number:44093). Data were analyzed using the Spearman’s rank-order correlation and path analysis (with observed variables). Statistical significance was set at p<.05.

Results: The prevalence rate of acne among the study sample was 65.4%. The participants’ social appearance anxiety, perceived acne severity, and acne’s impacts on their lives were inversely proportional to their quality of life. However, the perceived acne severity and acne’s impacts on their lives were directly proportional to their social appearance anxiety. Acne distress accounted for 19% of the change in AQOL scores, which in turn caused 61% of the change in social appearance anxiety scores. The change in social appearance anxiety scores accounted for 5% of the rate of complementary and alternative medicine (CAM) use, while acne distress was responsible for 29%. On the contrary, an inverse correlation was observed between CAM use and prescription medication use.

Discussion and Recommendations: In conclusion, 7 out of 10 students (an acne prevalence of 65.4%) were distressed from acne. The students whose quality-of-life had deteriorated due to acne had higher social appearance anxiety. Social appearance anxiety had a minor effect on complementary and alternative medicine use, which was affected mainly by acne distress. Acne distress increased CAM use. No relationship between acne quality of life and CAM use was found. Hence, further studies should be performed to determine the causational relationships. It is recommended that acne treatments would be more helpful if they also addressed psychological symptoms (social appearance anxiety and deterioration in the quality of life) instead of just focusing on skin lesions and took patients’ CAM use into account.

Keywords: acne, complementary therapy, social appearance anxiety, quality of life