Gender-Related Characterization of Acne in Chinese: A Multiple-Center Cross-Sectional Survey on 13085 Cases.

Background: Acne is a common inflammatory dermatosis. Although gender-related differences in prevalence and age of onset have been documented. Other gender-related characteristics of acne have not been well elucidated yet.

Objective: We compared characteristics of skin lesions, severity and risk factors of acne between males and females in Chinese.

Methods: Investigator-administered questionnaire was used to collect demographic data, clinical feature and risk factors of acne from May 2020 to August 2021. All participants were from outpatient clinics in seven cities, China.

Results: A total of 13085 participants, including 4746 males (36.27%) and 8339 females (63.73%), aged 8 to 35 years old, completed the questionnaire. The age of onset of acne was significantly younger in males than in females(p<0.001). More females than males had comedones(83.76% vs 75.22%, p<0.001). In contrast, more males than females had pustules, cyst/nodules, scars and severer lesions(p<0.001). Moreover, the major risk factors for acne were constipation, cosmetics, dairy and sweet foods for females, while the major risk factors for males were computer usage/playing electronic games, staying up late at night, intake of hot or spicy foods. More females than males experienced good response to photodynamic treatment(79.52% vs 52.86%, p<0.05).

Conclusion: Acne appears earlier in males than in females. Clinical features and risk factors for acne differ between males and females. More females than males experience good response to photodynamic therapy.

Limitation: This questionnaire survey was carried out in Chinese aged 8 to 35 years old. Gender-related characteristics in other ages and regions remain to be explored.