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ORIGINAL ARTICLE |
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| Year : 2022 | Volume
: 67
| Issue : 6 | Page : 682-687 |
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| Knowledge and treatment behaviour of acne vulgaris among female students of university of Nigeria, Enugu Campus, Enugu State, Nigeria |
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Chidinma E Israel1, Chisom I Ralph-Nwachukwu1, Cynthia A Attah2
1 From the Department of Nursing Sciences, Faculty of Health Sciences, College of Medicine, University of Nigeria, Nsukka, Nigeria
2 Department of Nursing, Faculty of Health Science and Technology, University of Nigeria, Nsukka; Department of Nursing, Medway Maritime Hospital, Institute of Nursing Research, Osogbo, Osun State, Nigeria
| Date of Web Publication | 23-Feb-2023 |
Correspondence Address:
Chidinma E Israel
Department of Nursing Sciences, Faculty of Health Sciences, College of Medicine, University of Nigeria, Nsukka
Nigeria
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijd.ijd_766_21
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 Abstract | | |
Background: Acne Vulgaris is a common chronic inflammatory skin disease, with a prevalence of about 80% among adolescents and adults. Aim: The study was designed to assess knowledge and treatment behavior of acne vulgaris among female students of the University of Nigeria, Enugu campus, Nigeria. Method: Descriptive survey design was adopted for this study. Three hundred and nineteen (319) female students of the University of Nigeria, Enugu Campus recruited through stratified random sampling were involved in the study. A questionnaire with a reliability coefficient of 0.80 Cronchbach alpha was used for data collection. Ethical clearance was obtained from the University of Nigeria, Teaching Hospital. Ethical principles of Informed consent, confidentiality and anonymity were maintained in the study. Data were presented in tables and analysed using descriptive statistics of frequency, percentages, means and standard deviation; and Chi-square (P < 0.05) inferential statistics. Findings: Majority (95.3% (304)) of the respondents have good knowledge of acne vulgaris. Consultation with a dermatologist was seen as very important for the management of acne vulgaris (M = 3.42 ± 0.62), removing acne by squeezing is not considered necessary (M = 2.04 ± 0.92) and the majority of the respondents (86.8%) use medically approved drugs and formulations like cleansers, exfoliants, sunscreen. No statistically significant relationship was found between the level of academic study and knowledge of acne vulgaris. Conclusion: Nurse educators must consolidate health campaigns on the evidence-based treatment options available for acne vulgaris. This is necessary to prevent complications arising from the use of untested dermatological products.
Keywords: Acne vulgaris, attitude, female students, knowledge, treatment behaviour
How to cite this article:
Israel CE, Ralph-Nwachukwu CI, Attah CA. Knowledge and treatment behaviour of acne vulgaris among female students of university of Nigeria, Enugu Campus, Enugu State, Nigeria. Indian J Dermatol 2022;67:682-7 |
How to cite this URL:
Israel CE, Ralph-Nwachukwu CI, Attah CA. Knowledge and treatment behaviour of acne vulgaris among female students of university of Nigeria, Enugu Campus, Enugu State, Nigeria. Indian J Dermatol [serial online] 2022 [cited 2023 Mar 23];67:682-7. Available from: https://www.e-ijd.org/text.asp?2022/67/6/682/370345 |
| Introduction | |  |
Acne Vulgaris is a common chronic inflammatory skin disease,[1] with a prevalence of about 80% among adolescents and adults.[2],[3] It is mostly characterized by comedones, papules, pustules, cysts and nodules.[4]
Acne is commonly found in adolescent males,[4] while in the post-adolescent period, it is more frequent in females.[5] A study done in Nigeria estimated that approximately 80–85% of adolescents are affected at a given time, and the effects can continue into adulthood.[6]
Acne can be complicated by scarring.[7] The complications and impact of acne vulgaris are not only limited to physical appearance but have been linked with psychological issues such as low self-esteem, loss of confidence,[8] fuelling anxiety, depression, and other emotional trauma that threaten the quality of life.[4],[9] Negative impacts on social, employment and educational performance have also been documented.[10] Females are generally known to be more concerned about their body image thus acne and issues surrounding its treatment may be contributing to their quality of life.
According to recent dermatologic guidelines, the current first-line treatments for acne are conventional pharmacological therapies such as antibiotics, retinoids, hormonal agents and benzoyl peroxide. Inadequate adherence leads to the recurrence of acne, patient dissatisfaction, and increased medical costs.[11] However, there is an emergence and emphasis on organic dermatological products in Nigeria. The vendors and formulators of these products ascribe acne-resolving properties among other functions to these products. Unfortunately, some of these products have not been subjected to rigorous scientific testing and certification for use and thus may be unsafe.
Across studies, there is misinformation about predisposing factors of acne implicating diet, poor skin hygiene, stress, and using varying brands of cosmetics as important predisposing factors.[12] A study done in Saudi Arabia among medical students showed that only 37.2% of the students were found to have adequate knowledge about acne vulgaris and most of the students also had misconceptions about the causes.[8]
Due to these misconceptions and multi-factorial causation, the knowledge, attitude and practices regarding acne hold a major significance in the etiopathogenesis and outcomes of acne patients,[13] it is imperative therefore to establish educational programs in this regard.[4],[8],[12],[14] Since previous studies have established a lack of knowledge and misconception about acne vulgaris, this study aimed to assess the knowledge and treatment behaviour of acne vulgaris among female students of the University of Nigeria, Enugu campus, Enugu state, Nigeria.
| Materials and Methods | | |
The descriptive survey design was adopted for this study among 319 female students of the University of Nigeria, Enugu Campus. Firstly, stratified random sampling was used to group the students according to their hostels of residence before selecting the participants through simple random sampling. Institutional ethical committee clearance was obtained from the ethical committee of the University of Nigeria, Teaching Hospital. Principles of confidentiality, anonymity and informed consent were maintained during the study.
A researcher developed a questionnaire with a reliability coefficient of 0.80 Cronchbach alpha was administered to the participants for data collection. The questionnaire was subdivided into subsections to elicit responses on the variables of interest which include knowledge of acne vulgaris, attitude towards acne vulgaris, treatment behaviour and factors influencing the choice of treatment. The collected data was analysed using descriptive statistics of frequency, percentages, means and standard deviation; and Chi-square inferential statistics. The IBM Statistical Package for Social Sciences (SPSS) statistics software version 25 was used in the analysis. The level of significance was set at P < 0.05.
| Result | | |
[Table 1] presents the demographic characteristics of the students. Their age ranged from 16 to 30 years with a mean and standard deviation of 21.56 ± 2.82 and a modal age group of 21–25 (47.3%). They were predominantly single (92.8%) and Christian (97.8%). The majority were in the Faculty of Health Sciences (38.9%) and FASSA (28.5%) and 200 years of study (28.2%). A greater percentage of the respondents were residents in Lady Ibiam Hostel (42.0%) is the biggest hostel in the university.
[Table 2] shows that the entire students have heard about acne vulgaris before (100.0%), of which their information sources were mainly from friends and family (47.2%) and internet/social media (42.3%). Most students knew that acne is a chronic, inflammatory skin condition that causes spots and pimples (89.0%), it involves the oil glands at the base of hair follicles (83.4%), it could be whiteheads, blackheads, pimples, cysts and nodules (89.3%), it could be caused by menstrual cycle (88.4%), use of certain cosmetics/make-up (87.1%), tension/stress (82.1%), reactions to some drugs (76.2%), consuming fatty food (78.1%), inheritance (74.3%) and poor hygiene (73.4%), and could be prevented by good personal hygiene (73.0%). Generally, the overall knowledge was good; almost all had good knowledge (95.3%).
From [Table 3], the majority of the student had the right attitude towards the treatment of acne vulgaris (79.6%). The majority (3.42 ± 0.62) of the participants thought that consulting a dermatologist is important and that acne can resolve without medical intervention (2.93 ± 0.75) and about the negative impact of over-counter medication (2.79 ± 0.82). On the hand, most of the students identified the use of home remedies like face masks and scrubs (2.98 ± 0.73) and squeezing as a treatment option for acne (2.04 ± 0.92).
Findings from [Table 4] show that medically approved drugs and formulations (86.8%) and anti-acne products and therapies (81.5%) were the most used treatment regimen among the female students. Many also used processed organic products (78.1%) and ordinary soap and water (60.2%) treatment plans.
All the factors in [Table 5] influenced the choice of acne treatment behaviour. Advice/persuasion from friends (87.8%), prescription by medical personnel (82.4%), past experience (81.8%) and price of products and therapies (81.2%) were the major influencing factors.
From [Table 6], there is no significant relationship between knowledge of acne vulgaris and educational level (p =0.396). No particular year of study was associated with good knowledge more than the other [100 level (13.8%), 200 level (28.2%), 300 (20.5%), 400 (20.8%), 500 (16.8%)]. | Table 6: Relationship between educational level and knowledge of acne vulgaris
Click here to view |
No significant relationship also existed between the student's attitude towards the treatment of acne vulgaris and their age (p =0.258), marital status (p =0.588), faculty of study (p =.083), year of study (p =.346) and Hostel accommodation (p =.876). Their attitude was hence never dependent on their socio-demographics [Table 7]. | Table 7: Relationship between socio-demographic variables and their attitude towards treatment of acne vulgaris
Click here to view |
| Discussion | | |
The findings of this study reveal that majority of the female students (95.3%) have good knowledge of acne vulgaris. The good level of knowledge as regards this study may be attributed to the fact that some of the students have learned about it in their course of study. It could be a result of their previous experiences with acne vulgaris, especially during their adolescence stage. Participants below the age of 16 were not included in the study because all students of the university are above 16 years. This agrees with the findings of Lama et al.,[10] who reported that 62% had good knowledge of acne vulgaris and 38% had poor knowledge. In contrast, Albahlool et al.[15] reported that only 6.1% of respondents had good knowledge of acne vulgaris, 59.1% had average knowledge of acne vulgaris and 34.8% had poor knowledge of acne vulgaris. Although a good knowledge of acne was reported in this study, the 25% who believe acne is not treatable is not to be neglected, therefore holding huge implications on education and campaign about acne. While a previous study,[8] reported that only 37.1% of students had good knowledge of acne vulgaris and found a relationship between the level of study and knowledge, this study found no significant relationship between the level of study and knowledge.
The findings of this study showed that the majority of the participants (79.6%) had the right attitude towards the treatment of acne vulgaris. Most of them considered the impact of taking over-counter medication as negative and considered the removal of acne by squeezing necessary. This is in line with Situmorang who reported that 58.2% of participants had a good attitude towards acne.[16] In similarity with other studies[8],[17] this present study revealed that students identified causes of acne to be genetic (74.3%), fatty food (78.1%), poor hygiene (73.4%) stress (82.1%), and hormonal imbalance (88.4%). The high percentage of students who identified poor hygiene as a cause of acne reinforces the need for health education campaigns to correct this myth. Contrary to the study by Hulmani et al.[13] where patients with acne vulgaris were not willing to participate and few were in favour of consulting a doctor and very few persons said that they wash their face regularly to prevent acne, most students in this study demonstrated good treatment behavior by believing that dermatologist consultation is important for treatment and recovery.
Our study revealed that the majority of the students indicated that the use of anti-acne products and therapies recommended by friends or pharmacists like antibiotics, steroids, acne surgery (81.5%), use of medically approved drugs and formulations like cleansers, exfoliants, sunscreen (86.8%), use of processed organic products like clay masks, scrubs, and moisturizers (78.1%) and ordinary soap and water (82.4%) were the treatment behaviours used among female students in UNEC. This is in congruence with Jaber et al.[18] who showed that 4.6% reported beauty centres and 47.1% used cleansers, 35.3% used scrubbing creams, 66.7% used prescribed oral and topical antibiotics and retinoids and 25.5% used natural mixtures in the treatment of their acne. Similarly, Abbas, Awan and Ishfaq revealed that 52.8% used topical agents, 43.5% used oral antibiotics and retinoids and 15.9% used hormonal agents.[19]
In disagreement, Kaushik, Gupta and Mahendra showed that fatty food and stress were the most common agents held responsible for acne flaring. Also, 102 patients had used steroids in one way or the other.[20] Acne was considered curable by 65% with an anticipated duration of treatment lasting up to 12 months.
In this study, most students reported that advice and persuasion from friends (87.8%), price of products and therapies (81.2%), the influence of particular brands (58.3%), popularity on social media (65.8%), past experience with the products or therapies (81.8%) and prescription by medical personnel (82.4%) influenced their choice of treatment. This is in agreement with Kaliyadan, Alsultan and Alsaqer who showed that preferred acne treatments ranged thus; 78.2% for topical treatment, 40.7% for home remedies, 25.8% for diet modification and 14.5% for systemic treatment.[21] Factors that influenced the choice of treatment included cost (23%), the mildness of acne lesions (16.1%) and previous experiences with acne treatment (10.9%).
Limitations
One of the limitations of this study was the possibility of bias in answering the questionnaire.
| Conclusions | | |
Acne vulgaris is one of the commonest dermatological challenges faced by youth. It lasts several years, running a chronic course with complications such as scarring. The fact that this occurs most commonly on the face, leads to profound psychological implications that cause emotional trauma and affect a person's quality of life. Consultation and treatment of acne vulgaris will reduce the risk of complications thereby boosting the confidence and self-esteem of the sufferer. One of the major ways that will help promote the right attitude towards the treatment of acne vulgaris includes health education on treatment behaviours for acne vulgairs to reduce the frequency and severity of the lesions as well as promote better healing of the lesion sites without scarring. Also, health education on the negative impact of using over-the-counter medications, unprocessed organic mixtures and picking or squeezing of acne lesions should be given to discourage such practices and prevent further inflammation.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7] |
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