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Preadolescent Acne Linked to Higher Body Mass Index


A new study also explores why the incidence of acne vulgaris is higher in girls than boys.

Preadolescents with acne are more likely to be girls, and obese, according to a new study, published in Pediatric Dermatology.

The population-based retrospective cohort study, which was based in Olmstead County, Minnesota, identified 643 preadolescents with an initial acne diagnosis between 2010–2018 and calculated the incidence.1 For the study, senior author Megha M. Tollefson, MD, and coauthors defined the preadolescence age range of 7 through 11 years of age. Two age- and sex-matched without acne were randomly selected per case, and their body mass index (BMI) was also recorded.

  • 58.0 per 10,000 person-years 
  • Higher in females versus males (89.2 versus 28.2 per 10,000 person-years, p < .001)
  • Increased with age (4.3, 24.4, and 144.3 per 10,000 person-years among 7–8, 9–10, and 11–12 -year-olds, respectively, p < .001)

The study found systemic medication use was associated with increasing BMI (odds ratio = 1.43 per 5 kg/m2 increase in BMI, 95% CI 1.07–1.92, p = .015). A previous, unrelated study found children with high BMI are more likely to have increased insulin-like growth factors, which have been implicated in acne pathogenesis, but the severity of acne was found to be independent of BMI.2 Dietary habits were not assessed in this study, however, nutrition as a confounder may be considered to better understand the relationship between obesity and acne.

Tollefson concluded that acne incidence is higher in preadolescent girls and increases with age. Study authors also identified a “potential association” with precocious puberty that they say should be considered, especially for acne patients under 8 or 9 years old. Future studies should investigate the measures taken to improve BMI status on acne to further understand preadolescent acne epidemiology and risk factors.

The study was supported by the National Institute on Aging and the Rochester Epidemiology Project. The authors reported no conflicts of interest.


1. Rodriguez Baisi KE, Weaver AL, Shakshouk H, Tollefson MM. Acne incidence in preadolescents and association with increased body mass index: A population-based retrospective cohort study of 643 cases with age- and sex-matched community controls. Pediatr Dermatol. 2023 Jan 3. doi: 10.1111/pde.15223.

2. Anaba LE, Ogunbiyi OA, George OA. Adolescent Facial Acne Vulgaris and Body Mass Index: Any Relationship? West Afr J Med. 2019 May-Aug;36(2):129-132.


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