Three Major Risk Factors Identified for Scarring in Patients with Acne


This data indicates that to prevent aggravation of acne and the eventual scar formation, it may be necessary to treat acne from an early stage.

Three major risk factors for individuals with acne scars are having a positive family history of acne, being of the male gender, and severity of acne, according to recent findings.1

These findings were the result of a meta-analysis of available literature and the study was conducted to assess the prevalence and risk factors around the world of acne scarring in those with the skin condition.

The research was authored by Jin Chen,from the Department of Dermatology at The First Affiliated Hospital of Chongqing Medical University in China.

“Therefore, through a systematic and comprehensive literature search, we performed a meta-analysis designed to assess the prevalence and risk factors of acne scars in patients with acne,” Chen and colleagues wrote.

Background and Findings

In order to identify relevant studies, the investigators had 2 researchers conduct independent searches in the Web of Science, PubMed, and EMBASE databases to find relevant research published prior to January 09, 2023.

As far as search terms, the ones the research team used were "acne AND (scar odds ratio [OR] scars OR scarring OR cicatrix OR cicatrization)" without any additional restrictions. In order to ensure a comprehensive search, the team’s reference lists of relevant data was manually reviewed to identify additional studies.

The investigators’ study selection process involved removing duplicate records initially. Then, the titles and abstracts of the remaining studies were independently reviewed by the 2 selected researchers for the initial selection stage. The second selection stage involved a full-text review by the same researchers.

Inclusion criteria the research team designated were as follows: original observational studies, studies with necessary data to determine prevalence of acne scars and corresponding 95% confidence intervals (CI), as well as studies with data on odds ratios (OR) for risk factors, and studies published in the English language.

In cases where multiple studies examined individuals from the same population, the most informative study was selected. Any disagreements or uncertainties encountered by the investigators during the review process were discussed with another senior reviewer.

Data from all eligible studies were extracted and organized by two investigators. The extracted data included year, author, country, acne scar definition, study design, number of patients, gender distribution, source of patients, age, and assessment methods.

In total, the research team used 37 studies with 24,649 acne patients that were included in the analysis. The pooled prevalence of acne scars among these individuals was shown to be 47% (95% confidence interval [CI]: 38 - 56%).

Their subgroup analysis revealed variations in prevalence based on factors such as gender, acne severity, age, and the source of patients. Furthermore, the investigators identified 3 risk factors associated with acne scars: being male (odds ratio [OR]: 1.58, 95% CI: 1.19 - 2.09), having a positive family history of acne (OR: 2.73, 95% CI: 1.26 - 5.91), and experiencing moderate (OR: 2.34, 95% CI: 1.54 - 3.57) or severe acne (OR: 5.51, 95% CI: 2.45 - 12.41).

“In conclusion, based on the published data, this meta-analysis found that 47% of patients with acne suffered from acne scars and male gender, positive family history of acne, and acne severity were risk factors for acne scars,” they wrote. “In order to prevent further aggravation of acne and formation of scars, it is important to treat acne at an early stage.”


  1. Liu, L, Xue, Y, Chen, Y, et al. Prevalence and risk factors of acne scars in patients with acne vulgaris. Skin Res Technol. 2023; 29: 1– 9.
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