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Perceived vs. Clinical Acne Severity: Impact on QoL and Treatment Adherence in Male Military Personnel: A Cross-Sectional Study

Year: 2026

Type: article

Abstract: Background: Acne vulgaris imposes a significant psychosocial burden, which may be intensified when patients' perceived severity diverges from objective clinical grading. Such discordance may be amplified in high-stress populations like military personnel, yet evidence in this cohort remains limited. This study quantified this discordance in male military personnel and evaluated whether subjective or objective severity better predicts quality of life (QoL) impairment and treatment adherence. Methods: -test, and Chi-square test as appropriate. Results: Significant discordance existed between clinician and patient severity assessments (P<0.001). Clinicians classified severity as mild (39.0%), moderate (52.7%), and severe (8.3%), whereas self-ratings were 12.7% mild, 53.0% moderate, and 34.3% severe; 52.3% of patients overestimated their severity. Self-rated severity correlated more strongly with DLQI impairment than GAGS scores (r=0.314 vs. 0.206, both P<0.001). GAGS scores were primarily associated with impairments in physical symptoms, clothing, and social activities, while self-rated severity correlated significantly with all 10 DLQI domains. Higher DLQI scores were associated with marriage, acne scars, military service of 2-5 years, and persistent symptoms (all P<0.05). A treatment paradox emerged: patients with objectively severe acne sought more interventions but had shorter treatment duration (64% discontinued within ≤1 month, P=0.040), whereas those with subjectively severe acne maintained longer courses (69.9% continued >3 months, P=0.011). Conclusion: In military populations, self-perceived acne severity more strongly predicts QoL impairment than objective grading and drives differential treatment engagement. Integrating dual-dimensional assessments and psychological support into military dermatology protocols is essential to optimize acne management.

Source: Clinical Cosmetic and Investigational Dermatology

DOI: 10.2147/ccid.s606857

Authors: Tao Xu, Min Li, Dandan Zhan, Xiao Li, Xiaohan Hu, Zhou Zhou

Institution: Chinese People's Liberation Army

Language: English

Topic: Acne and Rosacea Treatments and Effects

Subfield: Dermatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836