Educational, labour market and relationship outcomes in people with acne

John S Barbieri; Dóra K Farkas; Niels Skipper; Ketaki Bhate; Sinéad M Langan; Line Kibsgaard; Henrik T Sørensen; Sigrun A J Schmidt

doi:10.1111/jdv.20323

Educational, labour market and relationship outcomes in people with acne

J Eur Acad Dermatol Venereol. 2024 Sep 18. doi: 10.1111/jdv.20323. Online ahead of print.

Authors

John S Barbieri¹, Dóra K Farkas², Niels Skipper³, Ketaki Bhate⁴, Sinéad M Langan^{4

5}, Line Kibsgaard⁶, Henrik T Sørensen², Sigrun A J Schmidt^{2

6}

Affiliations

¹ Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
² Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark.
³ Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark.
⁴ Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
⁵ Health Data Research, London, UK.
⁶ Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.

PMID: 39291920
DOI: 10.1111/jdv.20323

Abstract

Background: Although acne is associated with scarring, mental health comorbidities and bullying, little is known about its impact on socio-economic outcomes.

Objectives: To examine the association between acne and educational, labour market and relationship outcomes.

Methods: We conducted a nationwide registry-based cohort study in Denmark. We included birth cohorts from 1982 to 1988 and compared those with and without acne identified using hospital diagnosis codes and redeemed prescriptions. Our main educational outcome was educational attainment. The main labour market outcomes were earned income at age 30 and long-term unemployment at any time before age 30. The main relationship outcomes were single partnership and childlessness by age 30. Outcomes were assessed using Poisson regression for binary outcomes and linear regression for continuous outcomes, adjusted for sex, calendar year, mother's socio-economic position and hormonal contraception use.

Results: Those with acne had a lower risk of not completing upper secondary education (relative risk (RR): 0.79; 95% confidence interval [CI]: 0.76-0.83) and higher education (RR: 0.90; 95% CI: 0.88-0.91), with absolute differences up to 4 percentage points. Persons with acne had slightly higher income (mean percentile difference: 2.6%, 95% CI: 2.2-2.9) and lower risk of long-term unemployment than those without acne (9.8% vs. 11.4%; RR: 0.90; 95% CI: 0.87-0.93). The prevalence of being single until age 30 was similar (19.7% vs. 20.1%; adjusted RR: 0.96; 95% CI: 0.94-0.98) but childlessness was slightly more prevalent (60.5% vs. 57.5%; adjusted RR: 1.03; 95% CI: 1.02-1.04). However, all associations were attenuated or lost in secondary analysis restricted to exposure-discordant siblings to address confounding from family-related factors.

Conclusions: Acne during adolescence does not seem to affect long-term educational, labour market or relationship outcomes. However, there is a need for additional studies to validate the findings in untreated patients and different health and social systems.

Abstract

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