Importance: Surveying identical twins allows us to qualitatively separate genetic and environmental factors that may contribute to acne severity.
Objective: To study a cohort of identical and fraternal twins to identify environmental factors that may influence acne severity.
Design, setting, participants: A survey was administered to 139 identical and fraternal twin multiples (279 subjects) at the Annual Twins Day Festival in Twinsburg, Ohio on August 6-7, 2016. One set of triplets was included.
Main outcome(s) and measure(s): Acne incidence, severity, and triggers were analyzed using the N-1 Chi-squared test and paired, 2-tailed t test.
Results: The proportion of concordant pairs was significantly higher in identical (64%) vs fraternal (49%) twins (P=0.04). Acne was found to be associated with polycystic ovarian syndrome (PCOS; P=0.045), anxiety (P =0.014), and asthma (P=0.026). Identical twin pairs with acne had a higher BMI (P= 0.020) and exercised significantly less (P=0.001) than those without acne. Analyzing concordant twin pairs, the twin with more severe acne was more likely to report aggravation of acne with cosmetic product use (P=0.002) and sugar intake (P=0.048).
Conclusions and revelance: This twin study further supports that there may be a genetic phenotypic link, though social and environmental factors may also have an influence in the disease process. <p><em>J Drugs Dermatol. 2018;17(4):380-382.</em></p>.