A preliminary investigation of the impact of oily skin on quality of life and concordance of self-perceived skin oiliness and skin surface lipids (sebum)

Two key words characterize the uniqueness of skin lipids: complexity and perversity. Each suggests a function. Complexity manifests itself in the large number and variety of both saturated and unsaturated fatty chains synthesized by human skin. Functionally, this allows each individual to have a distinct odor or chemical fingerprint. Perversity manifests itself when one compares the lipids synthesized by skin with those synthesized by internal tissues. For example, skin makes odd instead of only even chains, branched instead of only straight chains, free instead of only esterified acids, places double bonds in unusual positions in the fatty chains, extends chains to extreme lengths, and accumulates intermediates in the synthesis of a biologically valuable compound such as cholesterol. Functionally, these products may pose metabolic problems to potential pathogens and thus contribute to the survival of only compatible microorganisms.

To determine the effects of acne vulgaris on the quality of life of adult dermatology patients. Cross-sectional and longitudinal questionnaire study. Sixty patients with acne vulgaris attending appointments with their dermatologists. Findings using Skindex, a validated 29-item instrument to measure the effects of skin disease on patients' quality of life. Results are reported as 3 scale scores (functioning, emotions, and symptoms) and a composite score (average scale score). In addition, dermatologists rated the clinical severity of patients' skin disease, and patients responded to a global question about how they are bothered by acne. Higher Skindex scores indicate greater effects on quality of life. Patients with acne experienced functioning and emotional effects from their skin disease comparable with those of patients with psoriasis, but experienced fewer symptoms (for patients with acne and psoriasis, respectively, Skindex functioning scores of 14.9 and 22.8 [P=.08]; emotion scores, 39.2 and 38.9 [P=.95]; and symptoms scores, 29.5 and 42.1 [P<.05]). Skindex scores were higher in older patients than in younger patients, and patients aged 40 years or older were less likely to report improvement in their acne after 3 months (43% vs 85%; P<.05). Among patients reporting no improvement in their acne, older patients reported greater effects of their acne on their quality of life. Furthermore, in multivariate analyses, older adults reported more effects of acne on their quality of life than younger adults, even after controlling for sex and acne severity as judged by the dermatologist. Acne vulgaris significantly affects patients' quality of life. Regardless of the severity of acne, older adults were more affected by their acne.