Psychosocial impact of acne among medical, Speech and Hearing Sciences, and Occupational Therapy undergraduates at a Sri Lankan University

Acne vulgaris is associated with substantial psychosocial effects, including impaired socioemotional well-being among young adults. This study aimed to determine the prevalence of acne and to examine the relationships and predictive effects of acne-related quality of life on psychological distress and self-esteem, in addition to exploring gender differences among medical and allied health undergraduates. A descriptive cross-sectional study was conducted from April to June 2025 among undergraduates aged 18–28 years from three degree programmes: Medicine (MBBS), Speech and Hearing Sciences (SHS), and Occupational Therapy (OT) at the Faculty of Medicine, University of Kelaniya, Sri Lanka. At this Faculty, SHS and OT are the only allied health undergraduate programmes; therefore, these were the allied health disciplines included. The participants were recruited via convenience sampling via a self-administered online questionnaire with three validated psychometric tools: The Acne Quality of Life Questionnaire (Acne-QoL), the Rosenberg Self-Esteem Scale (RSES) and the Depression, Anxiety, Stress Scale-21 (DASS-21). Data analysis was performed in SPSS v22, employing descriptive statistics, chi-square tests, linear regression and Pearson correlation. Statistical significance was set at p ≤ 0.05 for chi-square and regression analyses, and a more stringent significance level of p ≤ 0.001 was used for correlation analyses. Ethical approval was obtained from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya (No: P/12/02/2025). The study period coincided with a post-pandemic phase of normalized on-campus activity, providing relevant psychosocial context for undergraduate life. A total of 480 undergraduates completed the survey (361 females, 119 males). Among all respondents, 398 reported having acne, with prevalence significantly higher in females (87.0%) than in males (70.6%) (p < 0.05). In accordance with predefined criteria, 109 respondents (23%) were excluded: 82 (17%) who did not have acne and 27 (6%) who reported a pre-existing diagnosed psychological disorder. The final analytical sample therefore comprised 371 participants with acne (79% female; mean age 23.9 years). The Pearson correlation analysis revealed very strong positive correlations among the four Acne-QoL domain demonstrated a moderate positive correlation with overall self-esteem (r = 0.424 to 0.519, all p < 0.001), with the role social domain correlating most strongly with self-esteem (r = 0.519, p < 0.001). Significant negative correlations were found between all four Acne-QoL domains and the following psychological distress measures: anxiety, depression, and stress (p < 0.001). Linear regression revealed that the acne symptoms domain was a positive and significant predictor of self-esteem (B = 0.154, β = 0.221, p = 0.006), whereas the role social domain was the strongest positive predictor (B = 0.420, β = 0.615, p < 0.001). Conversely, the role emotional domain negatively predicted self-esteem (B = -0.176, β = -0.314, p = 0.030). The acne symptoms domain is a significant negative predictor of depression (B = -0.139, β = 0.209, p = 0.017). Similarly, the role social domain also significantly negatively predicts depression (B = -0.218, β = -0.333, p = 0.013). For anxiety, the acne symptoms domain score was also a significant negative predictor (B = -0.204, β = -0.320, p < 0.001). For stress, the acne symptoms domain also showed a significant negative association (B = -0.163, β = -0.259, p = 0.004). Gender differences emerged in the depression and stress models: females reported lower depression and stress scores related to social roles but higher scores related to emotional roles (all p < 0.05). This study highlights the significant psychosocial impact of acne among medical and allied health undergraduates, underscoring the importance of holistic care that addresses both dermatological and mental health needs.