{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:19:50Z","timestamp":1787066390735,"version":"build-2736575974"},"reference-count":23,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,6,20]]},"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acne vulgaris (acne) is a common adolescent skin condition. It is associated with negative psychological impacts and sufferers do not easily seek help, hence is undertreated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We investigated the self-reported prevalence, severity and psychological sequelae of acne, together with assessing help-seeking behaviour and its barriers, in separate school and hospital samples. We explored opportunistic treatment by paediatricians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Self-reported survey with participants drawn from: (1) 120 adolescents aged 13\u201318 in a London tertiary paediatric outpatient department and (2) 482 adolescents from two London schools, aged 11\u201318. Adolescents confidentially and anonymously completed a questionnaire (paper or online) and those with acne completed the Cardiff Acne Disability Index (CADI) questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>To explore if acne is being addressed opportunistically in outpatient appointments and the behaviours associated with seeking help and psychological implications of acne.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Acne prevalence was reported as 58.3% in the clinic and 42.3% in schools, with 34.3% and 20.6% of participants having moderate acne (MA) or severe acne (SA), respectively. The correlation between acne severity and CADI was significant (regression coefficient=4.86, p&lt;0.005 (MA) and 9.08, p&lt;0.005 (SA) in the hospital; 1.92, p&lt;0.001 (MA) and 7.41, p&lt;0.005 (SA) in schools). Severity of acne was associated with increased likelihood of seeing a doctor in both samples (OR=8.95, 2.79\u201328.70 (MA) in the clinic and 1.31, 1.30\u20132.90 (MA) and 3.89, 0.66\u201322.98 (SA) in the community). Barriers to help seeking included embarrassment and believing doctors were unapproachable. Doctors addressed acne opportunistically in 2.9% of the sample, although 16.7% of those with MA and SA wished their doctor had raised it.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Acne is common and has negative psychological implications, correlating with severity. Young people often forego seeking help and hospital clinicians rarely address acne opportunistically. Further work is needed to investigate how to reduce barriers to help seeking for acne.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-016964","type":"journal-article","created":{"date-parts":[[2017,9,22]],"date-time":"2017-09-22T20:10:19Z","timestamp":1506111019000},"page":"e016964","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Help-seeking behaviours, opportunistic treatment and psychological implications of adolescent acne: cross-sectional studies in schools and hospital outpatient departments in the UK"],"prefix":"10.1136","volume":"7","author":[{"given":"Karishma Parimal","family":"Desai","sequence":"first","affiliation":[{"name":"Department of Medicine, University College London Medical School, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Martyn-Simmons","sequence":"additional","affiliation":[{"name":"Department of Paediatric Dermatology, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell","family":"Viner","sequence":"additional","affiliation":[{"name":"Department of General and Adolescent Paediatric Unit, UCL Institute of Child Health, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry","family":"Segal","sequence":"additional","affiliation":[{"name":"Department of Adolescent Endocrinologist, University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,9,21]]},"reference":[{"key":"2025121222372749000_7.9.e016964.1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/bjd.13462","article-title":"A global perspective on the epidemiology of acne","volume":"172","author":"Tan","year":"2015","journal-title":"Br J Dermatol"},{"key":"2025121222372749000_7.9.e016964.2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12149"},{"key":"2025121222372749000_7.9.e016964.3","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2001.04346.x"},{"key":"2025121222372749000_7.9.e016964.4","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1159\/000107624","article-title":"Living with acne. A study of adolescents' personal experiences","volume":"215","author":"Pawin","year":"2007","journal-title":"Dermatology"},{"key":"2025121222372749000_7.9.e016964.5","doi-asserted-by":"publisher","DOI":"10.1590\/S0365-05962012000600007"},{"key":"2025121222372749000_7.9.e016964.6","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2010.264"},{"key":"2025121222372749000_7.9.e016964.7","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1111\/j.1468-3083.2006.01829.x","article-title":"Acne is prevalent but use of its treatments is infrequent among adolescents from the general population","volume":"21","author":"Nijsten","year":"2007","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2025121222372749000_7.9.e016964.8","doi-asserted-by":"publisher","DOI":"10.2165\/00128071-200809050-00001"},{"key":"2025121222372749000_7.9.e016964.9","doi-asserted-by":"crossref","first-page":"e70","DOI":"10.1111\/ijd.12753","article-title":"Beliefs, perceptions, and treatment modalities of acne among schoolchildren in Lithuania: a cross-sectional study","volume":"54","author":"Karciauskiene","year":"2015","journal-title":"Int J Dermatol"},{"key":"2025121222372749000_7.9.e016964.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.2010.01286.x"},{"key":"2025121222372749000_7.9.e016964.11","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/1751-0759-5-11","article-title":"Psychosocial judgements and perceptions of adolescents with acne vulgaris: A blinded, controlled comparison of adult and peer evaluations","volume":"5","author":"Ritvo","year":"2011","journal-title":"Biopsychosoc Med"},{"key":"2025121222372749000_7.9.e016964.12","unstructured":"DiTomasso R , Golden B , Morris H . 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