The Impact of Acne Scarring on Quality of Life, Willingness-to-pay, and Time Trade-off: A Cross-sectional Analysis.

Objective: We sought to evaluate the impact of the presence of acne scarring in patients with acne vulgaris on quality of life as assessed by the Dermatology Life Quality Index (DLQI) and the Cardiff Acne Disability Index (CADI); disease severity using the Investigator's Global Assessment of Acne (IGA); and health utility measures including willingness-to-pay, time trade-off, time spent on concealment, and percent of income willing to exchange for resolution of disease. Methods: We conducted a cross-sectional, single-institution survey. Results: In total, 94 patients with acne vulgaris participated, of which 53.2 percent had acne scarring and 46.8 percent did not. The presence of acne scarring was associated with higher DLQI, CADI, and IGA scores. Utility measures including willingness-to-pay, time trade-off, concealment time, and percent of income willing to exchange for resolution of disease were similar for participants with and without scarring. For participants with and without scarring, a greater impairment of quality of life as assessed by the DLQI was positively correlated with WTP25, percent of monthly income, IGA, and the CADI. Limitations: As the study design was single-site and cross-sectional, and therefore results may not be generalizable. Conclusion: The presence of acne scarring significantly impacts quality of life. A greater impairment of quality of life in patients with acne vulgaris correlates positively with severity of acne and some measures of health economics. Interventions to minimize or prevent acne scarring may reduce psychosocial burden of disease.