Psychosocial Impact of Acne Among Medical and Allied Health Undergraduates in Sri Lanka: A Cross-Sectional Study Using Validated Tools

Background: 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 explore the relationships and predictors of acne-related quality of life, psychological distress, and self-esteem among medical and allied health undergraduates at the University of Kelaniya, Sri Lanka. Methods: A descriptive cross-sectional study was conducted in 2025 among undergraduates aged 18–28 years from three degree programmes: Medicine (MBBS), Speech and Hearing Sciences (SHS) and Occupational Therapy (OT). 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. Results: Among 480 respondents (361 females, 119 males), acne incidence was significantly greater in females (87.0%) than in males (70.6%) (p < 0.05). After 109 responses were excluded on the basis of predefined criteria, the final sample included 371 participants (79% female), with a mean age of 23.9 years. The Pearson correlation analysis revealed very strong positive correlations among the four Acne-QoL domains-acne symptoms, self-perception, role emotional, and role social-with correlation coefficients ranging from 0.812 to 0.950 (all p < 0.001), with the strongest correlation being between self-perception and role emotional (r = 0.950, p < 0.001). Each 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). Conclusions: 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.