Impact of Stress on the Prevalence of Acne Among Medical Students in the Middle East: A Systematic Review.

Abstract

Acne vulgaris is a prevalent dermatological condition among young adults, with stress frequently implicated as a contributing factor. Medical students, due to their academic demands, are particularly susceptible to both stress and acne. This systematic review aims to evaluate the impact of stress on the prevalence and severity of acne among medical students in the Middle East. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, CINAHL Ultimate, and Google Scholar. Eligible studies included those that examined the association between stress and acne among medical students. In total, 11 studies met the inclusion criteria, encompassing 3,063 participants, primarily medical students with an average age of 21 years. Most studies (n = 9) were cross-sectional, with one case-control and one prospective study. The pooled prevalence of acne was 64.3%. Nine studies reported a statistically significant association between stress and acne severity (p < 0.05), while the remaining studies noted a non-significant but suggestive relationship. Common assessment tools included the Perceived Stress Scale, Global Acne Grading System, and Dermatology Life Quality Index. The findings support a potential bidirectional relationship between psychological stress and acne flare-ups. There is consistent evidence suggesting that stress significantly contributes to the prevalence and severity of acne among medical students in the Middle East. Early stress management interventions may help mitigate acne severity in this population.