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已发表论文
探究中国东部地区患有痤疮的年轻成人社交回避及心理社会因素
Authors Xu F , Yahaya NA , Zhou Y, Chen J, Ruan JY, Sun Y, Chong MC
Received 10 July 2025
Accepted for publication 8 October 2025
Published 11 October 2025 Volume 2025:18 Pages 2617—2627
DOI https://doi.org/10.2147/CCID.S549119
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Monica K. Li
Fen Xu,1,2 Nor Aziyan Yahaya,1 Yunxian Zhou,3 Junya Chen,1 Jia Yin Ruan,4 Yue Sun,1 Mei-Chan Chong1
1Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 2Department of Dermatology, Hangzhou Third Hospital, Hangzhou, Zhejiang, People’s Republic of China; 3School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 4Rory Meyers College of Nursing, New York University, New York, NY, USA
Correspondence: Mei-Chan Chong, Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia, Email mcchong@um.edu.my
Background: Acne is highly prevalent among young adults, and in East Asian contexts—where appearance standards, social media exposure, and the cultural construct of “face” (mianzi) are particularly prominent—visible skin lesions may incur amplified social burdens. However, evidence from China remains scarce regarding the key drivers of social avoidance in this population: specifically, whether anxiety, body image disturbance, income level, and lesion distribution exert independent effects, beyond the influence of acne severity itself. This study aims to fill this research gap by examining a sample of young adults with acne from East China.
Objective: To investigate social avoidance and its associations with body image disturbance, anxiety, and sociodemographic factors in Chinese young adults with acne.
Methods: A cross-sectional study of 201 acne patients (18– 29 years) in East China assessed social avoidance (SADS-SA), body image (BIDQ), and anxiety (GAD-7). Pearson correlation analyzed associations among variables, and multivariable linear regression explored independent effects of social avoidance.
Results: Mean social-avoidance score was 5.71± 3.79 and correlated with BIDQ (r = 0.343, P < 0.01) and GAD-7 (r = 0.546, P < 0.01). In multivariable models, higher income (≥ 5000 CNY) was negatively associated with avoidance (B =− 2.640; β=− 0.288; P = 0.022), whereas combined facial/neck + torso was positively associated with avoidance (B = 1.098; β= 0.122; P = 0.040); torso-only was negatively associated with avoidance (B =− 3.889; β=− 0.175; P = 0.003). Anxiety showed the strongest independent association with social avoidance (B = 0.330; β= 0.458; P < 0.001), while body image disturbance showed no significant direct association (P = 0.053).
Conclusion: In Chinese young adults with acne, anxiety is strongly associated with social avoidance—not acne severity itself. Higher income acts protectively, and combined facial/neck and torso distribution indicates greater risk. These findings support the integration of brief anxiety screening, targeted psychosocial interventions, and focused care for patients with visible lesions into dermatological care to reduce social avoidance.
Plain Language Summary: Acne is a common skin condition, especially among teenagers, and can affect more than just appearance. It may lower self-confidence and lead to social avoidance. This study explored why some young people with acne avoid social activities and what psychological factors contribute to this behavior. Researchers surveyed 201 acne patients aged 18 to 29 in eastern China, asking them about their social life, body image, and anxiety levels. The study also considered factors like income and acne location.
The findings revealed that: (1) higher anxiety levels were linked to increased social avoidance; (2) dissatisfaction with appearance led to stronger tendencies to avoid social interactions; (3) acne affecting both the face and body had a greater impact; and (4) individuals with higher income levels were less likely to avoid social activities.
These results suggest that acne not only impacts appearance but also emotional well-being and social life. Addressing anxiety and improving self-perception may help reduce social avoidance. Professional support and greater public awareness can improve the quality of life for young people with acne.
Keywords: acne, young adults, social avoidance, body image, anxiety, influencing factors
1Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 2Department of Dermatology, Hangzhou Third Hospital, Hangzhou, Zhejiang, People’s Republic of China; 3School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 4Rory Meyers College of Nursing, New York University, New York, NY, USA
Correspondence: Mei-Chan Chong, Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia, Email mcchong@um.edu.my
Background: Acne is highly prevalent among young adults, and in East Asian contexts—where appearance standards, social media exposure, and the cultural construct of “face” (mianzi) are particularly prominent—visible skin lesions may incur amplified social burdens. However, evidence from China remains scarce regarding the key drivers of social avoidance in this population: specifically, whether anxiety, body image disturbance, income level, and lesion distribution exert independent effects, beyond the influence of acne severity itself. This study aims to fill this research gap by examining a sample of young adults with acne from East China.
Objective: To investigate social avoidance and its associations with body image disturbance, anxiety, and sociodemographic factors in Chinese young adults with acne.
Methods: A cross-sectional study of 201 acne patients (18– 29 years) in East China assessed social avoidance (SADS-SA), body image (BIDQ), and anxiety (GAD-7). Pearson correlation analyzed associations among variables, and multivariable linear regression explored independent effects of social avoidance.
Results: Mean social-avoidance score was 5.71± 3.79 and correlated with BIDQ (r = 0.343, P < 0.01) and GAD-7 (r = 0.546, P < 0.01). In multivariable models, higher income (≥ 5000 CNY) was negatively associated with avoidance (B =− 2.640; β=− 0.288; P = 0.022), whereas combined facial/neck + torso was positively associated with avoidance (B = 1.098; β= 0.122; P = 0.040); torso-only was negatively associated with avoidance (B =− 3.889; β=− 0.175; P = 0.003). Anxiety showed the strongest independent association with social avoidance (B = 0.330; β= 0.458; P < 0.001), while body image disturbance showed no significant direct association (P = 0.053).
Conclusion: In Chinese young adults with acne, anxiety is strongly associated with social avoidance—not acne severity itself. Higher income acts protectively, and combined facial/neck and torso distribution indicates greater risk. These findings support the integration of brief anxiety screening, targeted psychosocial interventions, and focused care for patients with visible lesions into dermatological care to reduce social avoidance.
Plain Language Summary: Acne is a common skin condition, especially among teenagers, and can affect more than just appearance. It may lower self-confidence and lead to social avoidance. This study explored why some young people with acne avoid social activities and what psychological factors contribute to this behavior. Researchers surveyed 201 acne patients aged 18 to 29 in eastern China, asking them about their social life, body image, and anxiety levels. The study also considered factors like income and acne location.
The findings revealed that: (1) higher anxiety levels were linked to increased social avoidance; (2) dissatisfaction with appearance led to stronger tendencies to avoid social interactions; (3) acne affecting both the face and body had a greater impact; and (4) individuals with higher income levels were less likely to avoid social activities.
These results suggest that acne not only impacts appearance but also emotional well-being and social life. Addressing anxiety and improving self-perception may help reduce social avoidance. Professional support and greater public awareness can improve the quality of life for young people with acne.
Keywords: acne, young adults, social avoidance, body image, anxiety, influencing factors