Association Between Acne Severity and Body Mass Index Among Patients: A Hospital Based Cross Sectional Study

Background: Acne vulgaris is one of the most common dermatological conditions affecting adolescents and young adults worldwide. Its severity is influenced by multiple factors, including genetics, hormonal imbalances, diet, and emerging evidence suggests that body mass index (BMI) may also play a role. Methods: A hospital-based cross-sectional study was conducted from January to June 2025 at the OPD, Dermatology and Venerology, Dhaka Medical College Hospital, Dhaka, Bangladesh from November 2024 to June 2025. A total of 150 patients aged 15–35 years presenting with acne vulgaris were enrolled consecutively. Acne severity was evaluated using the Global Acne Grading System (GAGS), classifying patients as mild, moderate, or severe. BMI was calculated as weight in kilograms divided by height in meters squared (kg/m²) and categorized according to WHO guidelines: underweight (<18.5), normal (18.5–24.9), overweight (25–29.9), and obese (≥30). Data were analyzed using descriptive statistics, cross-tabulation, and chi-square tests, with significance set at p < 0.05. Results: Among the 150 participants, 68 (45.3%) had mild acne, 55 (36.7%) moderate acne, and 27 (18%) severe acne. The mean age was 22.4 ± 5.1 years, with 78 males (52%) and 72 females (48%). BMI distribution showed 15 (10%) underweight, 80 (53.3%) normal weight, 36 (24%) overweight, and 19 (12.7%) obese participants. Severe acne was more prevalent among overweight and obese individuals, with 9 (25%) overweight and 7 (36.8%) obese participants presenting with severe acne, compared to 10 (12.5%) of normal weight and 1 (6.7%) underweight participant. Mean BMI increased progressively with acne severity: mild (22.1 ± 2.7), moderate (24.3 ± 3.1), and severe (26.5 ± 3.5) kg/m². Chi-square analysis confirmed a statistically significant association between higher BMI and greater acne severity (p < 0.05). No significant sex differences in acne severity were observed. Conclusion: This study demonstrates a positive association between BMI and acne severity, with overweight and obese patients more likely to exhibit moderate to severe acne. These findings underscore the importance of considering metabolic health in acne management. Interventions targeting weight reduction and lifestyle modification may complement dermatological treatment, potentially improving outcomes. Further longitudinal studies are warranted to explore causal mechanisms linking BMI and acne severity.