European Journal of Pediatrics

, Volume 172, Issue 4, pp 465–471 | Cite as

Acne vulgaris is associated with intensive pubertal development and altitude of residence—a cross-sectional population-based study on 6,200 boys

  • Ralitsa Robeva
  • Yavor Assyov
  • Analia Tomova
  • Philip Kumanov
Original Article


Acne vulgaris is a chronic inflammatory disease with a complex pathogenesis that affects predominantly adolescents. The aim of the study was to investigate the interrelations between the presence of acne and several variables associated with somatic growth, pubertal maturation, and environmental conditions (altitude and regions of residence). A population sample of 6,200 clinically healthy boys (0–19 years) was examined and the presence of acne was determined. Height, weight, testicular volumes, penile length and circumference, as well as pubic hair were also measured. The prevalence of moderate and severe acne in the whole group was 7.74 %, while in the age group 12–19 years, it was 19.31 %. Twelve–15-year-old boys with acne were taller and heavier than the ones without. They also had increased penile length and circumference as well as larger testicular volumes. Somatometric and pubertal characteristics of 17–19-year-old boys with and without acne were similar. The prevalence of the disease did not differ between the rural and urban inhabitants. However, the acne frequency decreased with the increasing of the altitude where the boys lived. Conclusions: Our results showed that the development of acne vulgaris in male adolescents was associated with an intensive growth and pubertal maturation, while obesity per se did not play an important role. Of particular interest was the association between the prevalence of acne and the altitude of residence.


Acne Male puberty Growth Obesity Altitude Pilosebaceous unit 



The authors express their gratitude to Professor M. Vucov for the statistical analysis of the data and to all children, adolescents, and their families for participation in the study. The study was supported only by the Medical University of Sofia. No other project support or funding was received.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Ralitsa Robeva
    • 1
  • Yavor Assyov
    • 2
  • Analia Tomova
    • 1
  • Philip Kumanov
    • 1
  1. 1.Clinical Center of Endocrinology and GerontologyMedical University of Sofia, Faculty of MedicineSofiaBulgaria
  2. 2.Medical University of Sofia, Faculty of MedicineSofiaBulgaria

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