<![CDATA[Background: Acne vulgaris is increasingly recognized as a skin-barrier disease, yet data linking facial hydration to graded severity in tropical Asian young adults are scarce. Objective: To determine the association between facial skin hydration and acne vulgaris severity in Indonesian university students. Methods: In this cross-sectional analytic study, 33 students aged 17–25 years with acne vulgaris were enrolled by purposive sampling at a Surabaya dermatology clinic. Facial stratum corneum hydration was measured by capacitance and classed as dry (<35%), normal (35–50%) or moist (>50%); severity was graded by the Lehmann/Indonesian Acne Expert Meeting criteria. Associations were tested with chi-square, odds ratios, Spearman correlation, multivariable logistic regression and receiver-operating-characteristic (ROC) analysis. Results: Participants were predominantly female (69.7%); 54.5% had dry skin and 60.6% had moderate acne, with no severe cases. Lower hydration was significantly associated with greater severity (χ²=9.641, p=0.008; Cramér's V=0.541). Dry skin conferred ten-fold higher odds of moderate acne (OR=10.00, 95% CI 1.94–51.54), and each 10% reduction in moisture independently raised the odds (adjusted OR=3.87, 95% CI 1.39–10.72, p=0.009). Facial moisture discriminated moderate acne well (AUC=0.792; Spearman ρ=−0.536, p=0.001). Conclusion: Lower facial hydration is independently associated with more severe acne, supporting barrier-directed, non-comedogenic moisturization as an adjunct in acne care for Fitzpatrick III–V skin.]]>
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