Introduction: Acne vulgaris (AV) is a chronic inflammatory disease of the pilosebaceous unit that is common among young adults. Air pollution exposure and face-washing behavior may be associated with AV. This study aimed to analyze the association of air pollution exposure and face-washing behavior with AV among medical students. Methods: This analytical cross-sectional study included 117 eligible students from the 2024 cohort of the Faculty of Medicine, Universitas Muhammadiyah Surakarta, using total sampling. Data were collected using questionnaires that underwent content and face validation, as well as clinical observation. We assessed the association between facewashing behavior and AV using the Chi-square test, and the association between air pollution exposure and AV using Fisher's exact test. Results: AV prevalence was 79.5%. Overall, 94.9% of respondents had heavy air pollution exposure, and 59.8% had positive face-washing behavior. Face-washing behavior was not significantly associated with AV (Chi-square = 1.521; p = 0.217; OR for negative vs positive behavior = 1.83; 95% CI 0.69–4.84). Air pollution exposure was also not significantly associated with AV (Fisher's exact p = 0.601; OR for heavy vs moderate exposure = 2.02; 95% CI 0.35–11.76). Conclusion: In this sample, neither air pollution exposure nor face-washing behavior was significantly associated with AV. Interpretation is limited by the highly imbalanced exposure distribution, the small moderate-exposure group, and the cross-sectional design.
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