The mean temperature varied from 32

The mean temperature varied from 32.2°C in summer, 31°C inrainy season, and 15°C in winters (Table 3). The mean humidity insummer was 49.2%, in rainy season was 68.5%, and in winter was79.7% (Table 4). The ANOVA analysis (Tables 3 and 4) indicated thatthe mean temperature and mean humidity are significantly varyingwith seasonal aggravation of acne.Post hoc analysis found that the aggravation of acne with temperature was significantly different between summer vs. winter seasonand rainy vs winter season. Similarly, there was a significant difference in aggravation of acne and mean humidity between summer andrainy, rainy and winter, and winter and summer season (Figure 2).4 | DISCUSSIONIn our study, 82 patients (47.95%) reported a seasonal variation with69 exhibiting aggravation in summer and 45 exclusively in summer.A total of 89 patients (52.05%) did not report any seasonal variation.There was a significant variation of acne between summers and winters. Our results are in consonance with previous studies fromIndia3,6 where a majority of patients noticed a summer aggravation.The studies published in western literature1,7,8 report that fewerpatients seek treatment in the summer months, but a study fromMunich found that while one‐third of the patients (46 of 139)reported an aggravation of their acne in winter and an improvementin summer, another one‐third of the patients (44 /139) complainedabout an aggravation of their acne in summer, and one‐third (49 of139) did not notice any change.9Clinical observations have shown that acne can worsen dramatically if patients are exposed to tropical and subtropical climates. Wefeel that the variation depends on the ambient temperature and possibly the humidity. This can be assessed only if other confoundingfactors that can aggravate acne are excluded like history of use ofany topical comedogenic agent, details of treatment undertaken foracne and use of any drugs, topical or oral causing or aggravatingacne. These were excluded in our study by meticulous questioning.