Body Mass Index (BMI) is a widely used indicator to assess body fat and classify individuals into underweight, normal weight, overweight, and obese categories. In recent years, increasing evidence has highlighted the role of BMI in influencing susceptibility to various infections, including skin and soft tissue infections. Both low and high BMI have been associated with altered immune responses, making individuals more vulnerable to infectious diseases (4,5).

Obesity, in particular, has emerged as a significant risk factor for infections due to its impact on immune function, inflammation, and metabolic processes. Studies have demonstrated that obesity is associated with impaired immune responses, delayed wound healing, and increased susceptibility to bacterial and fungal infections (2,7). Additionally, obesity-related changes in skin physiology, such as increased sweating, skin folds, and altered barrier function, create a favorable environment for microbial growth (9,10).

Recent epidemiological and genetic studies have further strengthened the association between obesity and skin infections. For instance, Mendelian randomization studies have provided evidence supporting a causal relationship between increased BMI and the risk of skin and soft tissue infections (1). Similarly, population-based studies have shown that individuals with higher BMI have an increased risk of infection-related complications and hospitalizations (6).

Moreover, environmental and lifestyle factors, including hygiene and sanitation, may interact with BMI to influence the risk of skin infections. Research has indicated that both obesity and undernutrition can contribute to increased susceptibility to skin infections, suggesting a complex relationship between BMI and dermatological health (3).

The global rise in obesity has led to an increased burden of obesity-related skin conditions, highlighting the need to better understand the link between BMI and skin infections (8). Despite growing evidence, the relationship between BMI and skin infections remains multifactorial and not fully understood.

Therefore, this study aims to assess the relationship between Body Mass Index (BMI) and skin infections among individuals, with the goal of providing further insight into this important public health issue.

Study Design and Setting This cross-sectional study was conducted to assess the relationship between Body Mass Index (BMI) and skin infections among participants. Study Population A total of 300 participants aged 18–30 years were included in the study. Both male and female participants were recruited from outpatient departments, educational institutions, and community settings. Sampling Technique A non-probability convenience sampling technique was used to select participants who met the inclusion criteria. Inclusion Criteria • Individuals aged 18–30 years • Both genders • Willing to participate and provide informed consent Exclusion Criteria • Individuals with chronic systemic diseases (e.g., diabetes, immunodeficiency disorders) • Patients on long-term steroids or immunosuppressive therapy • Individuals with severe dermatological conditions unrelated to infections • Pregnant or lactating females Data Collection Procedure Data were collected using a structured and pre-tested questionnaire. The questionnaire included: 1. Sociodemographic Information: Age, gender, occupation, and lifestyle factors 2. Anthropometric Measurements: Participants were categorized as: • Underweight (<18.5) • Normal (18.5–24.9) • Overweight (25–29.9) • Obese (≥30) 3. Assessment of Skin Infections: Participants were clinically examined for common skin infections, including: Fungal infections (e.g., dermatophytosis) .Bacterial infections (e.g., cellulitis, impetigo).Viral infections (e.g., warts, herpes) .Diagnosis was made by a qualified healthcare professional based on clinical findings.

A total of 300 participants were included in the study. The mean age was 24.1 ± 3.5 years. Among them, 172 (57.3%) were females and 128 (42.7%) were males. The majority of participants belonged to the 21–25 years age group (48%), followed by 18–20 years (32%) and 26–30 years (20%).

Based on Body Mass Index (BMI), participants were categorized as follows: Underweight: 48 (16.0%) .Normal weight: 132 (44.0%) ,Overweight: 72 (24.0%) ,Obese: 48 (16.0%)  The majority of participants had normal BMI, followed by overweight individuals. Out of 300 participants, 162 (54.0%) were found to have one or more types of skin infections, while 138 (46.0%) had no skin infections.

Among those with infections: Fungal infections: 72 (24.0%) ,Bacterial infections: 54 (18.0%) Viral infections: 24 (8.0%) ,Other infections: 12 (4.0%) .Fungal infections were the most commonly observed. A significant association was observed between BMI and the presence of skin infections. Among obese individuals, a higher proportion had skin infections compared to normal BMI individuals.  Overweight participants also showed increased prevalence of infections. Underweight individuals had comparatively lower infection rates.  The statistical analysis showed:χ² = 16.82 , p = 0.002 (statistically significant) It was observed that: Obese participants were more likely to develop recurrent and severe infections, particularly fungal and bacterial types. Normal BMI individuals mostly had mild or no infections. Increased BMI was positively associated with infection severity. Overall, the study demonstrated that higher BMI is significantly associated with increased prevalence and severity of skin infections, with obesity being the strongest contributing factor.

Table 1: Sociodemographic Characteristics (n=300)

Table 2: Distribution of BMI Categories

Table 3: Prevalence of Skin Infections

Table 4: Association Between BMI and Skin Infections

The present study explored the relationship between Body Mass Index (BMI) and skin infections and found a significant association between higher BMI and increased prevalence of skin infections. These findings are consistent with previous literature indicating that obesity is a major risk factor for infectious diseases, particularly skin and soft tissue infections.

Obesity has been shown to impair immune function, thereby increasing susceptibility to infections. A systematic review and meta-analysis reported that individuals with higher BMI have a significantly increased risk of various infections due to altered immune responses and chronic low-grade inflammation (11). Similarly, population-based cohort studies have demonstrated that individuals with elevated BMI are more likely to be hospitalized due to infection-related complications (12).

The association between obesity and skin infections can also be explained by physiological and structural changes in the skin. Increased skin folds, moisture retention, and impaired barrier function in obese individuals create an environment conducive to the growth of microorganisms, leading to conditions such as fungal infections, cellulitis, and abscess formation (13,19). Clinical studies have further confirmed that obesity is linked with various dermatological conditions, including infectious skin diseases (14).

In addition to local skin changes, systemic factors also play a significant role. Obesity is associated with metabolic dysregulation and chronic inflammation, which negatively affect immune defense mechanisms. Studies have shown that obesity impairs both innate and adaptive immunity, increasing vulnerability to bacterial and fungal infections (17,18). Furthermore, classic research has established a strong relationship between obesity and infection risk, highlighting the role of excess adipose tissue in promoting inflammatory pathways (16).

The findings of the present study are also supported by epidemiological evidence demonstrating that obesity is associated with a higher prevalence of skin diseases, including infections. Research has indicated that obese individuals are more likely to develop dermatological disorders compared to individuals with normal BMI (20). Additionally, clinical observations suggest that infections in obese individuals tend to be more severe and recurrent (15).

Overall, the results of this study are in agreement with existing literature, confirming that higher BMI is a significant risk factor for skin infections. The relationship appears to be multifactorial, involving immune dysfunction, skin barrier alterations, and environmental factors.

This study concludes that there is a significant association between Body Mass Index (BMI) and skin infections. Individuals with higher BMI, particularly those who are overweight and obese, are more prone to developing skin infections due to impaired immunity and altered skin conditions. Maintaining a healthy BMI may help reduce the risk of skin infections and improve overall health outcomes.

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