Postadolescent acne in women
- Anetta Reszko, MD
Anetta Reszko, MD
- Assistant Professor of Dermatology
- Weill Cornell Medical Center
- Diane Berson, MD
Diane Berson, MD
- Assistant Clinical Professor of Dermatology
- Weill Medical College of Cornell University
Acne vulgaris is a skin disorder characterized by the presence of comedones and inflammatory lesions on the face, neck, shoulders, or trunk. Although the high prevalence of acne in the adolescent population has contributed to a perception that acne is a disorder of youth, acne remains a significant problem for many adults.
The unique features of postadolescent acne in women will be discussed here. General information on the pathogenesis, clinical features, diagnosis, and management of acne is reviewed separately. (See "Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris" and "Treatment of acne vulgaris" and "Hormonal therapy for women with acne vulgaris" and "Oral isotretinoin therapy for acne vulgaris" and "Light-based, adjunctive, and other therapies for acne vulgaris".)
Postadolescent acne is a common disorder that is often defined as acne that occurs in individuals aged 25 years or older. The disorder appears to occur more frequently in women than men [1-7]. As an example, in a population-based study of more than 17,000 individuals in China, acne was more common in men prior to the age of 30, but was more prevalent in women thereafter . Similarly, in a community-based study of 749 adults aged 25 years or older in the United Kingdom, clinically significant acne (defined as Leeds acne grade ≥1) was detected in 12 percent of women, but only 3 percent of men [7,8].
In addition, women may be more likely to visit healthcare providers for the evaluation and treatment of postadolescent acne [4,9]. In a retrospective study performed in the United Kingdom, 152 out of 200 patients over the age of 25 who were referred to a dermatology department for acne were female (75 percent) .
The prevalence of acne in women steadily decreases with age. This was evident in a prospective study of 2895 women (aged 10 to 70 years) performed in the United States, England, Italy, and Japan . Although acne was most prevalent at age 16 (present in almost 70 percent of subjects) and proceeded to decline after the age of 18, approximately one-half of women in their 20s, one-quarter of women in their 30s, and more than 10 percent of women in their 40s still had clinically significant acne (defined as more than four inflammatory lesions or comedones present on one side of the face). Acne occurred less frequently in post-menopausal women; among women aged 51 years and older, clinically significant acne was detected in less than 5 percent.
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- PATHOGENESIS AND ASSOCIATED FACTORS
- Menstrual cycle
- Cosmetic products
- Other factors
- CLINICAL FEATURES
- DIFFERENTIAL DIAGNOSIS
- EVALUATION AND TREATMENT PRINCIPLES
- Preparing for treatment
- Approach to treatment
- Cosmetic concerns and skin care
- SUMMARY AND RECOMMENDATIONS