Acne in adults is also called postadolescent acne. It can be persistent, with onset during teenaged years, or late onset beginning after the age of 25 years. It affects up to 15% of women, and is reported to be less common in men. However a Wisconsin survey reported adult acne was more common in men in their community.
Adult acne can be predominantly inflammatory, with papules and pustules, or predominantly comedonal, often with many large closed comedones (whiteheads). Deep inflammatory lesions and macrocomedones may result in scarring.
Adult acne usually presents as acne vulgaris (common acne). But it often has the following characteristics.
- The acne is very persistent and may continue into the 30s and 40s.
- It tends to be mild to moderate in severity.
- Affected women often complain of large pores.
- Some reports have suggested it is more common in people with olive skin (skin phototype IV).
- Inflammatory lesions are common on the jawline and neck but may be seen anywhere on face, neck, chest or back.
- Premenstrual flares are common.
- Macrocomedones (large whiteheads) are more common than in younger individuals. They are mostly found on chin, cheeks and forehead.
- Environmental factors have been associated with comedonal acne, particularly oily face creams and smoking.
- Onset of inflammatory acne is often attributed to stress.
As in younger subjects, hormonal factors may be important including pregnancy, polycystic ovarian disease and medicines (including supplements) with male hormone activity.
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