Post-adolescent acne: a review of clinical features.
Level 4 - case-series / case-control
Uncontrolled clinical case series of 200 referred adult acne patients.
What was done
Clinical features and potential etiological factors were evaluated in 200 patients aged 25 years or older (152 women, 48 men; mean age 35.5 years, range 25–55) referred to a dermatology department for acne management. Acne severity was graded with the Leeds Grading Scale, and histories of onset timing, prior therapies, family history, and external exposures were assessed.
What was found
The cohort was predominantly female (76%, 152/200). Acne was mild to moderate and mainly inflammatory, with mean Leeds grades of 1.125 for men and 0.75 for women. Late-onset acne (onset after age 25) occurred in 18.4% of women (28/152) and 8.3% of men (4/48), while the rest had persistent adolescent acne. Clinical hyperandrogenicity features were noted in 37% of women. Prior therapy failure was common: 82% (164/200) had failed multiple antibiotic courses and 32% (64/200) relapsed after isotretinoin. A first-degree family history of post-adolescent acne was present in 50% (100/200). External factors (cosmetics, drugs, occupation) were not found to be significant etiological factors.
Why it matters
This study delineates post-adolescent acne as a distinct, frequently treatment-recalcitrant entity with strong familial predisposition, highlighting subgroups of women who may benefit from endocrine evaluation.
Limits
The study is an uncontrolled, single-center descriptive case series subject to referral bias toward severe or treatment-resistant cases. Diagnostic criteria for hyperandrogenicity, definitions of external exposure assessment, and objective laboratory evaluations are not detailed in the abstract.
Cited by
- partial Approximately 40% of adults experience adult-onset acne.