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Factors Affecting Severity of Adult Acne
J Dermatolog Treat; 2017 Dec; Chlebus, et al
Lifestyle change-related stress, sensitive skin, discontinuation of oral contraceptives. and using full-coverage foundations increase severity of adult acne (AA), according to a recent observational cohort study that included 111 patients with AA (aged >25 years) in 2015–2016. Clinical manifestation, previous treatments, environmental risk factors, and features of juvenile acne affecting AA were assessed. Researchers found:
- The maximum severity of persistent acne was significantly lower after age 25, as compared to adolescence (7.2 vs 6.4).
- The number of acne therapies used in AA was twice as high as in juvenile acne (22 vs 11).
- The severity of AA sufficient to leave scars was significantly lower than of juvenile acne (6.0 vs 7.3) with 22% of patients developing scars only in adult life.
- Patients linked exacerbations to stress exposure, finding lifestyle changes the most stressful.
- Those using full-coverage foundations received significantly more acne treatments over lifetime (5.4 vs 3.6) and for AA (4.4 vs 2.8).
- Discontinuation of oral contraceptives or sensitive, erythema-prone skin also worsened the symptoms.
Citation:
Chlebus E, Chlebus M. Factors affecting the course and severity of adult acne. Observational cohort study. J Dermatolog Treat. 2017;28(8):737-744. doi:10.1080/09546634.2017.1329500.
A recent study evaluated the factors which affect the severity of adult acne. Though the severity of persistent acne was lower after age 25, and the propensity for scarring was lower for adults, the number of therapies used for treatment was twice as high in adult patients compared to those who are younger. Factors which exacerbated breakouts for adults included stress, especially lifestyle changes, the presence of sensitive or erythema-prone skin, the discontinuation of oral contraceptive pills, and using full-coverage foundation makeup (though type of makeup was not presented). Though I do agree that acne flares in adults seem to increase with both stress and hormonal changes, especially stopping the birth control pill, I feel that formulations and vehicle options for makeup have improved and may be less acneigenic than in the past. Another observation I have is that perhaps these patients develop more sensitive skin when too many topical are given at once. Skin care discussions should be an integral component of the management of acne.
—Diane S. Berson, MD, FAAD
Associate Professor, Department of Dermatology, Weill Medical College of Cornell University, New York, NY
Assistant Attending Dermatologist, New-York Presbyterian Hospital, New York, NY