Adult-onset acne: An expert consensus (original) (raw)
Related papers
Expert consensus on the management of acne in India
International Journal of Research in Medical Sciences, 2022
Acne, a common cutaneous disorder, is estimated to affect a significant proportion of the population at some point in their lifetime. It is one of the most common presentations reported in dermatological consultations in India. Treatment options for acne include topical, oral and procedural therapies. Patients with mild acne can be treated with topical therapies; however, those with moderate to severe acne require systemic cure. Oral antibiotic treatment, hormonal therapies and isotretinoin are the mainstay systemic therapies for acne. Additionally, procedural therapeutic modalities in dermatology include chemical peels, laser therapy, micro needling techniques, to name a few. Scientific advances are continually improving knowledge of acne and contributing to refinement of treatment options. Hence, it is vital for clinicians to regularly update their clinical practice patterns to reflect current standard. An experts' panel discussion involving dermatologists from across India was conducted, to outline a practical approach for the management of acne. The present consensus document focuses on the assessment of acne, use of topical treatments, role of systemic therapy and procedures in treating acne and post-inflammatory hyperpigmentation. It also emphasizes the role of patient education and counselling on prophylactic and treatment strategies in acne management.
Adult female acne: a guide to clinical practice
Anais Brasileiros de Dermatologia
Background: Acne in women is often associated with anxiety and depression, and may persist from adolescence as well as manifest for the first time in adulthood. Genetic and hormonal factors contribute to its etiopathogenesis, and maintenance treatment is required, usually for years, due to its clinical evolution. oBjective: To develop a guide for the clinical practice of adult female acne. Methods: A team of five experts with extensive experience in acne conducted a literature review of the main scientific evidence and met to discuss the best practices and personal experiences to develop a guide containing recommendations for the clinical practice of adult female acne. results: The group of specialists reached consensus on the main guidelines for clinical practice, providing detailed recommendations on clinical picture, etiopathogenesis, laboratory investigation and treatment of adult female acne. conclusion: Different from teenage acne, adult female acne presents some characteristics and multiple etiopathogenic factors that make its management more complex. This guide provides recommendations for best clinical practices and therapeutic decisions. However, the authors consider that additional studies are needed in order to provide more evidence for adult female acne to be better understood.
Bentham Science Publishers
This paper is a general overview that contributes for the knowledge systematization concerning the characteristics of the acne in the adult, its prevalence, causes, diagnosis, classification and drugs available for treatment. The reference therapy is the combination between topical retinoids and oral antibiotics. Oral isotretinoin is still the only available therapy that may modify the different acne physiopathologic factors and therefore it is the standard treatment for severe acne. The importance of the acne treatment in the adult should be enhanced as it can also lead to symptoms of serious depression and anxiety.
Adult-onset acne: prevalence, impact, and management challenges
Clinical, cosmetic and investigational dermatology, 2018
Acne is a multifactorial and inflammatory disease of pilosebaceous follicles, which affects most adolescents. Recent epidemiological data revealed a difference in adults affected by this disease. Women have a high prevalence and incidence when compared with men, especially after 25 years of age. In contrast to what was initially thought, most of these patients do not present endocrinopathy capable of leading to the development of the lesions. When present, polycystic ovarian syndrome is the main cause. However, in these cases, acne is rarely the only dermatological manifestation; hirsutism and acanthosis nigricans are often present. The majority of the normoandrogenic acne patients present a history since adolescence, but in many cases the lesion distribution and intensity change with time. There is often a typical localization of the lesions in the lower third of the face and lateral region of the neck. Another interesting feature is related to the impact on quality of life (QoL), ...
Adult female acne: Clinical and therapeutic particularities (Review)
Experimental and Therapeutic Medicine, 2021
Acne is a chronic inflammatory condition affecting the pilosebaceous unit that was traditionally viewed as a disease of the adolescence. However, over the past several years, an increasing number of adult women have been reported to suffer from this condition. The prevalence of adult female acne ranges between 12 and 54%. Two clinical types can be distinguished in this population, a 'retentional' and an 'inflammatory' type, which usually tend to overlap. In terms of evolution, three main subtypes can be identified: Persistent acne, which is the most frequent subtype, late-onset acne and recurrent acne. This type of acne is mainly mild-to-moderate in severity and may be refractory to conventional treatment. The etiopathogenesis is complex and has yet to be fully elucidated. It appears to involve an interaction among genetic predisposition, hormonal factors, and chronic activation of the innate immune system overlapping with external factors, such as daily stress, Western-type diet, use of tobacco and cosmetics. The treatment may be challenging and a holistic approach is required, with special attention to the individual needs and particularities of adult women. Both topical and systemic treatments are available, with hormonal therapies being of special value in this population. The aim of the present article was to provide up-to-date, evidence-based information on the clinical presentation, etiopathogenesis and treatment of adult female acne. Contents 1. Introduction 2. Prevalence 3. Clinical presentation 4. Etiopathogenesis 5. Treatment of adult female acne 6. Conclusions
Adult female acne: a new paradigm
Journal of the European Academy of Dermatology and Venereology, 2013
In the adult female, acne is a chronic condition with a substantial negative psychological, social and emotional impact. Based on time of onset, two subtypes of adult female acne are recognized: 'persistent acne' is a continuation of the disease from adolescence, while 'late-onset acne' first presents in adulthood. The morphological characteristics of adult female acne are often distinct from adolescent acne. In adults, inflammatory lesions (particularly papules, pustules and nodules) are generally more prominent on the lower chin, jawline and neck, and comedones are more often closed comedones (micro cysts). Adult acne is mainly mild-to-moderate in severity and may be refractory to treatment. A holistic approach to acne therapy should be taken in adult females, which combines standard treatments with adjunctive therapy and cosmetic use. A number of factors specific to the adult female influence choice of treatment, including the predisposition of older skin to irritation, a possible slow response to treatment, a high likelihood of good adherence, whether of child-bearing age, and the psychosocial impact of the disease. Adherence to therapy should be encouraged through further patient education and a simplified regimen that is tailored to suit the individual patient's needs and lifestyle. This article reviews the specific characteristics of adult female acne, and provides recommendations for acne therapy in this patient group.
Journal of the American Academy of Dermatology, 2017
Scientific advances are continually improving the knowledge of acne and contributing to the refinement of treatment options; it is important for clinicians to regularly update their practice patterns to reflect current standards. The Global Alliance to Improve Outcomes in Acne is an international group of dermatologists with an interest in acne research and education that has been meeting regularly since 2001. As a group, we have continuously evaluated the literature on acne. This supplement focuses on providing relevant clinical guidance to health care practitioners managing patients with acne, with an emphasis on areas where the evidence base may be sparse or need interpretation for daily practice.
The contemporary issues related to conventional treatment of acne and the way forward
People perceive acne as a minority disorder (not a major health concern), but it has a significant impact and burden on the victims. Although conventional drugs are available for its treatment, which are applied directly to the affected skin, such as azelaic acid, benzoyl peroxide, and salicylic acid etc. or formulations that are applied to the skin and taken by mouth such as Antibiotics and retinoids as well as birth control pills. This paper discusses the contemporary issues related to conventional treatment of acne with a view of exploring the way forward. Relevant literatures of stakeholders report and studies conducted globally and locally were searched and reviewed. Economic, environmental, emotional, social and spiritual issues are the major contemporary issues related to acne conventional treatment. The article recommend the use of scientific evidence based herbals for acne as it is a promising strategy and the real pharmacy today with no side effects.
Factors affecting the course and severity of adult acne. Observational cohort study
Journal of Dermatological Treatment, 2017
Objective: To identify factors improving symptoms and shortening duration of AA. Material and methods: The observational cohort study was performed in 111 patients with AA (> 25 y.o.) in 2015-2016. Clinical manifestation, previous treatments, environmental risk factors and features of juvenile acne affecting AA were assessed. Results: The maximum severity of persistent acne was significantly lower after 25 years of age, as compared to adolescence (7.2 vs 6.4; P=0.0027). 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; P=0.0001) with 22% of patients developing scars only in adult life. Patients linked exacerbations to stress exposure (P=0.09 and <0.0001 for those reporting at least one stressor and all patients, respectively), finding lifestyle changes the most stressful (P=0.046). Those using full-coverage foundations received significantly more acne treatments over lifetime (5.4 vs 3.6; P=0.0359) and for AA (4.4 vs 2.8; P=0.0043). Discontinuation of oral contraceptives or sensitive, erythema-prone skin also worsened the symptoms. Conclusion: Lifestyle change-related stress, sensitive skin, discontinuation of oral contraceptives and using full-coverage foundations increase severity of AA.
Female type of adult acne: Physiological and psychological considerations and management
Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG, 2018
Today we see more cases of acne after adolescence, with a greater prevalence in females than males. Adult female acne has a distinct clinical presentation and is associated with a number of specific pathophysiological features and gender-specific triggers. The psychological impact of acne is generally significant and largely underestimated; stress during professional and private life, anxiety and sleep quality, in particular, have a reciprocal relationship with disease susceptibility and severity. It is essential to compare with males. Acne in females often causes greater distress in adults than in adolescents. The impact of disease may therefore be greater for female patients, triggering higher levels of psychosocial anguish and increasing the likelihood of sequelae such as skin picking and the risks of cutaneous superinfection, scarring and PIH and acne recurrence. The management of adult female acne should encompass not just medical treatment of the symptoms, but also a comprehen...