Etiology of Adult Female Acne–Systematic Review

Background

Acne vulgaris is a common inflammatory disease of the skin. Acne occurring in > 25 years old is called “adult acne,” and it occurs more commonly in women than in men.

Purpose

The aim of this study was to examine the recent findings of the connection between genetic factors, hormones and diet with adult female acne.

Methods

The study was conducted as a systematic literature review. For the review, data searches were made on the PubMed and Scopus databases. Finally, 20 articles met the inclusion criteria.

Results

According to this systematic literature review, several different hormones may be linked to the development of adult acne. Androgens play a particularly important role, as they can stimulate growth of the sebaceous glands and increase the secretion of sebum, thus promoting the formation of skin changes associated with acne. A high glycemic diet increases the secretion of insulin, which in turn causes an increase in the amount of insulin-like growth factor (IGF)-1. IGF-1 increases the growth of the sebaceous gland, sebum production, keratinocyte proliferation and it activates androgen synthesis, thus contributing to acne pathogenesis. Adults with acne have a positive familial history more often than healthy controls, which indicates the genetic nature of adult acne.

Conclusion

This literature review highlighted that especially hyperandrogenism, a positive familial history and a high-glycemic diet may be linked to the development of adult acne. Understanding the pathogenesis of adult acne is crucial for effective treatment.