Post-adolescent Acne Research Articles

A clinico-epidemiological and investigative study of post adolescent acne

Background: Although acne is usually recognized as an adolescent skin disorder, the prevalence of adults with acne is increasing. The clinical and epidemiological data of adult acne were evaluated with a view to establishing possible contributing etiological factors and observing whether clinical features differ from adolescent acne. Methods: A total of 170 patients over the age of 25 years with acne were taken up for the study and a detailed history and clinical examination was done. Hormonal profile was done in all the patients. The data was statistically evaluated and inferences drawn. Results: Out of 170 patients included in the study 87.6% were women. The mean age of the patients was 33.5 years. Persistent acne was observed in 62.4%, while it was late onset in 37.6%. Most common predominant site of involvement was cheek (78%), followed by chin (62%), and mandibular area (33.2%). Family history of acne was present in 15.3%. Premenstrual flare was seen in 31.2% of female patients, obesity in 25.9%, hirsutism in 41.8% and menstrual abnormalities in 15.1%, but raised laboratory markers of hyperandrogenism were observed in only 4.02%. Conclusions: The study identified key contributing factors and patterns of post adolescent acne, providing valuable insights for tailored management strategies.

Serum clusterin levels, postadolescent acne, and the link to metabolic syndrome: exploring the interplay of factors

Background Clusterin (CLU) is a multifunctional glycoprotein with a multiplicity of physiologic and pathologic effects. A role in inflammatory diseases and metabolic syndrome (MetS) components has been suggested. Objectives The objective was to investigate serum CLU and lipids levels, blood pressure, and BMI in patients with postadolescent acne, and demonstrate any possible interactions between those conditions. Patients and methods A case–control study including 50 postadolescent acne patients and 30 matched controls was performed to estimate serum levels of CLU and lipids in all participants together with the full clinical dermatological and general examination. Results Significantly elevated levels of CLU were detected in sera of postadolescent acne patients versus controls, correlating positively with acne severity. Patients were found to have higher BMI and blood pressure values than controls. Patients diagnosed with MetS had considerably greater serum CLU levels than those who did not. CLU showed high accuracy in diagnosing postadolescent acne and MetS in those patients. Conclusions CLU levels in the sera of patients with postadolescent acne may play an integral role in the pathophysiology of the disease and the development of MetS in these patients.

The Question of Adolescent and Postadolescent Acne: The Nigerian Experience

Introduction: Differences between adolescent and postadolescent acne are increasingly being recognized. This study aimed to document the clinical profile of facial acne vulgaris and, additionally, to compare adolescent to postadolescent acne and any gender-based differences. Methods: Cross-sectional descriptive study of 261 facial acne vulgaris patients was conducted from February 2021 to March 2022 at three dermatology clinics. Patients had their anthropometric measurements, type of acne lesions, and severity and scarring assessed. Results: A total of 261 patients (75.5% females) with a mean age of 24.5 (±7.4) years were diagnosed to have facial acne vulgaris. The severity of acne was mild in 44.8%, moderate in 48.3%, and severe in 6.9%. Acne was noninflammatory in 69.7%, inflammatory in 13.0%, and mixed in 17.2%. Adolescent and postadolescent acne significantly differed in the type of acne, BMI, type of acne lesions, and acne scarring. Gender-based differences included BMI, lesions of acne, and severity. Conclusion: There is an increasing prevalence of postadolescent acne with persistent being the most common category. There are significant differences between adolescent and postadolescent acne: type of acne, BMI, type of acne lesions, and acne scarring. Gender-based differences exist in both adolescent and postadolescent acne.

Can isotretinoin be used in treating multiple neurofibromas thanks to its apoptotic effect?

The most common benign tumor of the peripheral nerve sheath is neurofibromas. The only known curative treatment is total surgical excision. In neurofibromatosis patients with multiple cutaneous neurofibromas, it is not possible to treat all neurofibromas with surgical excision. We happened on a case of neurofibromatosis type-1, whose neurofibromas shrank while using isotretinoin for the treatment of excessively oily skin and postadolescent acne. We think that isotretinoin executes this effect through its apoptotic mechanism of action.

A Comparative Clinical and Laboratory Study of Adolescent and Adult Acne in Iraqi Women.

Background Acne vulgaris is a common chronic inflammatory disease of the pilosebaceous units associated with long-term sequelae and complications. Currently, acne in women is classified into adolescent and post-adolescent forms. However, comparative studies evaluating the clinical and laboratory parameters across various age groups in women with acne are lacking. The aim of the study is to compare the clinical and laboratory characteristics of different groups of women with acne vulgaris. Patients and methods Over 3 years (2018-2021), a cross-sectional study was carried out on 340 women with acne consulting the Dermatology and Venereology Outpatient Clinic, Basrah Teaching Hospital, Basrah, Iraq. Eligible patients were carefully evaluated and fully examined, emphasizing on signs of hyperandrogenism and scoring of acne severity. Hormonal assays of serum total testosterone (TST), dehydroepiandrosterone sulfate (DHEAS), luteinizing hormone (LH), follicular stimulating hormone (FSH), and serum prolactin (PRL) were done. Pelvic ultrasonography was performed to identify any pelvic pathology. The patients were classified according to their age of onset. Clinical and laboratory data were compared among groups. Results Three groups were recognized: 160 patients (47%) with adolescent acne (AA) (mean age SD: 17.2±1.6 years), 80 (23.5%) with early adult-onset acne (EA) (mean age SD: 21.4±1.2 years), and 100 (29.4%) with post-adolescent acne (PA) (mean age SD: 28.7±2.9 years), which were further sub-grouped into late-onset acne (40 cases, 11.7%), and persistent acne (60 cases, 17.6%). The mean body mass index was normal in the AA group and overweight in the EA and PA groups. Moderate obesity was more frequent in PA (24%, p=0.03). While 78.5% of AA was mild to moderate acne, 77.5% of EA was moderate to moderately severe, and 72% of PA was moderately severe to severe. Clinical and biochemical markers of hyperandrogenism were seen in all groups, however, they were more frequent in PA and EA groups than in the AA group (p<005). Conclusion Clinical and biochemical hyperandrogenism were present in a significant proportion of women with acne; their prevalence was higher in post-adolescent acne than in adolescent acne. Acne that began between the ages of 20 and 25 was classified as "early adult-onset acne," and showed variable features of hyperandrogenism. A complete evaluation, regardless of age, for every female with acne, including a hormonal analysis and pelvic ultrasound examination to detect hormonal imbalances as early therapy, can help to prevent and reduce the risk of consequences.

DEMODEX INFESTATION IN ACNE VULGARIS

Introduction: Acne is a very common skin disease in adolescents and young adults, but it also affects adults. However, its aetiology is not yet fully understood. Demodex mites are found on the skin of healthy people and patients with skin disorders Some reports indicate the association between acne vulgaris and demodicosis.&#x0D; Objectives: To investigate the Demodex infestation rate in acne patients and to analyze the relationship between Demodex infestation with some characteristics of the disease: age, gender, duration time of disease, clinical types of acne, severity of acne and GAGS score. &#x0D; Material and methods: Case control study on an acne group of 40 acne patients and an age-sex matched healthy control group comprising 31 individuals at HCMC Hospital of Dermato - venereology. Dermatological examinations were performed and a direct microscopic examination was used to determine the presence of Demodex mites.&#x0D; Results: The median age was 22.5 (inter-quartile range 20.25 – 25), acne affected women than men (72.5% versus 22.5%). The median age of onset was 19,5 (inter-quartile range 16-23). Demodex infestation was seen in 7 (17.5%) patients in the acne group and 0 (0%) in the control group; this difference was statistically significant (p &lt; 0.05) (OR =1.212; 95% CI: 1.051- 1.398) (p=0.015). Pain was related to Demodex positivity (OR=8.333 95% CI=1.906- 36.44), (p=0.003).&#x0D; Conclusions: The findings of our study emphasize that acne vulgaris is significantly associated with Demodex infestation. Demodex infestation should be considered when the classical therapies are ineffective especially in cases of post adolescent acne.

Acne and insulin resistance: A systematic review and meta-analysis

To the Editor: Acne is more common in westernized societies, suggesting that environmental factors likely contribute to acne pathogenesis.1Cordain L. Lindeberg S. Hurtado M. Hill K. Eaton S.B. Brand-Miller J. Acne vulgaris: a disease of western civilization.Arch Dermatol. 2002; 138: 1584-1590Crossref PubMed Google Scholar Metabolic abnormalities may influence key factors in the development of acne, such as the proliferation of basal keratinocytes in the sebaceous-pilosebaceous unit and abnormal desquamation of follicular corneocytes.2Del Prete M. Mauriello M.C. Faggiano A. et al.Insulin resistance and acne: a new risk factor for men?.Endocrine. 2012; 42: 555-560Crossref PubMed Scopus (50) Google Scholar Therefore, we hypothesized that patients with acne would demonstrate higher levels of insulin resistance. In this systematic review and meta-analysis, we examined the relationship between insulin resistance and acne, as it may have important therapeutic and diagnostic implications, such as exploring insulin modifiers as an adjunctive acne treatment and screening acne patients for metabolic syndrome. PubMed and Embase were systematically searched for studies published prior to March 17, 2021 that evaluated insulin resistance in patients with acne. In PubMed and Embase (acne OR acne vulgaris) AND (insulin resistance OR diabetes OR blood glucose) were searched as Medical Subject Heading terms and keywords, respectively. Only clinical studies measuring values for Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), a validated laboratory measure of insulin resistance, in acne patients and control subjects were included.3Muniyappa R. Madan R. Assessing insulin sensitivity and resistance in humans.in: Feingold K.R. Anawalt B. Boyce A. Endotext [Internet]. MDText.com, Inc, 2000Google Scholar Studies were excluded if they were unpublished, abstracts, not written in English, or included patients with polycystic ovarian syndrome in order to exclude hyperandrogenism as a potential confounding variable. Database searches yielded 136 unique results. Thirteen articles met inclusion criteria and were included in the analysis (Supplementary Fig 1, available via Mendeley at https://data.mendeley.com/datasets/bfrm4wbdrz/2). The following data were extracted from each article: number of acne subjects, mean age of acne subjects, mean body mass index of acne subjects, acne severity, other acne qualifiers (postadolescent acne or treatment nonresponders), control subjects, mean HOMA-IR value in both acne and control groups, and quality assessment score (Supplementary Table 1, available via Mendeley at https://data.mendeley.com/datasets/bfrm4wbdrz/2). Meta-analysis compared the differences between acne and control patients. Hedges' g standardized mean difference between HOMA-IR values in acne patients and controls was calculated as the summary statistic. Results are reported from a random effects model. An I2 statistic was calculated to estimate heterogeneity across studies.4Egger M. Davey Smith G. Schneider M. Minder C. Bias in meta-analysis detected by a simple, graphical test.BMJ. 1997; 315: 629-634Crossref PubMed Scopus (32351) Google Scholar Moderating variables were studied in a mixed-effects model. Statistical analyses were conducted with R statistical software (version 4.0.5) using the meta package.5Balduzzi S. Rücker G. Schwarzer G. How to perform a meta-analysis with R: a practical tutorial.Evid Based Ment Health. 2019; 22: 153-160Crossref PubMed Scopus (952) Google Scholar Acne patients had higher HOMA-IR values than controls (standardized mean difference = 0.60; 95% CI, 0.33-0.88; P < .001) (Supplementary Fig 2, available via Mendeley at https://data.mendeley.com/datasets/bfrm4wbdrz/2). Onset of acne in the postadolescent period, average age of participants, sex of participants, average body mass index, publication year, or quality score were not significant modifying variables in our model. There was heterogeneity between studies (P < .001), which was a limitation of our study. Publication bias was assessed visually using a funnel plot and quantitatively with Egger's regression test of asymmetry (Supplementary Fig 3, available via Mendeley at https://data.mendeley.com/datasets/bfrm4wbdrz/2). Although some asymmetry exists, the large effect size of study 13 appears to mitigate the asymmetry (P = .47). However, due to the small number of studies with a large variation in effect sizes and standard errors, we do not have enough evidence that publication bias does not exist in this study. Dermatologists should be aware of the potential relationship between acne and insulin resistance and consider referring acne patients to primary care for further evaluation. Early treatment of insulin resistance can prevent the development of diabetes and cardiovascular disease. None disclosed.

Evaluation of serum insulin-like growth factor-1, insulin, glucose levels in patients with adolescent and post-adolescent acne.

There are many endogenous and exogenous factors that cause acne formation. This study aimed to determine whether the acne severity in patients with various age ranges is associated with serum insulin-like growth factor, insulin, and glucose and to identify how much they affect the acne severity. In this case-control prospective study, 44 patients withacne vulgarisand 44 age- and gender-matched control subjects withoutacnewere evaluated. Patients and the control group were divided into two age-groups as adolescence and post-adolescence. According to the Global Acne Scoring System (GASS) of the acne group, the acne score grades between 0 and 44 were calculated. The correlations between the IGF-1, insulin, glucose levels, and acne grades were calculated in each group. In our study, the acne scores and serum IGF-1levels were found to be significantly higher in patients under the age of 21 than patients over the age of 21. There was a statistically significant difference in acne score between the two groups. However, there was no statistically significant difference between the serum IGF-1, insulin, and glucose levels of the acne group and the control group. In this study, it has been revealed that IGF-1 is effective at the pathogenesis of acne in adolescence.

The Association Between Short-Term Air Pollution Exposure and Post-Adolescent Acne: The Evidence from a Time Series Analysis in Xi'an, China.

BackgroundPost-adolescent acne is a common skin disease faced by adults. However, whether air pollution (AP) serves as a risk factor for post-adolescent acne remains elusive.AimTo determine the relationship between short-term AP exposure (within 7 days) and outpatient visits for post-adolescent acne.MethodsDaily outpatient visit data for post-adolescent acne and routinely AP data between 2010 and 2013 were collected from Xi’an, China. A generalized additive regression model was used to analyze the relationship between outpatient visits for post-adolescent acne and short-term ambient AP exposure. The gender-specific analyses were conducted as well.ResultsTotally, 27,190 outpatient visits for post-adolescent acne were included. The results revealed that a 10 μg/m3 increase in PM10, SO2, and NO2 at lag 0–7 day was associated with the increase of outpatient visits for post-adolescent acne at 0.84% (95% CI: 0.53%, 1.16%), 1.61% (95% CI: 0.12%, 3.10%), and 3.50% (95% CI: 1.60%, 5.40%), respectively. The significant positive associations of PM10, SO2, and NO2 were found at both single-lag models and moving average models. The gender-specific analyses showed that the effect estimates of PM10 was stronger for females than for males, while there was no observed gender difference in the effects of SO2 and NO2.ConclusionShort-term exposure to AP was associated with increased outpatient visits for post-adolescent acne, especially for females in the effects of PM10.

Analysis of 3702 patients with acne vulgaris and concomitant comorbidities in Turkey: a multi-centered, prospective, controlled study.

Acne vulgaris is a chronic inflammatory skin disease that affects the pilosebaceous unit. Although it is considered to be a skin-limited disease, different clinical studies have recently been published in which the disease is accompanied by systemic symptoms. In this study, systemic comorbidities accompanying acne vulgaris and the relationship between existing comorbidities and disease severity are investigated. This prospective multicenter study was conducted by the Turkish Society of Dermatology Acne Study Group. Twelve dermatology clinics and 14 clinicians throughout Turkey participated in the study. A structured physician-administered questionnaire was used to collect patient demographics, clinical findings, and lifestyle data. Physicians recorded each participant's medical history, including current and past comorbidities, duration of any comorbidity, smoking, and drinking. Body mass index (BMI) was calculated. There were 3022 patients in the adolescent acne group and 897 in the control group. The incidence of nonmigraine headache in adolescents with acne was significantly higher than in the nonacne group (P=0.019). There were 680 patients in the postadolescent acne group and 545 in the control group. In the postadolescent group, incidence of metabolic disease was lower than the control group (P=0.003). In the postadolescent group, premenstrual syndrome (P<0.001) and PCOS (P=0.007) were more common than the control group. In this study, we observed that acne vulgaris does not cause systemic comorbidities. There is also a need for new studies involving a large number of patients to illuminate systemic diseases accompanying acne vulgaris.

Impact of low ghrelin level in patients with postadolescent acne.

Ghrelin is a 28 amino acid peptide predominantly produced by the stomach. There are many putative roles for ghrelin beyond homeostatic appetite control. To determine ghrelin's level in postadolescent acne and study its relationship to plasma lipid profile, IR and acne severity and to correlate variables. This is a case-control study where 50 patients with postadolescent acne and 50 age-sex compatible controls were enrolled. Acne severity was assessed according to the Hayashi acne grading criteria. The parameters measured were serum level of ghrelin, fasting blood glucose, total cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides, and insulin. The mean serum level of Ghrelin was significantly lower in patients compared to control group and acne severity had a significant effect on ghrelin's level. Serum levels of insulin, fasting glucose, HOMA-IR, and TG were significantly increased in patients group compared to control. Serum TC, HDL, and LDL showed no significant difference between both studied groups. Ghrelin hormone had a positive correlation to HDL and a negative correlation to BMI, LDL, HOMA-IR, and Insulin. This study postulated that low level of ghrelin may predispose patients with postadolescent acne to hyperinsulinemia, type 2 diabetes or dyslipidemia.

Effect of acupoint catgut embedding, fire needle, auricular acupuncture on female post-adolescent acne and serum sex hormone

To compare the difference of serum sex hormone between female patients with post-adolescent acne and healthy women, and to explore the efficacy and action mechanism of acupoint catgut embedding, fire needle, auricular acupuncture on skin lesion in female patients of post-adolescent acne. A total of 107 female patients of post-adolescent acne were divided into an integrated acupuncture group (54 cases, 4 cases were excluded) and a medication group (53 cases, 5 cases were excluded). The patients in the integrated acupuncture group were treated with comprehensive treatment of acupoint catgut embedding, fire needle, auricular acupuncture; the acupoint catgut embedding was applied at Dazhui (GV 14), Yintang (GV 29), Yangbai (GB 14) through Yuyao (EX-HN 4) and other acupoints based on syndrome differentiation; the fire needle was applied at skin lesion; the auricular acupuncture was applied at erjian (HX6，7i), e (AT1), kou (CO1), etc. The patients in the medication group were treated with oral administration of tanshinone capsules (4 capsules each time, 3 times a day) and external use of adapalene gel (one treatment per day at night). Patients in the two groups were treated for 8 weeks. The skin lesion of acne was evaluated before treatment as well as 4 weeks and 8 weeks after treatment in the two groups; the serum levels of testosterone (T) and estradiol (E2) were tested 24 hours before menstruation in the integrated acupuncture group (50 cases) and healthy control group (46 cases), and the change of serum sex hormone after treatment was observed in 21 patients with sex hormone disorder in the integrated acupuncture group. Before treatment, the level of E2 in the integrated acupuncture group was significantly lower than that in the healthy control group (P<0.01), but T/E2 in the integrated acupuncture group was significantly higher than that in the healthy control group (P<0.01). After treatment, the level of E2 was significantly increased (P<0.01) and T/E2 was reduced (P<0.01) in the 21 patients with sex hormone disorder in the integrated acupuncture group. The skin lesion scale of acne was significantly reduced in the two groups after 4-week and 8-week treatment (all P<0.01); the difference between the two groups was not significant after 4-week treatment (P>0.05); the skin lesion scale of acne in the integrated acupuncture group was significantly lower than that in the medication group after 8-week treatment (P<0.01). The efficacy between the two groups was not significant after 4-week the treatment (P>0.05); after 8-week treatment, the cured and effective rate was 66.0% (33/50) in the integrated acupuncture group, which was superior to 45.8% (22/48) in the medication group (P<0.05). Compared with healthy women, the level of serum sex hormone of E2 is reduced in the female patients of post-adolescent acne, resulting in relative increased level of T; the acupoint catgut embedding, fire needle, auricular acupuncture have better efficacy than medication for post-adolescent acne, which have regulation effects on sex hormone disorder.

Abnormal plasma lipids profile in women with post-adolescent acne.

IntroductionAcne vulgaris is a multifactorial chronic inflammatory disease that is increasingly recognized in adult women.AimTo investigate a relationship between plasma lipids profile and acne in women and a correlation between selected clinical features of acne (severity, age of onset, location of lesions and the presence of comedones) and lipids profile.Material and methodsSixty-four adult women with post-adolescent acne and 20 healthy controls were included in the study. Plasma total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels were determined in all the subjects.ResultsAdult women with acne had statistically significantly increased levels of TC, TG and LDL-C compared to healthy controls (p < 0.05). The level of HDL-C did not differ between the two groups. There was no relationship between higher levels of TC, TG and LDL-C and a clinical picture of acne.ConclusionsAcne in adult women is likely to be associated with increased levels of TC, TG and LDL-C. This abnormality seems to be important in the pathogenesis of adult acne and could be a result of high fatty acid diet. Performing a lipid profile examination in women with acne should be taken into account when screening patients and followed by appropriate dietary recommendations.

Demodex spp. as a possible aetiopathogenic factor of acne and relation with acne severity and type.

IntroductionAcne is a very common skin disease in adolescents and young adults, but it also affects adults. However, its aetiology is not yet fully understood. Demodex appears to be associated with multiple skin disorders, but controversy persists. Some reports indicate a connection between acne vulgaris and demodicosis.AimTo confirm the association between Demodex infestation and acne vulgaris.Material and methodsA total of 108 patients were enrolled in the acne group. Acne severity was calculated as GASS and acne type (adolescent and post adolescent) was recorded. An age-sex matched healthy control group comprising 65 individuals were included in the study. Dermatological examinations were performed and an SSSB was used to determine the presence of Demodex.ResultsIn our study, Demodex positivity was seen in 46 (42.6%) patients in the acne group and 8 (12.3%) in the control group; this difference was statistically significant (p < 0.001). A multivariate Backward Step-By-Step Logistic Regression analysis identified the most effective factors for acne development such as Demodex positivity (OR = 5.565, 95% CI: 2.384–12.99 and p < 0.001) and age under 25 years (OR = 2.3 and 95% CI: 1.183–4.473 and p = 0.014). Alcohol consumption was related to Demodex positivity (p = 0.019) in post adolescent acne.ConclusionsOur study is the first one to evaluate acne severity, acne type and the relationship to Demodex prevalence. We suggest that Demodex infestation should be considered when the classical therapies are ineffective especially in cases of post adolescent acne.

Spironolactone for the Treatment of Acne: A 4-Year Retrospective Study

Prior studies have demonstrated that spironolactone is an effective second-line treatment option for postadolescent acne, but has notable side effects. Data are, however, limited. We therefore present a 4-year retrospective study evaluating 291.5 patient-years of spironolactone for the treatment of acne. Our results showed that 86% of patients improved on spironolactone therapy. Further, patients who improved showed minimal side effects, supporting recent evidence that spironolactone is a safe option for acne treatment with a low risk of short-term adverse effects such as hyperkalemia. It is suggested that our study encourages consideration of spironolactone for postadolescent acne.

Relationship between clinical types and related risk factors in female patients with post-adolescent acne

Objective To investigate the relationship between clinical types and related risk factors in female patients with post-adolescent acne. Methods Female outpatients with post-adolescent acne aged more than 25 years were enrolled from Department of Dermatology of Renji Hospital between January and October 2016. A questionnaire survey was conducted to investigate related risk factors for post-adolescent acne in the females. Skin lesions and clinical types were evaluated by dermatologists. Statistical analysis was carried out by t test for comparison of means between two groups and by chi-square test for comparison of ratios. Results A total of 312 female patients with post-adolescent acne completed the survey, including 268 (85.9%) with mild to moderate acne and 44 (14.1%) with severe acne, 241 (77.2%) with persistent acne and 71 (22.8%) with late-onset acne, or 102 (32.7%) with comedonal post-adolescent acne (CPAA) and 210 (67.3%) with papular post-adolescent acne (PPAA) . Survey on related risk factors showed that 121 patients reported seasonal factors and 59 (18.9%) patients became worse in summer, and spicy, sweet and fried foods can aggravate the condition in 131 (42%) , 93 (29.8%) and 85 (27.2%) patients respectively. Other risk factors such as premenstrual period (62.8%, 196/312) , psychological factors (51.6%, 161/312) and exogenous chemical exposures (43.6%, 136/312) were complained of by the patients. Furthermore, premenstrual period, diet and constipation were found to be more associated with PPAA compared with CPAA (χ2= 4.523, 4.068, 3.910, respectively, all P < 0.05) . Exogenous chemical exposures, such as the use of cosmetics, exposure to polluted air environment and occupational hazards, were more associated with CPAA compared with PPAA, as well as with late-onset acne compared with persistent acne (χ2= 6.579, 9.057, both P < 0.05) . In addition, premenstrual exacerbation occurred more frequently in patients with persistent acne compared with those with late-onset acne (χ2= 4.512, P < 0.05) . Conclusions The risk factors for the occurrence of female post-adolescent acne are very complex. Premenstrual exacerbation plays a major role in the aggravation of papular and persistent post-adolescent acne, diet and constipation are more associated with PPAA, and exogenous chemical exposures are still be considered in the aggravation of comedonal and late-onset post-adolescent acne. Thus, clinical types should be considered in the diagnosis and treatment of post-adolescent acne in females. Key words: Acne vulgaris; Female; Post-adolescent acne; Clinical classification; Risk factors

Thyroid autoimmunity in female post-adolescent acne: A case-control study.

Acne vulgaris is an incompletely understood disorder of poliosebaceous follicles. A scourge of adolescence, it is increasingly persisting into the mid-forties, especially in females. 45% of women aged 21–30 years, 26% aged 31–40 years, and 12% aged 41–50 years, suffer from clinically-visible acne.1 The reasons for this rising prevalence have been unclear. Polycystic ovarian syndrome (PCOS) has been suggested as a possible contributor, however most acne sufferers have normal serum androgen levels.2,3 There has been increasing suspicion of a key autoinflammatory role in pathogenesis of chronic acne vulgaris. Autoinflammatory syndromes associated with acne have been described as possibly sharing common pathogeneses, involving dysregulated immunity with abnormal interleukin-1 signaling, leading to clinically significant inflammation.4,5 Thyroid autoimmunity has been detected in a number of chronic inflammatory skin conditions including acne vulgaris and chronic idiopathic urticaria.6,7 In 2012, Vergou and colleagues were the first to show female post-adolescent acne sufferers had significantly higher rates of thyroid autoimmunity compared with healthy controls.7 The relationship has not been examined since, despite a sound theoretical grounding. We aimed to confirm this association between thyroid autoimmunity and post-adolescent acne in adult women, as well as qualify its practical value with subsequent endocrinologist referral and intervention.

Evaluation of hyperandrogenemia and metabolic risk profile in women with postadolescent acne

Evaluation of hyperandrogenemia and metabolic risk profile in women with postadolescent acne

Does supplementation with green tea extract improve acne in post-adolescent women? A randomized, double-blind, and placebo-controlled clinical trial

BackgroundGreen tea is believed to have beneficial effects in the prevention and treatment of acne. ObjectiveTo examine the effects of a decaffeinated green tea extract (GTE), providing a daily dose of 856mg of epigallocatechin gallate (EGCG) upon women with post-adolescent acne. MethodsA randomized, double-blind, placebo-controlled clinical trial was conducted from May 2012 through October 2013. A final group of 80 subjects were randomly assigned to receive either 1500mg of decaffeinated GTE or placebo (cellulose) daily for 4 weeks. Inflammatory lesion counts were used as the major outcome measurement. At baseline and after 4 weeks of treatment, anthropometric measurements, fasting glucose levels and a lipid profile were measured from both groups. ResultsSixty-four of 80 women, from 25 to 45 years of age with moderate-to-severe acne completed the study. Statistically significant differences were noted in inflammatory lesion counts distributed on the nose, periorally and on the chin between the two groups. However, there were no significant differences between groups for total lesion counts. Within-group comparison revealed that the GTE group had significant reductions in inflammatory lesions distributed on the forehead and cheek, and significant reductions in total lesion counts. GTE resulted in significant reductions in total cholesterol levels within the GTE group. ConclusionsGTE resulted in significant reductions in lesions located on the nose, perioral area and chin. More research is required to determine whether a decaffeinated GTE standardized for EGCG content will provide clinical benefits in women with post-adolescent acne.

Assessment of dehydroepiandrosterone sulphate and total serum testosterone in Iraqi women with post-adolescent acne

Objectives: The aim of this study was to assess dehydroepiandrosterone sulphate (DHEA-S) and total serum testosterone (TST) in women with post-adolescent acne and their relationship to severity of acne and clinical markers of androgenicity. Methods: Two hundred forty women with post-adolescent acne (PAA), 132 women with late- onset acne (LOA) and 108 women with persistent acne (PA) were recruited in this cross-sectional study. All patients were examined clinically and by ultrasound for evidence of polycystic ovaries (PCO), and serum DHEA-S and TST levels were measured. Results: The results showed that there was an excess in androgens (DHEA-S) and TST levels. Serum androgens level were significantly correlated to the severity of PAA. In addition, clinical markers of androgenicity were frequently observed in women with PAA. Conclusion: There is an increased level of circulating androgens in significant proportion of women with PAA and it seems that hyperandrogenism appears to play an important role in the etiopathogenesis of acne. In addition, there was a direct correlation between severity of acne and androgen levels suggesting that both ovarian and adrenal abnormalities are common at this patients group. J Clin Exp Invest 2015; 6 (2): 121-125 Key words: Dehydroepiandrosterone sulphate, total serum testosterone, post-adolescent acne