Acne in adults is also called postadolescent acne. It can be persistent, with onset during teenaged years, or late onset beginning after the age of 25 years. It affects up to 15% of women, and is reported to be less common in men. However a Wisconsin survey reported adult acne was more common in men in their community.
Adult acne can be predominantly, with papules and pustules, or predominantly comedonal, often with many large closed comedones(whiteheads). Deep inflammatory lesions and macrocomedones may result in scarring.
Adult acne usually presents as acne vulgaris (common acne). But it often has the following characteristics.
As in younger subjects, hormonal factors may be important including pregnancy, polycystic ovarian
disease and medicines (including supplements) with male hormone activity.
Adult acne management is no different from that in younger individuals. However, because of the persistence of the disorder, more aggressive treatments may be recommended for relatively mild disease. Many adults consider acne abnormal at their age and demand effective treatment.
Mild acne is treated with topical anti-acne medications. This is suppressive not curative, and needs to be continued to maintain effects. Some people find blue light treatment has moderate efficacy at reducing the number of inflammatory lesions.
More severe acne may also be treated with antiinflammatory antibiotics such as tetracyclines. Antiandrogens such as certain oral contraceptives and spironolactone are also widely used as treatment of persistent acne in women.
Oral isotretinoin can be very effective for adult acne. It is well tolerated in low doses and may result in suppression of the acne for several years or long term. However, it has important side effects and risks. It must not be taken in pregnancy as it may cause birth defects.