Acne in adult women: a study of 169 cases

Background Although acne is regarded as a skin disorder of teenagers, postadolescent acne is now increasing. Objective To report a series of acne in women over the age of 25 years. Patients and methods We collected data from files of women aged over 25 years consulting for acne from January 2003 to December 2007 at the Department of Dermatology, Ibn Rochd Hospital, Casablanca, Morocco. Age, history of acne, duration, type and location of acne, treatment regimen, and follow-up were recorded. Results One hundred sixty-nine women (mean age =29.8 years) were included, representing 12% of all patients presenting with acne. Eighty-five (50.2%) women had persistent acne from adolescence. Comedones with inflammatory lesions of acne were observed in 88 cases (52%). Scarring was noted in 63 cases (37.2%). Of 140 women with acne, acne was mild in 55 (39.3%), moderate in 69 (49.3%), and severe in 16 cases (11.4%). Of the 169 women with acne, the mandible was involved in 98 cases (57.9%). Twenty-three women (13.6%) implicated facial cosmetics and 20 (12.4%) drug intake as precipitating factors. Treatment of the 169 cases consisted of cyclines and topical treatment in 56 women (33.1%). Oral isotretinoin was used in 40 cases (23.7%). Combination of cyproterone acetate and estradiol was used in 11 cases (6.5%). The rest of the cases [62 (36.7%)] had only topical treatment. Conclusion High prevalence of acne is observed in adult women and seems to be more inflammatory and of moderate severity. Persistent acne was found in half of the patients; acne involved the face, predominantly the mandibular region. Triggering factors must be investigated, such as cosmetics and drugs. Oral treatments must be considered because of the risk of scarring and pigmentary changes.