Background: The reasons for the appearance of acne in adulthood are largely unknown.
Objective: We explored the role of personal and environmental factors in adult female acne.
Methods: We conducted a multicenter case-control study in the outpatient departments of 12 Italian cities. Cases (n = 248) were consecutive women ≥25 years of age with newly diagnosed acne of any grade. Controls (n = 270) were females diagnosed with conditions other than acne.
Results: In multivariate analysis, a history of acne in parents (odds ratio [OR] = 3.02) or siblings (OR = 2.40), history of acne during adolescence (OR = 5.44), having no previous pregnancies (OR = 1.71), having hirsutism (OR = 3.50), being an office worker versus being unemployed or being a housewife (OR = 2.24), and having a high level of reported psychological stress (OR = 2.95) were all associated with acne. A low weekly intake of fruits or vegetables (OR = 2.33) and low consumption of fresh fish (OR = 2.76) were also associated with acne.
Limitations: We did not establish an onset date for acne. Some of our associations may reflect consequences of established acne.
Conclusion: Lifestyle factors may play an important role for acne development in adulthood, but their role should be further assessed in prospective studies.
Keywords: adult female acne; case-control study; diet; family history; risk factors; stress.
Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.