Adult female acne and associated risk factors: Results of a multicenter case-control study in Italy

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.