Abstract
BACKGROUND: Acne vulgaris is a common inflammatory disease of the skin. Acne occurring in > 25 years old is called "adult acne," and it occurs more commonly in women than in men. PURPOSE: The aim of this study was to examine the recent findings of the connection between genetic factors, hormones and diet with adult female acne. METHODS: The study was conducted as a systematic literature review. For the review, data searches were made on the PubMed and Scopus databases. Finally, 20 articles met the inclusion criteria. RESULTS: According to this systematic literature review, several different hormones may be linked to the development of adult acne. Androgens play a particularly important role, as they can stimulate growth of the sebaceous glands and increase the secretion of sebum, thus promoting the formation of skin changes associated with acne. A high glycemic diet increases the secretion of insulin, which in turn causes an increase in the amount of insulin-like growth factor (IGF)-1. IGF-1 increases the growth of the sebaceous gland, sebum production, keratinocyte proliferation and it activates androgen synthesis, thus contributing to acne pathogenesis. Adults with acne have a positive familial history more often than healthy controls, which indicates the genetic nature of adult acne. CONCLUSION: This literature review highlighted that especially hyperandrogenism, a positive familial history and a high-glycemic diet may be linked to the development of adult acne. Understanding the pathogenesis of adult acne is crucial for effective treatment.