Adult Acne Vulgaris

Acne vulgaris is a disorder of the pilosebaceous unit that primarily affects adolescents. Its effect on adults above 25 years is often under-recognized but nevertheless can cause significant psychosocial impact. Adult acne is more common in females and can be severe. Autoinflammatory syndromes, disorders of endocrine metabolism as well as dietary factors are reported to be important aetiologic factors to consider when managing adults with acne vulgaris. Therapeutic options besides the standard topical retinoids, benzoyl peroxide, oral antibiotics and isotretinoin for adult acne include metformin and light/photodynamic therapies and, in females, combined oral contraceptive pills and spironolactone. Acne during pregnancy and lactation poses special challenges, as they add additional constraints on the already limited armamentarium against acne management.