How Is Teen Acne Different from Adult Acne?

A study conducted in Korea and published in 2011 in the International Journal of Dermatology found that when teens have their first acne breakouts, these occur in the same locations for males and females, except that teen males have more acne on the neck and chest.⁶

A study of adult acne sufferers aged 26 to 45 in India, which was published in 2013 in the International Journal of Science and Research, described the most common sites of acne in adults:

The most common site of involvement was cheeks 80% followed by chin 66%, [jaw] 52%, forehead 48% and nose 16%. [Acne on the trunk (torso) of the body] was rare and was seen in only 6% of the patients. Nature of the skin was dry in 54% and oily in 46%.⁷

According to the same large Chinese study discussed above, from the late teens to the early twenties, more males than females have acne. After age 30, however, more females than males have acne.³

The researchers also found that males and females are equally affected by persistent acne, but the majority of late-onset acne sufferers are women. Two other studies which were mentioned above--one conducted in Korea and the other in India--also agree that when we look at adult acne overall, it is more likely to affect women than men.^3,6,7

One study of twins, published in 1988 in the British Journal of Dermatology, compared production of sebum and severity of acne in teens 12 - 18 years old.¹³ The researchers found the following.

- Identical twins: Same rates of sebum production, different degrees of acne severity

- Non-identical twins: Different rates of sebum production, different degrees of acne severity

The authors concluded that genetic factors control sebum production, since genetically identical twins displayed essentially the same rate of sebum production. However, since even genetically identical twins showed different degrees of acne severity, the researchers deduced that environmental factors must also affect the development of acne lesions.¹³

Another study on teens, published in 2005 also in the British Journal of Dermatology, compared the severity of acne in 778 pairs of twins.¹⁴ Each teen was examined at three different ages:

- Age 12: Checked for acne on the face, chest, and back

- Age 14: Checked for acne on the face, chest, and back

- Age 16: Checked for acne on the face

The authors reported that severity of acne at all sites and ages was strongly influenced by genetic factors, but was also affected by environmental factors. Genetics played a particularly large role in:

- Acne on the back

- Acne on the face in 14-year-old girls¹⁴

A third twin study published in 2002 in the Journal of Investigative Dermatology examined the impact of genetic and environmental factors on adult acne in the United Kingdom. The researchers examined 458 pairs of identical and 1099 pairs of non-identical twins, all women with an average age of 46 years. The authors concluded that adult acne possesses a strong genetic basis, since the vast majority of the differences in acne severity between different people in the study could be explained by family history.¹⁵

A study published in 2008 in the Journal of the American Academy of Dermatology examined the association between dairy intake and teen acne in boys and girls aged 9 - 15 years. The researchers found a link between drinking skim milk and teen acne. This link was stronger in girls than in boys. The authors suggested that the difference between boys and girls that was responsible for this may be that girls at this age are at a biologically more advanced stage of maturation.¹⁸

Another study published in 2012 in the journal BMC Dermatology investigated the connection between ingesting dairy products and acne in Malaysian teens and adults aged 18 - 30. The authors found:

- A link between frequency of drinking milk and acne

- A link between frequency of eating ice cream and acne

- No link between frequency of eating fermented dairy products (yogurt, cheese) and acne¹⁷

The researchers reported that young adults who drank milk or ate ice cream at least once per week were four times as likely to have acne as those who did not.¹⁷

The large Chinese study mentioned earlier found a link between being a smoker or ex-smoker and having teen acne.³

A study published in 2009 in the journal Dermato-Endocrinology examined symptoms of adult acne and any possible correlation with cigarette smoking in women aged 25 - 50 years. The authors found that cases of smoking were strongly linked with adult acne.¹⁹

Another study, published in 2014 in the Annals of Dermatology, examined 23 men and 27 women aged 25 - 45 years and also reported a possible link between cigarette smoking and adult acne.²⁰

A study published in 2018 in The Journal of Clinical and Aesthetic Dermatology looked at a total of 1,167 people with acne. The researchers concluded that cigarette smoking was more common among adults with acne than among teens with acne. In other words, there might be a stronger connection between smoking and acne in adults than in teens.¹²

On the other hand, a report published in 2015 in the journal Dermatology investigated the link between smoking and teen acne in French youth aged 15 - 24. The researchers found no evidence that smoking more than 10 cigarettes per day causes teen acne. In fact, their results seemed to suggest that smoking offered some kind of protection against severe acne.²¹ The authors wrote:

In comparing the smoking habits of individuals reporting to have acne with those reporting not to have acne, tobacco smoking was associated with no acne. Tobacco smoking seems to impact on acne by helping to prevent severe acne.²¹

The large Chinese study also found no connection between smoking and having adult acne.³

The large Chinese study discussed above found a connection between being a mild to heavy drinker and having teen acne.³

However, the same study found no connection between drinking alcohol and having adult acne in Chinese subjects.³