Most cases of acne clear spontaneously as an individual passes through adolescence and into their twenties. The reason for this is as yet undetermined, as there is no concurrent reduction in sebum production or change in its lipid composition. There are, however, two forms of post-adolescent acne in which the disease is evident in adulthood. Persistent acne commences in adolescence but does not resolve and is generally resistant to antibiotic therapy. Conversely, late-onset acne is generally less severe, evolves more commonly in women after 25 years of age, and has been linked to abnormalities in plasma androgens.11,12
The total burden of acne extends beyond financial costs; the impact on the individual can be devastating as the disease occurs at an age when its effects are acutely felt. Depression and anxiety are clearly linked to severe acne, and personality and self-esteem issues may arise that can have long-lasting effects on functioning as an adult. It has also been reported that acne patients have higher rates of unemployment, and the disease has been linked to suicide.13
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