Why does acne reflect our lifestyles?

Long regarded merely as a teenage phase, acne has now become a chronic, universal and persistent condition. It affects 1 in 4 adults over the age of 25, with a much higher prevalence among women.

At the EADV congress held in Paris in September, three world-renowned experts, Dr Jerry Tan (Western University, Canada), Prof Dedee F. Murrell (St George Hospital, Sydney, UNSW) and Prof Latanya T. Benjamin (USA, Florida) gave a symposium on the changing epidemiology of acne: from early onset to late persistence.

Their presentations highlighted the fact that acne is not just a short-term skin concern, but a chronic dermatological condition with multiple causes and profound impacts on physical, psychological and social health.
 

Teenagers: a generation under pressure

Acne affects the majority of teenagers and disrupts their daily lives. An international survey reveals that 41% of young people affected have stopped taking selfies because of their skin¹ . The psychological impact is severe, involving anxiety, isolation and loss of confidence. A worldwide meta-analysis estimates that 22% of acne sufferers show signs of depression² and almost 12% have suicidal thoughts. What's more, teenage acne is often recurrent and persistent, with relapses possible even after well-managed treatment.

Teenage angst is exacerbated by social networking sites with 90% of teenage girls and 75% of teenage boys retouching their photos before posting them. Filters, influencers and viral "miracle cures" are fueling unrealistic expectations and a growing mistrust of medical treatments. Adolescents are a prime target for misinformation: before-and-after videos, unreliable advice and promises of quick cures flood their screens, boosted by algorithms that exploit their insecurities.

Adult acne: why are women at the forefront?

Far from disappearing after puberty, acne is affecting more and more women between the ages of 25 and 40. Epidemiological data shows that acne is much more prevalent in women than in men. The psychological consequences are just as significant: affected adult women have quality of life scores comparable to those for severe chronic illnesses (DLQI ≈ 12³ ), regardless of clinical severity.

There are many causes including hormone fluctuations, metabolic predispositions such as insulin resistance, as well as social and aesthetic pressure. For Professor Murrell, 

acne is not a short-term problem, it is a chronic condition that disrupts daily life

Acne, the chronicle of an “epidemic” foretold

Acne is on the rise today because it lies at the crossroads of several transformations in our modern societies:
•    Hormonal and biological factors: the androgens-IGF-1 axis stimulates thicker, more inflammatory sebum production, leading to the formation of microcomedones.
•    Diet: increased consumption of fast-release sugars, dairy products and whey proteins activates the mTORC1 pathway, involved in precocious puberty, insulin resistance and persistent acne.
•    Pollution: dioxins and other pollutants activate skin receptors (AhR), encouraging the formation of lesions.
•    Skin microbiome: some strains of Cutibacterium acnes are inflammatory, while others are protective - the balance is upset by the impact of lifestyles.
•    Social and digital pressure: always being connected and the image culture exacerbate the obsession with 'perfect' skin, sometimes delaying medical treatment in favor of unapproved advice.

This metabolic background is often associated with polycystic ovary syndrome (PCOS), reminding us that female acne is a symptom of overall health and should be treated as such.

Acne is clearly a reflection of our modern times: stress, urban living, ultra-processed food, sedentary lifestyles, hyper-connection to social networks with unrealistic aesthetic standards (digital filters, retouched images) and omnipresent models of blemish-free beauty.

Acne, a symptom of our times

Specialists agree: acne is not just a skin problem, but a hormonal, environmental and societal condition.


 

Press Contact : Caroline Perdrix Thomas 
caroline.perdrix@pierre-fabre.com

Reference:

1. ALL Study - Pierre Fabre

2. Global prevalence of mental health comorbidity in patients with acne : an analysis of trends from 1961 to 2023. https://pubmed.ncbi.nlm.nih.gov/39692772/ 

3. The DLQI (Dermatology Life Quality Index) is an international questionnaire which measures the impact of skin problems on quality of life. The score is on a scale from 0 to 30. A score of 12 indicates a significant impact