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Journal of the American Academy of Dermatology
Volume 63, n° 5
pages 782-788 (novembre 2010)
Doi : 10.1016/j.jaad.2009.11.021
accepted : 13 November 2009
Original Articles

Underestimated clinical features of postadolescent acne

Bruno Capitanio, MD a, Jo Linda Sinagra, MD a, , Valentina Bordignon, PhD b, Paola Cordiali Fei, PhD b, Mauro Picardo, MD c, Christos C. Zouboulis, MD d
a Pediatric Dermatology Department, San Gallicano Institute, Istituti Fisioterapici Ospitalieri, Rome, Italy 
b Department of Clinical Pathology and Microbiology, San Gallicano Institute, Istituti Fisioterapici Ospitalieri, Rome, Italy 
c Cutaneous Physiopathology Department, San Gallicano Institute, Istituti Fisioterapici Ospitalieri, Rome, Italy 
d Departments of Dermatology, Venereology, Allergology, and Immunology, Dessau Medical Center, Dessau, Germany 

Reprint requests: Jo Linda Sinagra, MD, Pediatric Dermatology Department, San Gallicano Istituto di Ricerca e Cura a Carattere Scientifico, Via Elio Chianesi 53, 00144 Roma, Italy.

Postadolescent acne is usually described as an inflammatory, mild-to-moderate dermatosis, frequently involving the lower third of the face, the jawline, and the neck. However, we have also frequently observed a clinical form predominantly characterized by retention lesions (microcomedones and macrocomedones), with few inflammatory lesions (comedonal postadolescent acne [CPAA]), which appears significantly correlated with cigarette smoking.


We sought to investigate the clinical features of postadolescent acne in a group of female patients affected by acne and its relationship with cigarette smoking.


A total of 226 women with acne (25-50 years) attending our department were examined by a team of 3 dermatologists, to assess the age of onset of the disease, and the number, type, and distribution of acne lesions.


In all, 192 of 226 patients (85.0%) were classified as having CPAA and 34 as having papulopustular postadolescent acne. A smoking habit was confirmed in 150 of 226 (66.3%). Remarkably, 72.9% of patients with CPAA were smokers as compared with only 29.4% of those with papulopustular postadolescent acne (P < .0001).


Possible limitations are related to geographic area or to the prevalence of darker skin types (III and IV) (data about skin types have not been collected). Other possible aggravating factors (ie, stress and diet) have not been investigated.


According to our results, CPAA appears as the most frequent clinical form of postadolescent acne and seems to be strictly correlated with cigarette smoking.

The full text of this article is available in PDF format.

Key words : cigarette smoking, clinical features, postadolescent acne

Abbreviations used : ACh, CPAA, PPAA

 Funding sources: None.
 Conflicts of interest: None declared.

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