Adult female acne: A cross-sectional study of diet, family history, body mass index, and premenstrual flare as risk factors and contributors to severity

BACKGROUND: The risk factors for adult female acne (AFA) and their influence on severity are unclear. The aim of this study was to document the role of diet, body mass index (BMI), premenstrual flare, and family history of acne as risk factors and cause of severity of AFA. METHODS: This was a prospective, cross-sectional, case-control study of 112 women age ≥25 years. The women were clinically evaluated. Sociodemographic data (age, family history of acne, premenstrual flare, weight, and height) and dietary habits were documented. Age, weight, height, and dietary habits of controls were also documented. Data were analyzed using SPSS, version 22. RESULTS: The mean age of the 56 patients with AFA was 33.4 ± 8.2 years (controls: 24.5 ± 4.4 years). Premenstrual flare of acne was noted in 58.9% of patients, a family history of acne was present in 51.8% of patients, and the mean BMI was 25.2 ± 4.9 (32.1%). A risk factor for AFA was a family history of acne (p ≤ 0.001). Dietary habits (chicken, p = 0.457; beef, p = 0.845; cakes and sweets, p = 0.956; starchy food, p = 0.361; and type of milk, p = 0.919) and BMI (p = 0.486) were not risk factors for AFA. Premenstrual flare (p = 0.178), BMI (p = 0.206), family history of acne (p = 0.592), and diet did not contribute to the severity of AFA. CONCLUSION: Diet and BMI are not risk factors for AFA, but a family history of acne is. Severity of AFA is independent of premenstrual flares, diet, BMI, and a family history of acne.