The Breakout Breakdown: Acne in Men vs Women

There's an old saying that goes that men are from Mars, while women are from Venus. This holds true, especially when it comes to acne. Men's and women's skin properties vary, which explains why acne occurs differently between the two genders.

Onset

Acne usually begins during adolescence, specifically during puberty. Approximately 85% of individuals aged 12 to 24 experience this skin problem, according to Dr. Jaggi Rao of Medscape. 

Pimples that occur during adolescence occur due to the production and release of the hormone androgen. Since males experience a boost of the said hormone during adolescence, they are more likely to suffer from this type of acne. Statistics show that acne affects anywhere from 81 to 95% of all teenage males, compared to 72 to 82% of adolescent females. 

These trends change drastically once men and women enter adulthood. They may suffer from any of the 2 kinds of adult acne, which are: 

• Persistent acne, where pimples relapse or continue to transcend from adolescence to adulthood
• Late-onset acne, where breakouts develop in individuals (aged 25 and above) who were previously ‘free’ from acne

As mentioned, adult acne affects more women than men. The changes can be seen clearly in a report by Science Daily: 

• 20s: 50.9% of women develop acne compared to 42.5% of men
• 30s: 35.2% of women develop acne compared 20.1% of men
• 40s: 26.3% of women develop acne compared to 12% of men
• 50s: 15.3% of women develop acne compared to 7.3% of men 

Since adult breakouts are more prevalent in females, they are more likely to suffer from complications such as inflammation, pigmentation changes, and permanent scarring.

Acne Causes

Acne is brought about by different causes. Triggers also vary according to gender and age.

Like adolescent acne, adult female acne develops due to any of the following factors:

• Excess sebum (facial oil) production
• Follicular keratinization, where cells stick together instead of shedding normally on the skin surface 
• Propionibacterium acnes, a microbe that infects the pores

Apart from these factors, adult female acne can also be brought about by makeup or drug use.  Chronic stress, brought about by work, is deemed a factor behind adult female breakouts as well. 

Hormonal changes may also explain the prevalence of adult female acne. The menstrual cycle, as well as oral contraceptive pills, often lead to hormonal acne. 

Concerning family history, studies show that it is one of the main driving factors behind both female and male acne. 

Smoking, on the other hand, leads to acne at a fairly similar rate in both genders. Smoking can trigger acne by way of inflammation and follicular keratinization. 

Severity

Mild acne is the most common problem in both genders. This refers to less than 20 whiteheads or blackheads, less than 15 inflamed bumps, or less than 30 lesions overall. According to a study by Skroza et al., males and females – whether adolescent or adult – frequently suffer from this type of acne. 

Men, on the other hand, are more likely to develop moderate acne. This refers to the presence of 20-100 blackheads/whiteheads, 15-50 inflamed pimples, or 30-125 total lesions. Study results show that it affects 22% of teenage males and 15% of adult males, compared to 10% of teenage females and 7% of adult females. 

Males are also more likely to develop severe acne. This pertains to comedonal or acne count that exceeds the parameters of moderate acne. This affects approximately 3% of adult males, as well as 1% of the other subgroups (teenage males, adult, and teenage females). 

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Duration

According to a report, men are more likely to have longer-lasting acne.  Compared to women, men have more receptors for the hormone androgen. This results in more sebum production, a major driver behind acne development.

Impact on Quality of Life

Quality of life refers to a person's general well-being. It covers an individual's expectation for a good life. Unfortunately, acne tends to negatively affect the quality of life – especially in women. 

In the study by Skroza et al., this was measured through the Assessment of Quality of Life tool. Here, the lower scores (out of 114) you have, the ‘poorer’ quality of life you perceive to have.

Results show that acne badly affects women, with a higher negative impact on adults (35/114) compared to adolescents (45/114). While pimples affect men as well, adult males have a markedly better score (70/114), double to that of their female contemporaries. The same can be said with male adolescents who scored an average of 60 out of 114.  

Due to the negative impact of acne on quality of life, females are also more likely to develop anxiety, depression, psychological stress, even suicidal thoughts. 

Location

Acne locations vary greatly between the sexes. In men, they are usually found on the face and the back. The latter usually happens due to exercise or hot weather. Back sweat, if not cleaned immediately, can irritate the skin and affect the pores. 

As for women, acne usually affects the face, especially along the jaw. The latter often occurs in hormonal acne.

Female breakouts can also be seen on the back of the neck (cervical region) and the chest. 

Prevention and Treatment 

Since acne occurs differently in men and women, each gender is recommended with different prevention and treatment measures. 

• Men

Since men usually shave their faces, experts recommend using a clean razor every time. Males can also opt for prescription antibiotic foam, which can be mixed with shaving cream. 

Men can also benefit from retinol, salicylic acid, or benzoyl peroxide. These products can help prevent breakouts related to shaving. 

To help reduce back acne, men are advised to use a cleansing brush with extension. This can help clean the hard-to-reach areas in the back. Another good option is a sonic cleansing system with a changeable brush head. 

Again, salicylic acid and benzoyl peroxide can be used to treat male back acne. 

• Women 

A different approach is taken in women, given the other triggers that occur primarily in females. One is hormonal acne, which is usually addressed with contraceptive pills. More natural alternatives include herbal remedies that have hormone-like effects on the body. These include the chaste-tree berry, ginkgo, ginseng, black cohosh, and red clover, to name a few.

For make-up related acne, women may need to minimize cosmetic use. They may also need to shift to non-comedogenic makeups, whose formulations are less likely to clog pores. 

Men and women clearly differ when it comes to acne. As such, each gender needs ‘unique’ treatment approaches for clean, clear skin.