The Nuance

Why Is Acne More Prevalent Than Ever?

It may have something to do with your skin’s microbiome

Markham Heid
Published in
4 min readJun 27, 2019
Photo by jurien huggins on Unsplash

BBack in the 1990s and early 2000s, doctors from the United States and Venezuela conducted acne exams on more than 1,300 people living in two remote sections of Paraguay and Papua New Guinea. The results of those exams appeared in a JAMA Dermatology paper and they were, to quote the paper’s authors, “astonishing.”

The doctors turned up virtually zero cases of acne among rural men and women. The contrast between the clear complexions of the people in the study and the high occurrence of acne in the modernized world was so striking that the study authors wrote that the discrepancy “cannot be solely attributed to genetic differences among populations but likely results from differing environmental factors.”

In the U.S., acne pimples are a near-universal affliction among teens and are increasingly common among adults. By some estimates, nearly all American kids have to deal with acne pimples from time to time. Roughly one in three women in their thirties struggles with acne, along with 20% of men, according to a study in the Journal of the American Academy of Dermatology.

“Acne is not just for teens — there are extraordinary numbers of adults with acne, and the numbers seem to be going up”

While accurate historical data are hard to come by, evidence suggests acne rates are on the rise among both young people and adults. A 2016 study from the University of Colorado found that, between 1990 and 2010, acne rates increased 11% among U.S. teens. Recent research on adult acne has also turned up evidence that it’s an “emerging issue,” especially among women.

“Acne is not just for teens — there are extraordinary numbers of adults with acne, and the numbers seem to be going up,” says Dr. Adam Friedman, a professor and interim chair of dermatology at the George Washington University School of Medicine and Health Sciences. “I treat more adult acne patients than teens, and it’s mostly women in the thirty to fifty age range.”

Figuring out the causes of acne’s apparent surge is tricky. Some researchers have



Markham Heid

I’m a long-time contributor at TIME and other media orgs. I write mostly about health. I grew up in Michigan, but these days I live in southwest Germany.