Though it's often portrayed as a scourge of the teen years, acne can affect people of all ages. According to the National Institutes of Health (NIH), about 80 percent of people between the ages of 11 and 30 have outbreaks of the skin disorder at some point.
"Many see their acne go away by the time they reach their 30s," says Jane Liedtka, a medical officer at the Food and Drug Administration's (FDA) Center for Drug Evaluation and Research (CDER). "But for some, acne persists into their 40s and 50s."
Dianne Murphy, M.D., is director of FDA’s Office of Pediatric Therapeutics. Dr. Murphy graduated from the Medical College of Virginia and completed her residency in pediatrics at the University of Virginia in Charlottesville. She has been with FDA since 1998.
Q: How does FDA define “children”?
A: For drugs, a child is defined as a person up to 17 years of age. For devices, 21 years of age is the upper limit.
Q: Are medications that are intended for children clinically tested on children?
Spurred by inflammation of skin glands and of tiny, narrow canals in the skin known as hair follicles, acne is marked by pimples and other lesions. It commonly appears on the face, neck, back, chest, and shoulders.
Acne is not usually a serious health condition. "But it can cause significant emotional distress, as well as permanent scarring of skin tissue," says Liedtka, who has 15 years of clinical experience treating acne. She now works in CDER's Division of Dermatology and Dental Products.
A Disease of the PSUs
Clinically, acne is described as a disease of features known as pilosebaceous units (PSUs). Found just under the skin, PSUs are numerous on the face, upper back, and chest, and contain sebaceous glands that are connected to hair follicles. The sebaceous glands produce sebum, an oily substance that empties onto the skin via the hair follicle.
Liedtka explains, "it is known that acne is partly the result of the action of hormones on the skin's oil glands and the hair follicles," she says. "The earliest lesion of acne is a plugging of the pores of the skin."
Factors believed to be related to acne formation include
increases in sex hormones called androgens that occur in both boys and girls during puberty. Androgens cause sebaceous glands to enlarge and make more sebum in hair follicles
hormonal changes related to pregnancy or to starting or stopping use of birth control pills
Beware of Myths
"There are many misconceptions out there about how acne forms, as well as on how to treat the condition," says Liedtka.