Insulin Resistance Highest in Young Women With Severe Chest/Upper Back Acne Lesions, Diabetes Family History

Health problem, skin diseases. Young woman showing her back with acne, red spots. Girl scratching her shoulder with pimples.
The prevalence and characteristics of women with acne who have insulin resistance are examined.

Insulin resistance may be an underlying component of acne in young women, particularly if these patients present with central obesity, a family history of diabetes, and more severe acne lesions on the chest/upper back, study findings published in the Journal of Cosmetic Dermatology suggests.

The study included 524 women with acne (mean age, 23.47±2.97 years) and healthy control participants (mean age, 23.96±2.73 years). In the acne group, a total of 78 patients had severe acne, 207 patients had moderate acne, and 239 patients had mild acne. Insulin resistance was predefined as a homeostasis model assessment of insulin resistance (HOMA-IR) value of 2.5.

In the patients with acne, the prevalence of insulin resistance was 12.4%, with significantly higher prevalence rates reported in patients with severe acne (15.38%) and moderate acne (17.39%) vs mild acne (7.11%) (P <.05).

Women with severe acne and comorbid insulin resistance also had more severe lesions on the chest/upper back compared with patients with simple acne (1.3% vs 0.2%, respectively; P =.008). According to the investigators, this finding has not been reported in the literature. Although the pathogenesis is unclear, the researchers suggest that severe lesions on the chest/upper back region in women with acne could be taken as a sign of insulin resistance.

In addition, women with acne and insulin resistance had a higher prevalence of family diabetes history compared with patients with simple acne (56.9% vs 24.9%, respectively). The researchers suggest this finding highlights the importance of taking history of the patient with acne when diagnosing insulin resistance.

Other variables that were significantly higher in patients with acne and insulin resistance compared with patients with only simple acne included waist circumference (77.15 ± 10.23 vs 70.95 ± 6.57 cm, respectively; P <.01), glucose (5.24 ± 0.46 vs 4.89 ± 0.49 mmol/L; P <.01), insulin (15.35 ± 6.51 vs 6.03±2.12 mIU/L; P <.01), and triglycerides (1.12±0.52 vs 0.80±0.32 mmol/L; P <.01).

Limitations of this study included the relatively small sample size as well as the inclusion of only women.

The investigators noted that “dermatologists should be aware of insulin resistance underlying the acne in young women,” as “early diagnosis and treatment of insulin resistance are important” in these patients.


Guo D, Zhang H, Yang S, et al. Prevalence, clinical, and biochemical characteristics of the female acne patients with insulin resistance. Published online January 8, 2021. J Cosmet Dermatol. doi:10.1111/jocd.13939