Acne was traditionally looked upon as a disease of adolescence, but the past several years have proved it wrong with the frequent reports of adult women suffering from this condition. About 12% and 54% of adult females suffer from acne, which could be categorized into two clinical types – a ‘retentional’ and an ‘inflammatory’ type, which may overlap. Evolution stage may prompt its classification into three main subtypes – Persistent acne (most reported subtype), late-onset acne and recurrent acne. This type of acne presents with mild-to-moderate severity and may be refractory to conventional treatment. 

Adult female acne is different from the adolescent one concerning the clinical presentation, etiopathogenesis, as well as its tendency towards chronicity, which may extend up to the postmenopausal period. 

Their etiopathogenesis remains complex and demands a clear explanation. However, an exchange between genetic predisposition, hormonal factors and chronic activation of the innate immune system may be implicated coinciding with external factors, like daily stress, Western-type diet, tobacco and cosmetics use. 

Along with affecting the cosmetic appearance, acne can also have a great psychological impact, negatively impacting the quality of life and overall well-being of the sufferers.

As the treatment is challenging, a holistic approach must be taken, giving a particular lookout to the individual needs and specificities of adult women. Both topical and systemic treatments may be employed, along with hormonal therapies in this particular subset. 

More investigations regarding its etiopathogenesis are the need of time.

Source: Branisteanu DE, Toader MP, Porumb EA, et al. Adult female acne: clinical and therapeutic particularities (Review). Exp Ther Med. 2022;23(2):151.