Adult female acne: a new paradigm


  • Conflict of interest statements
    BD has served as a consultant for Bayer HealthCare, Fabre, Galderma, La Roche Posay and Meda; JCH, VAZ, AL and YY have served as advisory board members for Bayer HealthCare; EB has served as speaker for Bayer HealthCare and is conducting clinical trials for Bayer HealthCare, Galderma, La Roche Posay and Sigvaris, Brazil; CCZ has served as an advisory board member for Bayer HealthCare, Galderma, Merz and Stiefel/GlaxoSmithKline, as a consultant for Leo, and as a speaker for Bayer HealthCare, Galderma, General Topics, Glenmark, and Stiefel/GlaxoSmithKline; AZJ has served as a paid consultant for Bayer HealthCare; JLLE has served as a paid consultant for Bayer HealthCare, Galderma and Stiefel. This manuscript was developed following a consensus meeting funded by Bayer HealthCare. Editorial support was provided by Sarah Stowell PhD of Fishawack Communications Ltd and was funded by Bayer HealthCare.

  • Funding sources



In the adult female, acne is a chronic condition with a substantial negative psychological, social and emotional impact. Based on time of onset, two subtypes of adult female acne are recognized: ‘persistent acne’ is a continuation of the disease from adolescence, while ‘late-onset acne’ first presents in adulthood. The morphological characteristics of adult female acne are often distinct from adolescent acne. In adults, inflammatory lesions (particularly papules, pustules and nodules) are generally more prominent on the lower chin, jawline and neck, and comedones are more often closed comedones (micro cysts). Adult acne is mainly mild-to-moderate in severity and may be refractory to treatment. A holistic approach to acne therapy should be taken in adult females, which combines standard treatments with adjunctive therapy and cosmetic use. A number of factors specific to the adult female influence choice of treatment, including the predisposition of older skin to irritation, a possible slow response to treatment, a high likelihood of good adherence, whether of child-bearing age, and the psychosocial impact of the disease. Adherence to therapy should be encouraged through further patient education and a simplified regimen that is tailored to suit the individual patient’s needs and lifestyle. This article reviews the specific characteristics of adult female acne, and provides recommendations for acne therapy in this patient group.