Adult female acne

May is packed with dedicated days celebrating women, such as Mother’s Day and International Day of Action for Women’s Health. With that said, this month we are going to focus on a few skin conditions commonly seen in women. Adult female acne is a very common skin disorder, and one which need to cause embarrassment in adulthood.

Nearly everyone can remember having acne at one or other time in their lives. Although acne is most often seen as a condition affecting teenagers, it is not uncommon in older age groups. Adult female acne occurs in women over the age of 25. This type of acne most commonly persists from teenage years or it may present for the first-time during adulthood.

Is acne becoming a more common issue in adult women?

The reasons for the increased rates of adult female acne is unknown but genetic and lifestyle factors may play a role. There may be a genetic component such as a family history of acne. Other associated factors may be a history of acne as a teenager, no previous pregnancies, a hormonal imbalance and lifestyle factors.1

Lifestyle factors include high levels of psychological stress and diet-related factors. In an Italian study comprising of 248 adult female acne patients, diets low in fruit, vegetable and fresh fish were associated with increased levels of adult female acne.1 Some studies suggest that a high glycaemic index diet may be associated with acne. Limited data may point to dairy consumption (especially skim milk) and increased rates of acne. Further trials need to be performed to confirm whether any of these factors play a role in acne development.2

Cigarette smoking may also play a role in the development of adult female acne. Smoking is responsible for the development of a non-inflammatory acne. In this type of acne, comedones (white and black heads) predominate.3

Adult females may also be prescribed medication that may trigger acne development. Medications include some types of antidepressants, vitamin B-type complexes and progestin contraceptives.3

Medical conditions such as polycystic ovarian syndrome that are associated with increased male hormones can also be a cause of adult female acne.

How do we treat adult female acne?

Adult female acne is challenging condition where patient and dermatologist need to work together to achieve the best results. A complete history and physical examination may provide clues to underlying conditions and triggers.

Acne has a tendency to relapse, so maintenance therapy is very important. Women with acne might have sensitive skin and this may also further complicate treatment. Cosmetics may cause or worsen the condition. Use only non-comedogenic facial products and a mild face wash.

Treatment is aimed at the grade of acne severity. If acne is mild, dermatologists usually start with topical therapy. For more severe grades of acne or acne resistant to topical therapies, your dermatologist might decide to use tablets such as certain oral contraceptives, oral antibiotics or vitamin A (Roaccutane). 

Dr. Johann de Wet is a top dermatologist in Stellenbosch and skin specialist who also specializes in the treatment of adult female acne. His dermatology services and especially skin cancer screening in the Cape Winelands extends from Stellenbosch to Somerset West and Cape Town.


  1. Di Landro A, Cazzaniga S, Cusano F et al. Adult female acne and associated risk factors: Results of a multicenter case-control study in Italy. J Am Acad Dermatol.2016 Dec;75(6):1134-1141.
  2. Zaenglein AL, Pathy AL, Schlosser BJ et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2016;74:945-73.
  3. Bagatin E, de Freitas THP, Machado MCR et al. Adult female acne: a guide to clinical practice. An Bras Dermatol. 2019 Jan-Feb; 94(1): 62–75.