Adult acne (AA) is defined as acne that develops (late-onset acne) or continues (persistent acne) after 25 years of age. 1 Epidemiological data demonstrate that AA can affects approximately 30-50% of the adults. 2 In women, the disease incidence is increasing, and for this, it is also named adult female acne (AFA). 3 The clinical features of AFA are quite specific: inflammatory acne lesions in the lower facial region or macro comedones (microcysts) spread over the face. 4 In fact, AFA commonly affects the lower third of the face and the jawline and its incidence is increasing. AFA seems to be particularly frequent among adult female smokers, even if there is not concordance

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