One of the most common skin diseases in women is mature acne. The mechanisms that are responsible for the visible skin lesions are still being recognized, and it is impossible to put a single factor that is culpable for the development of this dermatosis. The aim of the article is to describe the possible pathogenesis of adult acne with a description of the disorders occurring at the level of skin cells. The main focus is directed to the particular role of the endocrine system in the development of adult acne in women over 25 years of age and related diseases such as polycystic ovarian syndrome. Current specialized and cosmetological therapies were also described.