Adult female acne: relevance and possible solutions

Abstract

In recent years, there has been an increase in the proportion of AFA in the structure of acne incidence. The etiopathogenesis of the disease is multicomponent and has not been fully elucidated. It is assumed that hormonal factors and chronic activation of innate immunity are involved in the process against the background of genetic predisposition, which are stimulated by external environmental factors: daily stress, Western-style diet, tobacco use, hormonal drugs, cosmetics. The article presents a modern classification of the clinical course of AFA and scales for assessing the severity of the course of the disease: GEA (Global Acne Severity Scale) and AFAST (Adult Female Acne Scoring Tool). AFA is predominantly characterized by a mild or moderate course. Treatment requires a personalized approach with particular attention to the individual needs and characteristics of adult women. When choosing a topical therapy, the doctor should consider the less pronounced oiliness of the skin, the slow progression of the disease with the outcome in hyperpigmentation and scarring. Modern acne treatment regimens include systemic and topical therapy along with proper basic skin care. The most effective topical agents include retinoids, which can induce a specific biological response by binding and activating retinoic acid receptors. Comedonal and mild papulopustular acne are indications for adapalene monotherapy for acne in adult women. Adaklin (0.1% adapalene) cream is a highly effective first choice for the pathogenetic treatment of AFA. Rational mono- and combination therapy with adapalene is the key to successful external therapy of mild and moderate AFA and prevention of post-acne. The review provided up-to-date, evidence-based information on the clinical presentation, etiopathogenesis, and treatment of adult female acne (AFA).