Treatment of adult female acne: a new challenge

Abstract

Acne is affecting an increasing number of adult females and so can no longer be considered as a disease of adolescence. The disease has a greater negative impact on the quality of life of adult females than their younger counterparts.Adult female acne may persist from adolescence or may have its first occurrence once adulthood has been reached. The clinical presentation and pathogenesis of adult female acne may be somewhat different to that of adolescent acne and this may require a different treatment approach. Genetic and hormonal factors are thought to play key roles in the pathogenesis of adult female acne and the disease is characterized by a chronic evolution with frequent relapses requiring long-term maintenance therapy. Fixed-dose retinoid/antimicrobial combinations may be of interest for the treatment of adult female acne given that subgroup analysis of clinical trials has indicated that they are effective against both inflammatory and non-inflammatory lesions in these patients. These treatments may also be of interest, given the chronic course of the disease in adult females, the high likelihood of the presence of antibiotic-resistant P. acnes and the poor adherence of patients to other long-term therapies. Oral hormonal treatment or isotretinoin may be required in patients with severe acne or disease that is refractory to other treatments. Additional clinical studies of acne treatments specifically conducted in adult female patients are required to increase the evidence base on which future treatment recommendations can be based.

Epidemiology of post‐adolescence acne and adolescence acne in Singapore: a 10‐year retrospective and comparative study

“…Recent reports appear to indicate that there has been an increase in the prevalence of post-adolescence acne in recent years. 1,9 Two large studies by Dreno B et al 10,11 reported that acne vulgaris is affecting an increasing number of adult women, posing a new treatment challenge as it tends to run a more chronic course. In our study, the increase in the proportion of acne vulgaris patients in our tertiary dermatology referral centre was contributed by an increase in both adolescence and post-adolescence acne cases.…”

The possible role of diet in the pathogenesis of adult female acne

“…The four obvious factors typical of adolescent patients, which contribute to acne physiopathology are: inflammation, colonization with Propionibacterium acnes , increased sebum production and hyperkeratosis of the pilosebaceous duct [2, 18]. However, it is very probable that the influence of these factors on the acne course, may be somewhat different in adult female acne than in adolescent acne, and should be considered as a specific problem requiring another approach to treatment [19–21]. …”

Skincare Bootcamp: The Evolving Role of Skincare

“…43 Acne is incurable and commonly persists in adult women for more than 20 years. 44 It can be effectively managed with a combination of medicines (OTC and/or prescription) specifically targeting each step of the underlying pathogenesis. The drawback of topical acne medications is the dryness, redness, and irritation they often cause, making daily compliance a challenge.…”