Adult female acne
Adult female acne (AFA) affects a growing number of women and can present differently from adolescent acne. It is typically defined as acne occurring in women over the age of 25, either persisting from adolescence or developing for the first time in adulthood (Dréno et al., 2015).
Lesions are often distributed along the lower face, jawline, and chin, and may be associated with hormonal influences. In many cases, it can be persistent or recurrent and may require a tailored management approach.
What Contributes to Adult Female Acne?
Acne is recognised as a chronic inflammatory condition of the pilosebaceous unit (hair follicle and sebaceous gland) (Zaenglein et al., 2016).
Multiple contributing factors may be involved:
Hormonal fluctuations (e.g. menstrual cycle, pregnancy, perimenopause, or conditions such as PCOS)
Genetic predisposition
Stress
Cosmetic or skincare products
Medications (including hormonal therapies)
Lifestyle and environmental influences
Hormonal factors are commonly implicated in AFA, particularly androgens, which can increase sebum production and influence breakouts (Kamangar & Shinkai, 2012).
Stress has also been associated with acne severity, with some studies suggesting it may exacerbate inflammation and sebum production (Chiu et al., 2003).
Psychological and Social Impact
Acne can have a measurable impact on quality of life, including self-esteem, social confidence, and emotional wellbeing. Studies have shown associations between acne and increased rates of anxiety and depression (Tan & Bhate, 2015).
For this reason, management often considers both physical and psychological aspects.
Why Acne Can Be Difficult to Manage
Because acne is multifactorial, there is rarely a single cause or solution. Over-the-counter treatments may assist mild cases but may not address contributing internal or environmental factors.
Clinical guidelines recommend individualised treatment plans based on acne severity, skin type, and contributing triggers (Zaenglein et al., 2016).
Treatment Approaches for Adult Female Acne
Management of AFA may involve a combination of:
Topical treatments to support skin turnover and reduce congestion
Professional in-clinic treatments
Supportive skincare to maintain barrier function
Consideration of hormonal or medical factors (where appropriate, under medical guidance)
Lifestyle and environmental modifications
The goal is to support skin function while minimising inflammation and reducing the likelihood of recurrence.
The DMK Skin Revision Approach
The DMK approach focuses on supporting the skin’s natural processes and maintaining balance (homeostasis). Treatments are selected based on individual skin assessment.
In-Clinic Treatments
Enzyme-based therapies are designed to support circulation and assist in the removal of debris from the skin’s surface. While evidence on specific branded systems is limited, professional treatments that support exfoliation and skin renewal may assist in managing congestion and texture when appropriately prescribed.
pH Considerations
Skin pH plays a role in barrier function and microbial balance. Maintaining an appropriate pH may support overall skin health and reduce irritation (Lambers et al., 2006).
Different formulations may be used depending on the skin’s condition, with the aim of supporting exfoliation and improving skin clarity over time.
Extractions
When appropriate, extractions may be performed by trained professionals to assist in clearing congested follicles. This is typically done carefully to reduce the risk of inflammation or scarring.
The Role of Home Care
Consistent home care is an important component of acne management.
A personalised routine may include:
Gentle cleansers to avoid disrupting the barrier
Hydrating and barrier-supportive products
Ingredients that support skin turnover and reduce congestion
Supporting the skin barrier is particularly important, as impaired barrier function has been linked to increased inflammation and sensitivity (Dreno et al., 2018).
Lifestyle and Internal Factors
Lifestyle factors may influence acne in some individuals. These can include:
Stress levels
Diet (in some cases, high glycaemic load diets have been associated with acne severity) (Smith et al., 2007)
Sleep and general wellbeing
Addressing these factors, where relevant, may support overall skin management.
Treatment Planning
Acne management often requires a series of treatments over time, along with consistent home care.
Treatment frequency and duration vary depending on individual presentation, and outcomes can differ between individuals.
Final Thoughts
Adult female acne is a common but often complex condition influenced by multiple factors, including hormones, environment, and skin function.
A personalised, evidence-informed approach that considers both in-clinic treatments and home care may assist in managing symptoms and supporting overall skin health.
If you are experiencing persistent or recurrent acne, a professional consultation can help determine contributing factors and appropriate treatment options.
References
Dréno B, et al. (2015). Adult female acne: a new paradigm. Journal of the European Academy of Dermatology and Venereology.
Zaenglein AL, et al. (2016). Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology.
Kamangar F, Shinkai K (2012). Acne in the adult female patient. Journal of Clinical and Aesthetic Dermatology.
Chiu A, et al. (2003). The response of skin disease to stress. Archives of Dermatology.
Tan JK, Bhate K (2015). A global perspective on the epidemiology of acne. British Journal of Dermatology.
Lambers H, et al. (2006). Natural skin surface pH. International Journal of Cosmetic Science.
Dréno B, et al. (2018). The skin microbiome and acne. Journal of the European Academy of Dermatology.
Smith RN, et al. (2007). A low-glycemic-load diet improves acne. American Journal of Clinical Nutrition.