Eliot Mostow

Acne in Adult Women

A study of acne in adult women showed that acne lesions appeared in the same pattern as seen in teenagers with acne. Over 90% of women with acne had pimples and precursors to pimples on the face.

This study also showed that adult women with acne usually respond well to first-line acne therapy. While birth control pills and other hormonal treatments provide an important treatment option for some patients, most adult women will see positive results from the use of topical retinoid and some form of antibiotic.

These acne medications reduce plugging of the follicles that lead to the development of pimples and reduce the P. acne bacteria that cause inflammation.

Acne during adulthood is very common. Adult acne can be a continuation of teenage acne that never ended. This is called "persistent acne". It can appear for the first time in people who are 30, 40 or even 50 years old. Acne that appears for the first time is referred to as "late-onset acne".

Causes of adult acne

Acne in adults can be triggered by several factors, including the following:

  • Hormonal activity. Hormones are the main culprit in the worsening of teen acne (when hormonal fluctuations are most active) and can also play a role in adult acne, especially among women. Hormonal fluctuations are common during  menstruation, pregnancy, and menopause. Women who stop taking birth control pills might also get acne. Stress can also lead to hormonal changes and acne worsening. Under stress, the body produces more androgens, which stimulate sebum production.
  • Other medications. Anticonvulsants, corticosteroids, and certain medications have side effects that may include acne. Do not stop taking your medication if this happens. Instead, talk with your doctor to discuss alternatives or adjusting the dosage. Oral contraceptives containing both estrogen and progestins are sometimes used to prevent acne in women, but progestin-only birth control may worsen acne.
  • Family history. You may be predisposed to have acne if members of your immediate family (such as a sibling or parent) have had acne.
  • Cosmetics. Oily lotions or hair product may promote acne. Choose products labeled “non-comedogenic” or “non-acnegenic.”
  • Another health problem. Acne can signal an underlying medical condition, including polycystic ovaries or problems with the adrenal system.

Adult acne treatment options

Adult Acne

As with adolescents, acne treatment recommended is based upon several variables:

  • The type of acne (comedonal, inflammatory)
  • Its location
  • Your skin type (dry vs. oily skin)
  • Severity (mild acne, moderate acne or severe acne)
  • Your gender (some treatments optimal for one gender and not another)
  • Responses to past treatments

Some oral medications are prescribed to control the underlying hormonal trigger of acne among women. These hormonal treatment options include oral contraceptives, hormone replacement therapy (HRT), and spironolactone (aldactone). HRT is not commonly used to treat acne in pre-menopausal women and should never be taken during pregnancy.

For the most severe, unresponsive cases of acne, oral isotretinoin may be prescribed. Isotretinoin is one of the most effective treatments for severe acne, but it has serious side so treatment with isotretinoin requires working closely with a dermatologist.


This information is for general educational uses only. It may not apply to you and your personal medical needs. This information should not be used in place of a visit, call, consultation with or the advice of your physician or health care professional.

Communicate promptly with your physician or other health care professional with any health-related questions or concerns.

Be sure to follow specific instructions given to you by your physician or health care professional.

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