Adult female acne

An embarrassing problem for adult women

What is Adult Female Acne

Adult female acne refers to women in their 20s, 30s and 40s who experience acne, often in a ‘hormonal’ distribution around the chin and jaw line. Many of these women had acne as a teenager with persistence into the adult years, while others never had acne as a teenager and then inexplicably develop acne as an adult. So often, we encounter women that are baffled as to why they have acne at the age of 40 but cannot remember having acne when they were younger. Many of these women report flaring of acne around their menstrual cycle.

A recent survey of a thousand women reported the following estimates of adult female acne:

AgePrevalence of Acne
20 to 29 years51%
30 to 39 years35%
40 to 49 years26%
50 years and older15%

Many of these women are embarrassed, perplexed, and frustrated. Many seek camouflage and cosmetics to cover up their acne.

What causes adult female acne?

The two main underlying causes for adult female acne are genetics (i.e., family history) and hormones. Most women with adult female acne have normal circulating levels of hormones when tested. Those women with an implantable birth control, or IUD containing progestin only contraceptives, are more prone to adult female acne. It is important to screen women with adult female acne for signs of abnormal hormone levels. -This would include irregular menstrual cycles, excessive hair growth on the chest/abdomen/ sides of the face, acanthosis nigricans, and female pattern hair loss.


Treatment of adult female acne

In general, a gentle skin care regimen, with gentle nonmedicated skin cleansers and moisturizers that do not clog pores are recommended. (See questions and answers page of this website for further information on gentle cleansers and moisturizers.)

Unfortunately, there are limited studies that specifically look at the adult female acne population. Therefore, acne therapy is individually tailored to the needs of each patient, based on experience.

For those women with garden-variety comodonal and inflammatory acne, we will often proceed with traditional therapies. For those women who have late onset type acne with distribution around the chin and jaw line, there will be a greater focus on treating the hormonal component.

Topical therapies:

  • benzoyl peroxide 
  • retinoids (adapalene, tretinoin etc.)
  • topical antibiotics: clindamycin, sulfacetamide, minocycline
  • dapsone
  • Winlevi™
  • azaleic acid (good for skin of color)
  • Acne DS Clarifying gel™ combines specialized formulations of topical spironolactone with dapsone (found exclusively at Acne Center of Michigan ™)


Oral therapies:


Collier CN, Harper JC, Cafardi JA, et al. The prevalence of acne in adults 20 years and older. J Am Acad Dermatol. 2008;58:56-59.

Status Report From the American Acne & Rosacea Society on Medical Management of Acne in Adult Women, Parts 1, 2 and 3: 

Cutis. 2015 October, November, and December