Female type of adult acne: Physiological and psychological considerations and management

J Dtsch Dermatol Ges. 2018 Oct;16(10):1185-1194. doi: 10.1111/ddg.13664. Epub 2018 Sep 24.


Today we see more cases of acne after adolescence, with a greater prevalence in females than males. Adult female acne has a distinct clinical presentation and is associated with a number of specific pathophysiological features and gender-specific triggers. The psychological impact of acne is generally significant and largely underestimated; stress during professional and private life, anxiety and sleep quality, in particular, have a reciprocal relationship with disease susceptibility and severity. It is essential to compare with males. Acne in females often causes greater distress in adults than in adolescents. The impact of disease may therefore be greater for female patients, triggering higher levels of psychosocial anguish and increasing the likelihood of sequelae such as skin picking and the risks of cutaneous superinfection, scarring and PIH and acne recurrence. The management of adult female acne should encompass not just medical treatment of the symptoms, but also a comprehensive, holistic approach to the patient as a whole, her individual lifestyle factors and the impact of acne on her quality of life. Future management of this disease should aim to improve patient adherence to therapy and to develop validated outcomes of treatment regarding overall skin appearance and quality of life.

Publication types

  • Review

MeSH terms

  • Acne Vulgaris / diagnosis
  • Acne Vulgaris / physiopathology
  • Acne Vulgaris / psychology
  • Acne Vulgaris / therapy*
  • Adult
  • Anxiety / psychology
  • Combined Modality Therapy
  • Diagnosis, Differential
  • Female
  • Holistic Health
  • Humans
  • Life Style
  • Quality of Life
  • Risk Factors
  • Sex Factors