Dealing with breakouts? You’re not alone. Acne affects up to 20% of the global adult female population - learn about its causes and treatment options.
I am Ersa, a senior Clinical Specialist Pharmacist with over 15 years of experience in both private and NHS settings delivering expert clinical leadership and service innovation within dermatology.
Currently, I am delivering remote dermatology pharmacy services in the NHS and for an innovative dermatology prescription service. I work with patients who are experiencing inflammatory skin diseases, and I’m passionate about assisting patients to live the life they deserve and improving the psychological impact of skin disease on patients.
Adult female acne affects more and more women over 25, currently worldwide thought to be around 20% of the female population. Some will have had acne when they were younger, and it will recur. Some will experience it for the first time in their adulthood. Causes can be hormonal changes, genetic elements, dietary habits, stress, smoking, certain medications, and, of course, skincare. It often results in a lack of self-confidence and social anxiety, as well as depression.
This type of acne typically affects the lower part of the face and can either be inflammatory in nature (think big, inflamed cysts) or it can be a combination of blackheads and smaller cysts. Sadly, this condition is chronic, meaning it will often clear and recur shortly after, which means that it is best managed with maintenance treatment.
Unfortunately, the GP adult acne treatment guidelines are geared towards treating adolescent acne, often involving lengthy courses of antibiotics. Adult female acne will not respond to these (or will respond and shortly recur). Let us not forget that there is a hormonal element there rather than an infective cause!
This is very different from adolescent acne. Often, I see these patients return with acne when they have even had courses of isotretinoin, feeling even more deflated and stressed, adding to the vicious circle of the condition. In terms of oral treatment, the best results will be achieved with hormonal regulation (best discussed with your doctor), and these are often of a slow response.
Topical treatment is of great value in cases of adult female acne and should be continued long term. It must be started as early as possible to reduce the risk of scarring and hyperpigmentation. Ingredients like salicylic acid, lactic acid, retinols, niacinamide, and azelaic acid are the best suited in these cases as they can reduce the number of dead keratinocytes that can clog your pores, brighten the skin tone, and reduce the inflammation. All these ingredients have lots of evidence backing their use for acne. Formulations that pack lots of them are likely to help multiple facets of the problem.
A good cleansing routine will also help reduce an infection of the follicles. For cleansing adult female skin, look a bit further than teen formulas! The needs are very different. For skin that also has concerns beyond acne, like the adult female skin, consider products like Medik8 Surface Radiance Cleanse or my favourite Priori Active Cleanser Q SOD!
It goes without saying that using daily SPF will help clear the post-inflammatory hyperpigmentation that can last longer than a spot would; however, always make sure all your skincare is non-comedogenic or oil-free, including your sunscreen.
Lastly, there is a theory that emotions (fear, anxiety, sadness, etc) can affect your gut health, the brain-gut-skin theory. In cases where we cannot see other signs of hormonal dysregulation (ie, no hair loss, or oily skin, or excessive body hair growth), it is worth considering a gut issue. This can be corrected with a good quality probiotic like Neutrient Probiotic Capsules.
In conclusion, adult female acne is a complex dermatological condition that goes far beyond surface appearance. Its causes are multifactorial, its presentation is chronic, and its impact on psychological health is often underestimated. Successful adult acne treatment requires a thoughtful, holistic approach that includes hormonal regulation, appropriate topical therapy, psychological support, and lifestyle considerations.
As healthcare professionals, we must continue to advocate for evidence-based solutions, patient education, and the development of formulations that truly meet the needs of adult female skin.
