About acne in adult females

Adult female acne: a new paradigm.
Dréno B, Layton A, Zouboulis CC, López-Estebaranz JL, Zalewska-Janowska A, Bagatin E, Zampeli VA, Yutskovskaya Y, Harper JC.
J Eur Acad Dermatol Venereol. 2013 Sep;27(9):1063-1070. doi: 10.1111/jdv.12061. Epub 2013 Jan 10.

• Adult female acne is a problem.
• Indeed 12% of females at age 40 still have acne.
• Most have a history of mild acne during the teenage years with a beginning of bothersome lesions at 25 years old or even later.
• Lesions tend to be located on the mandibular region and the trunk is often less affected.
• Treatment is like normal acne, however difficult to treat cases need to be screened for hormonal balances and a gynecologist needs to examine the patient for other factors which could be related (such as hirsutism in Polycystic Ovary Syndrome (Stein Leventhal Syndrome).

• This review article deals with the problem from etiology to treatment.
• Treatment-wise spironolactone is the clasically described treatment when a hormonal imbalance is found, but all other treatments (topical, systemic, cosmetic) can be used. Interestingly the authors mention zinc salts which reduces inflammatory lesion count:
  • it is given at a dosage of 200mg daily without food
  • side effects include nausea and vomiting.