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Feature Article

Postadolescent acne in women

Jo-Ann See

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An updated version is available in the linked supplement

Abstract

Women with postadolescent acne are a relatively common presentation in general practice. Assessment should include identifying hyperandrogenism and possible underlying causes. Hormonal agents are effective treatments and may be combined with topical acne therapies and/or oral antibiotics.

Key Points

  • Female postadolescent acne may continue past the teenage years or develop at or after the age of 20 years.
  • Affected women may have normal or raised serum androgen levels.
  • Polycystic ovary syndrome may be an underlying cause of female postadolescent acne.
  • Assessment should include a menstrual history and examination for clinical signs of hyperandrogenism, such as hirsutism.
  • Hormonal therapy (usually the combined oral contraceptive pill) is an effective adjunct in the management of these patients, including those with normal serum androgen profiles. Other antiandrogens, such as spironolactone or cyproterone acetate, may need to be taken in addition to the pill.

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