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    Female acne

    On this page
    1. What causes acne in older females?
    2. Periods 
    3. Pregnancy
    4. The menopause
    5. Does polycystic ovary syndrome cause acne?
    6. Treating female acne
    7. What can pregnant women use for acne?
    8. What can menopausal women use for acne?
    9. Prescription acne treatment from Online Doctor

    Reviewed by our clinical team

    Lady with acne

    Most people experience acne at some point in their life. During puberty, it’s normal to develop oily skin and experience breakouts of spots. However, for some of us, these symptoms continue into adulthood, or even get worse with age – it’s thought that about 3% of adults have acne past the age of 35.

    Although adult acne affects both sexes, it’s more common in women than in men. This is probably because women are more prone to changes in hormone levels. If you’re a woman living with acne, read on to find out more about what might be triggering your symptoms, and how to get treatment.

    What causes acne in older females?

    Acne is caused by lots of different things, including genetic factors. However, during our teen years, acne is thought to be triggered by an increase in testosterone levels, which occurs in both boys and girls.

    The sebaceous glands in the skin are particularly sensitive to changing hormone levels, and can react by producing too much sebum, the oily substance that lubricates the skin. A build-up of this sebum in the follicles is what leads to spots.

    In older women, acne breakouts are thought to be caused by the same problem – fluctuations in hormones which cause the sebaceous glands to produce too much sebum.


    Spots can be a sign that your period is on its way – along with other PMS symptoms like bloating and breast tenderness. If you’re a woman who is prone to acne, you might find that your symptoms get worse around the time of your period, before calming down later in your cycle.


    It’s not uncommon for women to experience acne symptoms for the first time when they’re pregnant – usually within the first three months. On the flipside, some women’s acne can actually improve during pregnancy.

    The menopause

    During the menopause, levels of female hormones drop. In some women, this change can lead to acne. 

    Does polycystic ovary syndrome cause acne?

    Yes, polycystic ovary syndrome (or PCOS) can cause acne. 

    PCOS is a condition that affects how a woman’s ovaries work. It’s related to abnormal hormone levels – in particular, high levels of insulin which also contributes to the production and activity of hormones, like testosterone.

    One of the common symptoms of PCOS is oily skin and acne. Others include irregular periods, excessive hair growth on the face and body, and weight gain.

    Treating female acne

    How you treat your acne will depend on your age, your medical history and the severity of your acne. However, there are some general rules for getting treatment.

    If your acne is mild, start by visiting your local pharmacy and consulting your pharmacist for advice. There are plenty of treatments available that don’t require a prescription, including those that contain benzoyl peroxide.

    If pharmacy treatments don’t work, or if your acne is moderate to severe, you should visit your GP. They can prescribe things like topical retinoids and antibiotic tablets, as well as the combined contraceptive pill. A benefit of using the combined pill for your acne is that it can also be used as ongoing contraception.

    For very severe acne, you might need to be referred to a specialist. Treatments for severe female acne include isotretinoin (Roaccutane) and co-cyprindiol, which can be used as contraception.

    What can pregnant women use for acne?

    If you’re pregnant you’ll need to be a bit more careful about what treatments you use for your acne. For instance, pregnant and breastfeeding women have to use a different type of antibiotic tablet to other people. 

    Unfortunately, isotretinoin and co-cyprindiol are both unsafe for pregnant women. In fact, the NHS advises that women taking isotretinoin use contraception to avoid pregnancy during treatment and for one month after treatment has finished, as it can harm an unborn baby and increase the risk of miscarriage. 

    If you become pregnant while using either of these treatments, you should stop taking your medication straight away and speak to your prescribing doctor.

    What can menopausal women use for acne?

    For older women, a complication of acne treatment is that many standard options may be too harsh for menopausal skin, which tends to be thinner and drier. 

    If you have particularly dry and sensitive skin after going through the menopause, there are some good options for treatment, including salicylic acid and azelaic acid, both of which are less harsh on the skin that other topical treatments.

    Prescription acne treatment from Online Doctor

    To learn more about prescription acne treatments, visit our online acne service and browse available products. We stock a range of treatments suited to women including co-cyprindiol.


    Authors & editors

    • Reviewed and updated by

      Dr Sameer Sanghvi
      GMC number: 7085078
      Date published: 5th November 2021

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