Acne tarda L70.9

Acne beyond the age of 25.

w>m; in most cases, acne has been present since adolescence and persists into adulthood. In some patients, this form of acne occurs without preceding pubertal acne. Special forms are acne during pregnancy or after discontinuation of contraceptives (postcontraceptive acne) as well as peri- and postmenopausal acne.

Emphasis on the edges of the lower jaw and the chin, less intense on the lower cheek and the perioral region. Inflammatory papules and pustules with closed and open comedones are found in seborrhoeic skin. Deep-seated nodules are more rarely found. Traces of manipulation are frequently found. Mostly a worsening of the symptoms is indicated in case of menstration. Mixed pictures with rosacea and perioral dermatitis may exist.

e.g. low-dose isotretinoin therapy; locally azelaic acid is suitable.

see also under acne

In women with acne tarda, an evaluation for hormonal disorders—particularly hyperandrogenism and polycystic ovary syndrome (PCOS)—should be conducted. In particular, attention should be paid to menstrual irregularities, hirsutism, signs of androgenetic alopecia, and other signs of virilization. Initial hormonal testing can be performed by a dermatologist; if abnormal findings are detected, further evaluation by a gynecologist or endocrinologist is indicated.

Insulin resistance: A link between acne tarda and insulin resistance, as well as changes in the insulin/IGF-1 signaling pathway, is under discussion. However, routine measurement of insulin or HOMA-IR based solely on the presence of acne tarda is not currently established. In cases of PCOS, glucose metabolism should also be evaluated.

1. Augustin M et al. (2026) Acne tarda: Recommendations on classification, treatment, and care based on an expert discussion. J Dtsch Dermatol Ges 24:11–23. doi: 10.1111/ddg.15913_g.
2. German Dermatological Society (DDG): S2k Guideline “Treatment of Acne.” AWMF registration number 013-017, Version 3.0, as of August 1, 2026.
3. German Society for Endocrinology (DGE): S2k Guideline “Diagnosis and Treatment of Polycystic Ovary Syndrome (PCOS).” AWMF registration number 089-004, Version 1.1, as of August 13, 2024.
4. Telkkälä A et al. (2025) Etiology of Adult Female Acne—Systematic Review. Health Sci Rep 8. doi: 10.1002/hsr2.70697.