Abstract

Adult female acne (AFA) is characterized by a relapsing eruption of acne in women aged ≥ 25 years. It can be slower to respond to traditional adolescent acne treatments. Usually, androgens promote acne by stimulating sebum production, while oestrogens have the -opposite effect by reducing sebum output when present in adequate quantities. Oestradiol is a female sex hormone that has its highest absolute serum levels and highest oestrogenic activity during the reproductive years. Peel-off facial masks have been suggested to intensify the effect of added active ingredients by forming an occlusive film after drying. To study the safety and efficacy of weekly topical oestradiol 0.05% in the treatment of AFA. Twenty women with AFA were subjected to once-weekly application of an oestradiol 0.05% mask or placebo mask to either side of their face for 8 weeks. An acne lesion count was performed at baseline, at each visit and 8 weeks post-treatment. At the end of the treatment period, the treated side showed significant improvement in comedones, papules and pustules. Although lesion counts increased 2 months post-treatment, they remained significantly less common on the oestradiol-treated side compared with the side of the face treated with placebo. No side-effects were reported. Limitations included the small number of patients studied and the short follow-up period. The oestradiol effect was not studied at the cellular or molecular levels. Topical oestradiol peel-off masks may be a promising convenient, safe and effective treatment for AFA.

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