Acne vulgaris, commonly known as acne, is a skin disease that commonly affects the face of adolescents. The pathogenesis of acne is mainly due to increased sebum secretion and the narrowing of the ducts that discharge sebum at the skin openings, resulting in blockage of sebum discharge and the action of various types of bacteria caused by this foundation. Most acne in adolescents is related to increased sebum secretion at that age and is endogenous, while acne in middle-aged women is mostly exogenous acne. Acne in middle-aged women is related to the frequent use of various cosmetics and cleansers such as face wash and soap, so it is also called “cosmetic acne”. In addition, strong ultraviolet radiation also causes hyperkeratosis at the openings of the sebaceous glands, which is especially likely to occur after external cosmetic use, and generally recovers gradually after six months. There may be other causes of acne in middle-aged women, including exposure to diesel, leachate and various petroleum products at work; the use of estrogenic agents to prevent the recurrence of lesions after breast cancer surgery; endocrine disorders; and the systematic or local use of corticosteroid preparations and other medications that can cause acne. Therefore, middle-aged women with acne should go to the hospital in a timely manner, and most of them can be cured with symptomatic treatment after clarifying the causes.