Currently, acne has ceased to be a merely adolescent problem as it also concerns patients over 18-25 years old, especially women. According to the data of the OOO Clinic of Professor Yutskovskaya, there is a tendency towards increasing number of women who have acne eruptions at the age of 25-35 and older. Hyperandrogenic syndrome is an important etiological and initiating factor in pathogenesis of acne. The complicating factors include frequent stress, ultraviolet irradiation, malnutrition, etc. Therefore, the approaches to treatment should be adapted to the individual characteristics of an adult patient and her needs. When prescribing a drug, preferrence should be given to drugs affecting all stages of acne pathogenesis. Azelaic acid complies with all the requirements and is recommended as a first-line monotherapy for non-inflammatory and mild acne. For more severe forms of dermatosis, it is expedient to prescribe it in combination with hormonal therapy upon gynecologist's recommendation, which, in its turn, is an alternative to antibiotic therapy and the use of isotretinoin.