Glow Tech in Adult Female Acne: Preliminary Real‐World Experience

Adult female acne (AFA) represents a global health challenge with distinct clinical features, often requiring a multifaceted management strategy due to its recalcitrant nature and significant psychosocial burden [1, 2]. In a real-life clinical practice setting at a specialized center in Brazil, it has been observed that the integration of systemic therapy with sequential in-office procedures may offer a pragmatic pathway for treatment. This preliminary observational case series of seven Brazilian women (ages 18–45, Fitzpatrick skin types II–IV) is reported to share clinical observations derived from a combined approach referred to as the “Glow Tech” sequence. This work should be interpreted as a retrospective, exploratory case series reflecting real-world clinical experience rather than confirmatory evidence. Eligible patients were women aged 18–45 years, with no spironolactone use or esthetic procedures in the preceding 6 months, and willing to discontinue concurrent acne treatments. The study was conducted in accordance with the Declaration of Helsinki, and all patients provided informed consent for the anonymized use of their data and photographs. These observations primarily reflect hormonally influenced AFA phenotypes and should not be generalized to all clinical variants of adult female acne. All patients presented with mild-to-moderate inflammatory acne, predominantly in the mandibular region (U-zone). Underlying conditions, including Polycystic Ovary Syndrome (PCOS) or endometriosis, were confirmed in all subjects via hormonal evaluation and pelvic/transvaginal ultrasound. PCOS was diagnosed according to the Rotterdam criteria, with all affected patients fulfilling at least two of the following: hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology [1]. These patients had previously reported suboptimal results or low adherence to conventional topical monotherapies, reflecting the complexity of AFA in daily practice. The “Glow Tech” sequence represents an institutional multimodal clinical approach currently under exploratory evaluation. This series represents a subset of AFA patients with clear hormonal influence, and therefore the observations cannot be generalized to the entire spectrum of adult female acne. In-office procedure (monthly sessions × 4): A sequential procedure performed in a single visit following this strict sequence: Efficacy was assessed via standardized photographs evaluated by three independent board-certified dermatologists using the Investigator's Global Assessment (IGA) and the Adult Female Acne Scoring Tool (AFAST). Statistical analysis was performed using Python (SciPy library). Statistical outputs are presented purely as descriptive indicators rather than inferential evidence. Quantitative analysis showed a reduction in acne severity: the mean baseline IGA score of 2.38 ± 0.52 reduced to 0.95 ± 0.59, while the AFAST scale decreased from 1.38 ± 0.36 to 0.48 ± 0.18 (Figure 1). It must be emphasized that these findings are purely illustrative given the small sample size (n = 7), serving to document the clinical trajectory of these specific cases (Figure 2) rather than establishing a statistically powered conclusion. Patient satisfaction, recorded through a non-validated 5-point Likert scale, averaged 4.8. While the use of a non-validated tool is a limitation, it provides a qualitative glimpse into patient perception. A 6-month follow-up demonstrated maintenance of clinical improvement in all patients. The rationale behind this sequence lies in the complementary mechanisms of the agents involved, as combined therapies often show superior efficacy compared to monotherapy [6]. While spironolactone addresses the systemic androgenetic trigger, the carbon peel with 1064 nm Nd:YAG provides a keratolytic effect and reduction of C. acnes load [3]. The subsequent application of PDRN—an A2A receptor agonist—may contribute to a more favorable inflammatory environment, potentially improving tolerance to the retinoic acid mask [4, 5]. Regarding safety, expected adverse effects were observed across the entire cohort. Erythema and scaling occurred in 100% of patients during the first post-procedure week, often accompanied by transient skin sensitivity. These manifestations were expected, self-limiting, and effectively managed with the prescribed hydration and strict photoprotection regimen. No severe adverse events or long-term complications were recorded, suggesting the protocol is well-tolerated within a real-world clinical setting. The primary goal of this report is to exemplify a treatment possibility for AFA rather than to establish a new standardized method. Significant limitations, including the small cohort and lack of a control group, preclude definitive conclusions. However, these preliminary observations may contribute to the clinical discussion on optimizing outcomes for adult women. Further large-scale, randomized trials are essential to validate these initial clinical impressions. Rather than proposing a definitive therapeutic protocol, the “Glow Tech” sequence aims to stimulate clinical discussion regarding pragmatic, multimodal strategies in daily dermatologic practice. The author has nothing to report. The author declares no conflicts of interest. The data that support the findings of this study are available from the corresponding author upon reasonable request.