We tend to think that dealing with acne is simply a rite of passage for teenagers, but in fact, acne can continue on well into adulthood. Those with the condition may want to know what causes adult acne and how they can help improve their complexions.

Who's Affected and the Role of Genetics

Adult acne can occur in both men and women, although it is reportedly more common in women. The American Association of Dermatology estimates that acne affects up to 85 percent of people aged 12-24 and that adult acne is on the rise, affecting up to 15 percent of women.

It's impossible to know for sure if your teenage acne will still be present as an adult, or if you will get acne as an adult when you didn't have it as a teen. But doctors can make some educated guesses based on your genetics. In general, if your immediate family has a history of acne, you are more likely to get it. The severity of your acne is often similar to what your siblings or parents had.

What Causes Adult Acne?

All acne, whether teenage or adult, starts with certain male hormones. Both men and women have these hormones in their bodies naturally, although in different amounts. Small (but not abnormal) variations in these hormonal levels can cause your skin's oil-producing glands to secrete more oil into the pores of your skin. The face is especially acne-prone, as this is where oil glands are most abundant.

These oils can then become trapped, clogging pores and making your face more oily. Each clogged pore creates a low-oxygen environment in which the common skin bacteria C. Acnes thrives, creating inflammatory by-products from the trapped oil. Your body's immune system senses this and mounts an immune response to the irritation in the clogged pores. The more intense the immune response you have around a clogged pore, the redder and more raised it gets. This response can take a few different forms. For example, a severe immune response around a pore results in what is called cystic acne (an uncommon form of acne that can leave scarring), while the most minimal response makes comedones, which appear as whiteheads or blackheads.

Adult acne in females is often cyclical. When women ovulate prior to their periods, the body releases a surge of a male hormone called progesterone that can kick off the acne cycle. This is why adult women often break out a week or two before their menstrual cycle. Women who don't have regular menstrual cycles can also have more acne, as can women who use intrauterine devices with added male-type hormones or birth control pills with a higher ratio of male to female hormones. That said, some birth control pills with a higher female-to-male hormone ratio might help control acne. The prescribing doctor can advise you on alternative options.

Treatment for Adult Acne

Adult acne can be uncomfortable and damaging to your self-confidence, so it's understandable that you'd want to treat it however possible. Here are a few proven tips to manage the problem.

First, make sure you wash your face at least twice a day, and more if you are exercising. Get the sweat, dirt, lotions, and makeup off your face so it doesn't contribute to clogging up your pores. You don't need to use a specialized acne soap or cleanser—any gentle soap or cleanser will do. Don't pop or pick at your acne, as that will cause further inflammation and prolong healing.

Next, don't spot treat large blemishes with the so-called "spot treaters" you can buy over the counter, as these can actually inflame and further irritate acne spots when used on a swollen red bump. Such products usually contain benzoyl peroxide or salicylic acid, which serve best to prevent future acne. The more effective way to use them is actually to apply them all over your face, both where you have acne and where you don't. When you think about it, you are always just a bit too late if you're spot treating, whereas using medicine all over may stop the acne from occurring in the first place.

You may have read about alternative methods to fight adult acne such as drinking more water or changing your diet, but there is little conclusive evidence to back up these practices.

Finally, be sure to protect yourself from the sun. Contrary to another popular myth, sun exposure does not help make your acne better. In fact, ultraviolet rays from the sun damage unprotected skin in the long run. Experts will recommend the daily use of an oil-free broad-spectrum sunscreen with an SPF of at least 30.

When to Seek Expert Help

If you are still having breakouts despite washing frequently and using over-the-counter medications, it's time for a visit to a board-certified Dermatologist. They know the right questions to ask and can tailor a prescription treatment regimen just for you, including, if appropriate, a hormonally based treatment. As a matter of general health, you should continue seeing your Dermatologist for yearly check-ups.

You don't need to live with your adult acne or struggle to spot treat every breakout. With simple skin care practices and a Dermatologist on your side, you can address the root causes of adult acne and keep it from occurring altogether.


  • Lawrence J Green, MD

    Dr. Lawrence Green is an award-winning Dermatologist and clinical professor of dermatology at George Washington University School of Medicine. Based in Rockville, MD, he is the author of over 50 publications in peer-reviewed journals and a member of the Board of Directors of the American Academy of Dermatology.

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