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Acne, an inflammatory skin condition, is the eighth most common skin disease worldwide.

Though it most often occurs during puberty, it affects adults as well. In fact, the number of people who get adult acne has gone up over the past 2 decades.

Adult acne appears to affect women more often: In a 2018 study involving 454 adults with acne, 85 percent of the adults were female.

Acne can be mild, moderate, or severe:

  • Mild adult acne may consist of blackheads, whiteheads, or small pustules.
  • Moderate adult acne might also include papules, which cover between one-quarter and three-quarters of the face or body.
  • Severe adult acne often involves extreme redness or other discoloration, swelling, irritation, and deep cysts.

Adult acne vs. rosacea

You might notice another condition, rosacea, referred to as “adult acne.” But rosacea differs from classic acne in a few key ways.

With rosacea, the bumps are usually smaller, and they appear all at once, in cycles.

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Here’s everything you need to know about adult acne and how to treat it.

“Acne is an issue where the skin and pores are not functioning properly,” explains Dr. Robin Schaffran, chief dermatologist and co-founder of BalmLabs, a skin care line designed for adult acne.

“Oil is being overproduced by the sebaceous glands and the pores aren’t effective in eliminating the oil. This causes the pores to clog, which ultimately leads to blackheads, whiteheads, and ‘pimples,'” Schaffran says.

A few different factors can play a part in this skin concern.

Family history

Some people are simply genetically predisposed to have acne.

“Usually, when someone presents with acne, someone in the family has also experienced breakouts, either as a teen or adult,” Schaffran says.

This person doesn’t have to be your parent or sibling, either. It might be a more distant relative, such as an uncle, aunt, or cousin.

Changing hormone levels

Fluctuating or excessive sex hormones can lead to changes throughout your body and skin, including:

  • pH imbalance
  • inflammation
  • differences in circulation
  • excessive production of oil (sebum)

These changes often play a part in the development of adult acne.

Keep in mind that fluctuations in your hormones doesn’t necessarily translate to imbalanced or irregular hormone levels, according to Schaffran. Rather, your skin might simply respond to the typical hormonal fluctuations that characterize periods, like puberty or perimenopause.

Hormonal acne usually appears as deep and cyst-like, and it’s often tender or painful.

“If you suspect you might have some hormonal abnormality, like abnormal menses or excess hair growth, it can be helpful to have a dermatologist evaluate further and treat accordingly,” Schaffran notes.

Contact irritation

Anything that irritates your skin, from harsh cleansers to razors on dry skin, can lower your skin’s defenses and cause a protective reaction that leads to inflammation.

Hair and skin products

Oil-based products designed for use in your hair and on your skin have the potential to trigger acne breakouts.

Examples include:

  • shampoo and conditioner
  • styling products
  • leave-in conditioners
  • makeup
  • face creams and moisturizers

“Usually, this is only with oily or highly comedogenic products,” Schaffran notes.

Emotional stress

Stress can create biological changes in the body that can prompt many of the other triggers of adult acne.

When you feel scared, anxious, or pressured, for example, your adrenal glands make more of the stress hormone cortisol. This can lead to increased sebum production, which can make acne worse.

Physical stress

Physical strain on your body can also trigger hormonal changes, weakened immunity, and inflammation — any of which can lead to acne.

Potential causes include:

People who have allergies and migraines, along with those who smoke, are also more likely to have adult acne.

Clogged pores

Excess oil can clog pores, and a rapid turnover of skin cells can lead to backed-up hair follicles. In both cases, you’ll usually experience acne as an end result.

Bacteria

Bacteria called Propionibacterium acnes can cause acne when present in the skin, especially when the bacteria build up.

The bacteria accumulate under the skin and can’t always be reached through surface cleansing. In other words, you can’t remove it simply by washing your face.

Foods

Many people believe that excessive white flour products, sweets, chocolate, dairy, and fast food may contribute to adult acne. That said, experts haven’t come to any conclusions on whether specific foods can cause breakouts.

“There is no good science that has demonstrated that eating sugar leads to acne breakouts, despite many studies looking at this issue. In my practice, I can show you many patients who eat clean diets and still experience terrible acne, along with many patients who eat nothing but junk food and have acne-free skin,” Schaffran says.

The role of sugar in acne is much more complicated than simply eliminating sugar, or any other particular food, from the diet to reduce breakouts, Schaffran goes on to explain.

That said, you could certainly notice a pattern of acne after eating certain foods, so a dermatologist might recommend keeping a food diary to identify potential triggers.

Medications

Some medications have been linked to adult acne breakouts, including certain corticosteroids, antidepressants, and epilepsy medications.

Although many people use hormonal birth control pills to help treat adult acne, certain formulations may also cause it. A healthcare professional can offer more guidance on choosing a hormonal contraceptive that meets all of your needs.

Undiagnosed medical conditions

A number of health conditions and skin conditions can resemble acne or lead to acne breakouts.

Examples include:

If you suspect an underlying medical condition could be triggering your acne, it’s best to reach out to a healthcare professional for more guidance.

“Working with a dermatologist is a good idea whenever acne has become unmanageable and creates emotional distress, or when over-the-counter products aren’t helping,” Schaffran says. “A good dermatologist can evaluate what type of skin you have and what type of acne you have, and put you on a skin care regimen tailored to your specific needs.”

Potential treatments for adult acne include home remedies, over-the-counter (OTC) products, and prescriptions. Treatment results can vary from one person to the next, and not all types of acne treatment will work for everyone.

Sometimes, OTC remedies might work quickly — but if they don’t provide the results you want after a week or two, it’s generally best to get professional support.

A dermatologist or other healthcare professional can help you determine whether a prescription might work better.

Home remedies

Home remedies for adult acne include oral supplements and topical treatments you apply directly to your skin.

Some examples include:

Schaffran says many home remedies aren’t particularly helpful, especially for extensive or deep acne.

“Some home remedies, such as apple cider vinegar, toothpaste, and lemon juice, can actually damage the skin barrier, leading to further irritation and rashes,” Schaffran explains.

She does note, though, that warm compresses can be somewhat effective for deep cystic acne.

Medical treatment

Several OTC and prescription-strength medications can treat adult acne.

These treatments include:

Hormonal changes can continue throughout your 20s and 30s as your body adjusts to adulthood.

Changing hormone levels that contribute to adult acne can also happen as a result of:

To treat hormonal causes of adult acne, ask a healthcare professional about possible tests and age-specific recommendations.

Even if you have acne well into adulthood, that doesn’t mean you’re bound to experience it for the rest of your life. While some triggers are hard to avoid, you have plenty of options for treatment.

Just know those tried-and-true treatments that worked in your teenage years may have less effect now that you’ve reached adulthood.

“Adult skin is often more sensitive and prone to dryness and irritation,” Schaffran explains. “So harsh ingredients commonly used in traditional acne-fighting topicals, such as salicylic acid or benzoyl peroxide, are often not tolerated well in adult skin.”

In other words, switching to acne treatments designed for adult skin could make a big difference.

Preventing adult acne

There’s a process to effectively treating and preventing adult acne:

  • Be diligent about your skin care routine. “The best tip for treating current breakouts and preventing future ones is to get yourself into a regular skin care routine using topical ingredients appropriate for your skin type,” says Schaffran.
  • Moisturize properly. Schaffran says many people prone to acne tend to skip the moisturizing step, since they’ve been conditioned to believe that drying out breakouts is the only way to treat them. “In fact, excessive dryness can actually exacerbate acne and propel a continuous breakout cycle.”
  • Be patient. Change won’t happen overnight. “Too many people give up too early and don’t give the solution time to effectively work and generate results,” Schaffran notes. “Far too often, people get frustrated and switch from product to product, but I promise you… consistency and a little patience are key to any acne treatment regimen.”
  • Take care of your physical health. Steps like minimizing stress, eating a balanced diet, drinking enough water, exercising regularly, and getting plenty of sleep might not seem like they have direct impact on your skin. But they really can make a difference when it comes to getting relief from adult acne.

Maybe you never expected to still have acne, long after leaving your teenage years in the dust. But you’re not alone — and you have plenty of options for treatment.

If OTC products don’t do much to improve your breakouts, a dermatologist can offer more guidance on a skin care routine and treatment approach that fits your unique skin needs.