You may have adult acne if you have a genetic predisposition, changing hormone levels, certain bacteria, or irritation from skin or hair products. Treatment typically depends on the cause.
Adult 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 appear all at once, in cycles.
Here’s everything you need to know about adult acne and how to treat it.
“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.
Some people have a genetic predisposition for 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
- differences in circulation
- excessive production of oil (sebum)
These changes often play a part in the development of adult acne.
Remember that fluctuations in your hormones don’t necessarily translate to imbalanced or irregular hormone levels, according to Schaffran. Rather, your skin might 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.
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 on hair and skin can potentially trigger acne breakouts.
- shampoo and conditioner
- styling products
- leave-in conditioners
- face creams and moisturizers
“Usually, this is only with oily or highly comedogenic products,” Schaffran notes.
Physical strain on your body can also trigger hormonal changes, weakened immunity, and inflammation — any of which can worsen acne.
Potential causes include:
People who smoke are also more likely to have adult acne.
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 a result.
Bacteria called Propionibacterium acnes can cause acne when present in the skin, especially when the bacteria buildup.
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. It requires treatment with an oral antibiotic.
Many people believe that excessive white flour products, sweets, chocolate, dairy, and fast food may contribute to adult acne. That said, experts
“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.
Still, you may notice a pattern of acne after eating certain foods, so a dermatologist might recommend keeping a food diary to identify potential triggers.
- certain corticosteroids
- epilepsy medications
Although many people use hormonal birth control pills to help treat adult acne, specific formulations may also cause it. A healthcare professional can offer guidance on choosing a hormonal contraceptive that meets your needs.
Undiagnosed medical conditions
Some health and skin conditions can resemble acne or lead to acne breakouts.
- keratosis pilaris
- perioral dermatitis
- Cushing syndrome
- polycystic ovary syndrome (PCOS)
If you suspect an underlying medical condition could be triggering your acne, it’s best to contact 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. Results can vary from person to person, 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 determine whether a prescription might work better.
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 that warm compresses can be somewhat effective for deep cystic acne.
OTC and prescription-strength medications that treat adult acne include:
- hydroxy acids and other beneficial acids
- oral birth control pills
- antibiotics, including sarecycline (Seysara)
- retinol, or its prescription form, retin-A
- salicylic acid or benzoyl peroxide
- blue light therapy
- clascoterone (Winlevi), a topical cream designed to act on the hormones in your skin to help prevent breakouts
- oral isotretinoin
Some people with adult acne may experience breakouts on other parts of the body. Common locations can include:
- upper arms
Treating acne on other areas of the body can depend on the severity and how deep the acne is. You may be able to treat mild to moderate body acne with at-home treatment, such as cleansers and topical products. But for severe acne, you may need treatment options prescribed by a dermatologist.
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:
- your menstrual cycle
- stopping hormonal birth control, or changing your brand or type of pill
- high testosterone levels
- pregnancy and childbirth
You can ask a healthcare professional about possible tests and age-specific recommendations for hormonal 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 can make a difference in getting relief from adult acne.
While some triggers are hard to avoid, you have plenty of options for treatment.
But some treatments from your teenage years may have less effect now that you’ve reached adulthood. Switching to acne treatments designed for adult skin could make a big difference.
“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.”
Why do I still have acne in my 20s, 30s, or 40s?
You may experience adult acne due to a genetic predisposition, changing hormone levels, certain bacteria, or irritation from skin or hair products. Treating adult acne can depend on the cause.
What’s the best way to treat adult acne?
Dermatologists are often able to recommend treatment options to reduce or clear adult acne. The specific treatment can depend on the cause. Treatments can include oral medications such as antibiotics or birth control pills, topical treatments, and skin procedures like blue light therapy.
How do I know if my acne is bacterial or hormonal?
A dermatologist can conduct tests to determine the cause of your acne and recommend an effective treatment.
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.