All about adult acne, why we get it, and how to treat it

You might think acne is something you can stop worrying about after your teens, but some adults continue to suffer from pimple breakouts well into their 40s or 50s. In fact, around 15% of adult women suffer from acne, according to the American Academy of Dermatology. “Adult acne” is medically classified as acne that occurs after 25. But what causes it, and how can it be treated? Find out everything you need to know about adult onset acne now.

Common causes of adult acne

Just like during your teens, acne in adulthood has four primary causes. These are:

• Excess oil production
• Clogged pores
• Bacteria
• Inflammation

Whatever else is going on under your skin, it’s these four factors that cause pimples. For some sufferers, dealing with adult acne is as simple as getting the direct causes of acne under control. That could mean changing your skincare products or washing your face more frequently is all you need to stop a breakout in its tracks.

Excess oil production and acne

Oily skin and acne tend to go hand in hand. Skin oil, known as sebum, comes from sebaceous glands located inside our hair follicles. This oil is vital for keeping our skin healthy and protected from harsh elements. However if oil production gets out of control, it leads to blocked pores and ultimately, acne. There’s no one cure for oily skin, because it tends to be caused by a variety of environmental factors. However using gentle products designed to control skin oils, and remembering to moisturize regularly, can help keep sebum production in check.

Clogged pores and acne

Clogged pores are a common result of excess skin oil production, but they could also come from your skincare products. Some ingredients are comedogenic, which means they can block pores. The word “comedogenic” literally means “pimple-causing.” Common comedogenic ingredients include:

• Coconut, avocado, and other oils
• Alcohols
• Lanolin and its derivatives
• Cocoa and coconut butter
• Lauric and Stearic fatty acids
• Sodium Lauryl Sulfate and Sodium Laureth Sulfate

Don’t overlook your hair styling products either, especially if they use a spray applicator. It’s very common for hairspray, oils, waxes, and more to end up on your face, where they quickly cause pimples.

Bacteria and acne

Some pimples are caused by a bacteria called Propionibacterium acnes (P. acnes). This bacteria lives naturally on your skin that usually doesn’t cause any harm. However if it finds itself in a low-oxygen environment, such as inside a pore, it starts a chemical reaction that breaks down sebum into fatty acids that trigger inflammation in surrounding cells. Even worse, the fatty acids also neutralize enzymes that skin cells usually use to counter inflammation, meaning once a breakout starts, it’s hard to stop.

Scientists are still figuring out why only some adults experience acne caused by P. acnes, when we all have the bacteria on our skin. It’s likely variable conditions inside our hair follicles, a genetic predisposition to inflammation caused by bacteria, or different strains of P. acnes all play a role. One thing we can do to combat acne from bacteria is to balance the amount of skin oil we produce, which gives P. acnes less sebum to affect.

Inflammation and acne

Systemic inflammation may be at the root cause of many acne breakouts. Inflammation could trigger changes in sebum that result in oxidation, reducing surrounding oxygen levels and providing an ideal habitat for P. acnes to flourish. Studies on the Role of Inflammation in the Pathology of Acne demonstrate that inflammation exists at all stages of acne development, suggesting that acne itself is an inflammatory condition. This opens the door to new acne treatments using anti-inflammatory drugs to control the underlying cause and prevent breakouts altogether.

Indirect factors that contribute to adult acne

While the above four causes of acne are the physical factors that trigger a breakout, there are underlying elements that can aggravate or trigger inflammation, sebum production, and more.

Hormones and acne

Adolescent acne is triggered by the dramatic hormone fluctuations teens experience. As adults our hormones are generally more stable, but they can still cause breakouts, especially in women. Different stages of menstruation, pregnancy, breastfeeding, and menopause can all trigger episodes of adult acne. Hormonal acne is most common on the lower face around the chin and jawline. The good news is this kind of acne can be treated with medication called spironolactone, or with oral birth control.

Medical conditions and acne

Endocrine disorders such as polycystic ovary syndrome (PCOS) can cause acne well into adulthood. At their root these are hormonal disorders, and cause acne with many similarities to other hormone-based breakouts, such as an increased likelihood of acne around the lower face. As with hormone-related conditions, most endocrine disorders can be controlled through medication, reducing the severity of acne symptoms.

If you suspect a medical condition is the cause of your adult onset acne, it’s worth getting checked out. Most conditions can be diagnosed quickly with a simple blood test, and you can start getting the treatment you need to address all symptoms, not just the most visible ones.

Stress and acne

It’s not just a myth that stress causes acne. Researchers have documented changes in the severity of acne during times of increased stress. When we’re stressed, our bodies produce more androgens. Androgens are a type of male sex hormone, and they help us to respond to fight/flight situations. Stress triggers the production of androgens, which have a stimulating effect on sebaceous glands, triggering increased skin oil production. This in turn leads to acne.

Diet and acne

An increasing body of evidence suggests that your diet can affect your skin, and actually cause acne breakouts. A variety of factors influence the exact relationship our diets have with our bodies, but studies on diet and acne show a link between high-GI or dairy-rich diets and adult acne.

Medications and acne

Acne can be a side effect of many common medications, including corticosteroids, anabolic steroids, and lithium. Often the acne clears up once the medication is discontinued. If you have to remain on the medication then acne breakouts can be treated with antibiotics, antifungals, or topical products.

Genetics and acne

Some people are simply more prone to acne than others, especially if other members of their family have adult acne. Although the genetic component of acne isn’t fully understood, studies on the genetic and environmental factors affecting acne in adult twins found that genetics accounted for 81% of breakouts, with only 19% attributed to environmental factors.

How to avoid or treat adult acne breakouts

Whatever the cause of your adult acne, you can take a few simple steps to reduce pimple breakouts, and minimize them when they do occur.

Practice good skincare habits

While adult acne has many contributing causes, looking after your skin is an important first step in preventing breakouts. Wash your face twice a day, and never sleep in makeup. Use gentle cleansers and don’t scrub your skin — scrubbing or stripping away skin oils with harsh products only triggers the production of more sebum, making problem skin even more problematic.
Use the right skincare products

Some ingredients are more effective at managing acne than others. Salicylic acid, a beta hydroxy acid derived from willow bark, is very effective at minimizing acne breakouts. It works by penetrating deep into the skin where it can unclog pores and increase skin cell turnover, leading to a fresher, clearer complexion.

Retinol, a derivative of Vitamin A, also has powerful anti-acne properties. More commonly known as an antiaging ingredient, retinol can help reduce acne breakouts and minimize the appearance of acne scars. However retinol can be more irritating to sensitive skin than salicylic acid.

Use noncomedogenic products

Just as there are certain skincare ingredients that can block your pores, others are rated for avoiding this problem. Look for “noncomedogenic” on the label. Just keep in mind that there’s no standard rating for noncomedogenic products, so what works for one person might not work on another. Trust the results, not just the label, and pay attention to the ingredients to really understand how your skincare products affect your skin.

Consider adjusting your diet

If you’re already following good skincare and makeup practices but still suffering acne breakouts, genetic factors could be at play. Research has shown that increased dairy consumption is associated with higher instances of acne in adolescents and adults. A diet rich in high glycemic index foods such as white bread, white rice, sugars, carbs, and starches, has been shown in studies to have a “significant effect” on acne incidences.

You should always consult a physician before making any significant changes to your diet, but cutting out a few extra carbs or a little cheese is a small change you can make that might have a big difference for your skin.

Be kind to your skin

We all want flawless skin, but the truth is most of us don’t get that lucky. Whether you suffer the occasional pimple or your skin’s still partying like it’s 1999, there are ways to address adult acne and bring it under control. While you’re working on the solution that has the best effects for you, treat your skin with gentle products and try not to let adult acne stress you out.