Acne often begins with red pimples on the cheeks, chin, or forehead and sometimes appears in multiple areas at once. Trying to get rid of it as if it were just a skin blemish, or expecting it to disappear once you grow older and pass through adolescence and its hormonal changes, is a misconception. You may be surprised to see acne spreading at an older age, distorting the appearance of your skin without understanding why. There are several reasons why adults may experience acne.
Adult acne is a much deeper problem than teenage acne, which is usually caused by normal hormonal fluctuations.
We should ask: what exactly makes adult acne different from teenage acne?
In this article, we’ll provide more information about adult acne, its causes, and how to treat and manage it.
What Is Adult Acne and How Is It Different from Teenage Acne?
Acne is often considered a teenage problem, but in reality, it can affect anyone at any stage of life.
Acne develops when hair follicles and sebaceous glands become clogged with dirt, dead skin cells, and acne-causing bacteria.
During adolescence, hormones are the main culprits behind acne.
When reaching puberty, the production of a hormone called androgen increases in both boys and girls.
Androgen enlarges the sebaceous glands, causing them to produce more oil, which then clogs the follicles and promotes the overgrowth of P. acnes bacteria. This is why acne is common among teenagers.
Adult acne, also known as “post-adolescent acne,” tends to form deeper within the skin layers (unlike teenage acne, which appears on the surface).
It’s usually more painful compared to teenage acne.
Adult acne tends to occur in cycles, while teenage acne usually disappears once the body adjusts to hormonal changes.
Adult acne can persist for a long time and is often cystic, with most pimples appearing on the forehead and jawline.
It’s also typically inflammatory, making it more likely to leave long-term dark spots on the skin.
Causes of Adult Acne
1. Pregnancy and Menstruation
Pregnancy and menstruation are the two main factors behind hormonal changes in women.
During pregnancy—especially in the first and second trimesters—androgen levels increase.
This stimulates the sebaceous glands to produce more oil, clogging follicles and encouraging the growth of acne-causing bacteria.
During menstruation, different hormones dominate different parts of your cycle.
For example, estrogen dominates the first half, while progesterone dominates the second.
These hormonal shifts affect your skin: high progesterone levels stimulate oil production, clog pores, and cause breakouts.
2. Birth Control Pills
The hormones in birth control pills suppress androgen production.
However, some types (such as progestin-only pills) can disrupt hormone balance, which may take at least five months to stabilize again.
If you frequently change birth control methods, your body struggles to adapt to the changing hormone levels, which can lead to acne breakouts.
3. Menopause
Many women in their 40s and 50s experience acne after menopause.
When menstruation ends, hormonal levels change—either estrogen levels drop or testosterone levels rise—creating a hormonal imbalance that triggers acne.
Some women undergo hormone replacement therapy (HRT) to alleviate symptoms of hormonal deficiency or excess.
HRT involves introducing progestin into the body to replace the lost estrogen and progesterone.
4. Polycystic Ovary Syndrome (PCOS)
Sometimes, small cysts form around the edges of the ovaries, causing Polycystic Ovary Syndrome (PCOS).
This condition disrupts hormonal balance and increases androgen levels in women, leading to acne.
5. Other External Factors
Makeup, Cosmetics, and Skincare Products:
These can clog pores and trigger acne. If you have sensitive, acne-prone skin, such products may worsen your condition and spread acne.
Stress:
A study found that chronic stress increases adrenal androgen production in adult women, leading to more oil secretion and, consequently, acne. Reducing daily stress is essential.
Emotional Disturbance:
Another study showed that emotional distress activates the pituitary gland, releasing cortisol (the stress hormone). Corticotropin, part of the HPA axis response, stimulates oil production and leads to breakouts.
Genetics:
A study on patients aged 25–55 with severe acne found that about 50% had first-degree relatives (parents or siblings) with post-adolescent acne.
Environmental Factors:
Environmental changes and lifestyle habits can also influence adult acne.
Adult skin reacts more strongly to chemicals found in cosmetics and skincare products, which can lead to breakouts.
Habits like not washing your face properly, drinking too little water, or using corticosteroid medications can also contribute.
Symptoms and Types of Adult Acne
Small dark spots with open pores (blackheads)
Small white bumps under the skin without open pores (whiteheads)
Red, inflamed, pus-filled pimples (commonly known as pimples or boils)
Firm, slightly painful lumps under the skin
Painful pus-filled cysts beneath the skin (sebaceous cysts)
Treatment of Adult Acne
Due to health and environmental factors or lifestyle choices, adult acne can be extremely challenging and may take months or even years to heal.
However, it can be treated and managed effectively.
It’s best to consult a dermatologist rather than self-medicating—even with over-the-counter products.
Dermatologists often prescribe topical or oral medications, or a combination of both, depending on the severity of the acne.
Here are some treatments your doctor might recommend:
1. Retinoid Creams
Retinoids help unclog pores and can treat mild to moderate acne while maintaining healthy skin.
They are effective against both inflammatory and non-inflammatory acne.
Common topical retinoids include:
Adapalene, Tretinoin, Retinaldehyde, Beta-retinoyl, Tazarotene
The concentration depends on acne severity.
2. Benzoyl Peroxide
This is one of the most commonly used acne treatments.
It comes in various concentrations and forms—creams, lotions, gels, and cleansers.
It has antibacterial properties and works well for mild to moderate acne.
3. Salicylic Acid
Used as a comedolytic treatment (preventing comedones), salicylic acid is often combined with other treatments to treat mild to moderate acne.
4. Azelaic Acid
Found in acne creams at concentrations of 10–20%, azelaic acid is highly effective against inflammatory and comedonal acne.
5. Lactic Acid Cleansers or Creams
These reduce the number of comedones, cysts, and inflammatory lesions.
6. Picolinic Acid Gel (10%)
This gel has antibacterial, antiviral, and immune-modulating properties.
A study found that using picolinic acid gel twice daily for 12 weeks was highly effective for acne.
7. Dapsone Gel (5%)
This gel has anti-inflammatory and antimicrobial properties.
It’s considered a safe and effective treatment on its own or combined with other medications.
Home Remedies for Adult Acne
Aside from medications, many natural and plant-based remedies can help treat acne.
Natural treatments usually take longer to show results, but their effects can be excellent.
Before trying any natural remedy, consult your doctor—especially if you’re already using acne medications.
Here are a few home remedies you can try:
1. Green Tea
Topical application of green tea extracts helps reduce oil production and treat acne due to the polyphenols it contains.
Regular consumption of green tea can also prevent breakouts.
How to use it:
Drink up to three cups of green tea daily, use a 2% green tea extract cream or gel, or soak green tea and apply the liquid as a face mask.
2. Cinnamon Extract
A study found that cinnamon extract has antibacterial effects against P. acnes thanks to its anti-inflammatory and antimicrobial properties.
Cinnamon extracts can be incorporated into anti-acne formulations.
How to use it:
Use diluted cinnamon essential oil topically.
You can also mix cinnamon powder or oil with honey and apply it to affected areas.
3. Honey
Honey has antimicrobial effects due to its low moisture content, high sugar concentration, and low pH—all of which prevent bacterial growth.
Additionally, bees add an enzyme called glucose oxidase, which converts glucose into hydrogen peroxide, a substance toxic to microbes.
How to use it:
Apply raw honey directly to the affected area, leave it for a while, then rinse.
Alternatively, add a teaspoon of honey to your face creams for added benefits.
In Conclusion : Treating adult acne can take a long time because its causes are numerous and persistent.
Understanding your body and its changes is the first step toward managing acne effectively.
Consulting a doctor to identify the exact cause is essential, after which you can follow the appropriate treatment plan for your specific case.
