Struggling with adult acne? You’re not alone. Learn how to manage breakouts and get clearer skin during your adult years.
Just when you thought your acne struggles were behind you, pimples, blackheads, and whiteheads can resurface in adulthood. “Adult acne is more common than many realize,” says Karen Han, M.D., Ph.D., a board-certified dermatologist at the Palo Alto Medical Foundation. “It can appear well into your 30s, 40s, and even 50s,” often affecting the lower face and jawline.
The Hormonal Connection
Acne can strike at any age, especially when your body undergoes hormonal shifts. During puberty, hormonal changes cause sebaceous glands under the skin to produce excess oil, or sebum. This leads to clogged pores, which can develop into microcysts and eventually larger, inflamed pimples. If you pick at them, they can rupture, causing further irritation and even scarring.
Adult life stages, like pregnancy or perimenopause, can trigger similar hormonal fluctuations. “Your body undergoes rapid hormone changes at different stages,” explains Dr. Han. “At 12, your body is adjusting to puberty, while at 50, it’s adjusting to perimenopause.”
A Three-Step Approach to Treatment
“Acne can come and go, and treatment often depends on how frustrated you are with it,” says Dr. Han. “Some people can have 10 pimples and not mind, while others might feel upset by just a few whiteheads.” Treatment for adult acne typically involves a three-pronged approach: controlling oil production, reducing inflammation, and managing hormonal fluctuations (in more severe cases).
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Control Oil Production
Managing oil production starts with using non-comedogenic, oil-free cosmetics to prevent clogged pores. For mild acne, over-the-counter products containing salicylic acid can help reduce oil and clear blocked pores. If that’s not enough, your doctor may prescribe topical treatments like tretinoin or adapalene. For more severe acne, oral medications such as isotretinoin may be recommended. -
Reduce Inflammation
Treatment for inflammation varies depending on the severity of your acne. For mild cases, over-the-counter options like benzoyl peroxide or azelaic acid may work. If you experience larger pimples, a doctor may suggest topical antibiotics such as clindamycin, which targets inflammation rather than bacteria. For even more severe cases, stronger oral antibiotics like tetracycline, doxycycline, or minocycline might be necessary to prevent scarring. -
Hormonal Control
For women with severe acne, medications that regulate hormones—like oral contraceptives or spironolactone—may help. These treatments can clear skin but may have side effects, so it’s important to discuss options with your doctor.
Tailor Your Treatment
Rather than addressing each factor—oil, inflammation, and hormones—separately, Dr. Han often recommends a combination approach. “We typically treat all three aspects simultaneously,” she explains. “You might use a topical medication for oil control while taking oral medications for inflammation. Patients using oral contraceptives might also be prescribed isotretinoin for oil management.” Acne is multifactorial, so targeting just one aspect may not be enough for complete treatment.
Work With Your Doctor
Adult acne can understandably cause distress, but with the right treatment plan, clear skin is achievable. “How aggressively we treat acne depends on how aggressive you want to be,” says Dr. Han. “We can clear your skin, but it may take time and consistent effort.”
Consult with your doctor to determine the underlying causes of your acne and create a personalized treatment strategy that works for you.