Acne is often seen as a teenage issue, but adults can struggle with it too. While the likelihood of developing acne decreases with age, it doesn’t disappear entirely. Some people continue to experience breakouts well into adulthood—or even develop them for the first time. The good news? There are ways to manage and treat it.
How does acne develop?
No matter your age, acne is the result of four main contributing factors:
- Excess skin cell production in the sebaceous glands (oil-producing pores)
- Increased sebum (oil) production
- Presence of the bacteria Cutibacterium acnes on the skin
- Local inflammation
When these factors come together, they can clog pores and create comedones (whiteheads), which may evolve into blackheads or more severe scars, such as cysts, pustules, or nodules:
Whiteheads (closed comedones)
Blocked pores that can become inflamed and develop into cysts.
Blackheads (open comedones)
Sebum oxidized by air or UV rays, potentially leading to inflammation.
Pustules
Closed pores filled with pus, often inflamed and tender.
Cysts/nodules
Deeper pockets of pus, presenting as painful, swollen lumps under the skin.
Signs and symptoms
Contrary to popular belief, adult acne is not entirely different from teenage acne. Adults can develop blackheads, whiteheads, inflammatory or non-inflammatory scars as well as nodules, papules, or cysts. These scars primarily appear on the face, neck, and chest; they are not specifically limited to the chin.
What causes adult acne?
Several factors can trigger or worsen acne in adults:
Perimenopause
Hormonal changes during this phase can lead to breakouts.
Pregnancy
Can improve, worsen, or have no effect on acne.
Contraceptives
Hormonal birth control usually helps reduce acne.
Menstrual cycle
Fluctuations may trigger flare-ups in some women.
Excess androgens
Conditions like PCOS or hyperandrogenism can lead to increased sebum production.
Smoking
Linked to non-inflammatory acne.
Comedogenic products
Some cosmetics can clog pores and trigger acne.
Diet
Studies are mixed, but some suggest a link between acne and high-glycemic foods or excessive dairy.
Stress
Early research indicates a possible connection between emotional stress and acne.
How to treat adult acne
Skincare routine
Use a gentle cleanser with a physiological pH (between 5.5 and 7) once or twice daily, depending on your skin type. Avoid overwashing, which can irritate the skin and increase oil production.
Choose skincare products suited to your skin (dry, oily, etc.), and avoid frequent exfoliation—it can aggravate inflammation and make acne worse.
Opt for non-comedogenic cosmetics, and stop using any that seem to worsen your breakouts.
Lifestyle changes
Quitting smoking can help improve your skin. Your pharmacist can support you through the process.
Hormonal contraception may be an option for some individuals—speak to your pharmacist, who may be authorized to prescribe it under certain conditions.
Medications
Over-the-counter products can be effective for mild acne. Look for formulations that contain:
- Benzoyl peroxide
- Salicylic acid
- Retinol
If you have more severe acne (cysts, nodules), it’s best to consult a healthcare provider to determine if prescription treatment is needed.
What about scarring?
Acne scars can take weeks or months to fully heal, and some may leave marks—dark spots or textured scars. If these bother you, several treatment options are available with a prescription:
- Hydroquinone
- High-strength retinoids
- Corticosteroids
- Laser treatments or dermabrasion
A healthcare professional can recommend the best approach for your skin type and scar severity. And don’t forget—your pharmacist can advise you and point you to the right resources if you’re concerned about your skin.
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