My entire life, I’ve considered myself lucky when it comes to my skin. A spat of acne in high school quickly got under control with some mild prescription treatments, and the rest of my years were spent only dealing with a zit popping up here or there—that is, until I met my newest foe: adult acne.
At first, I was in a bit of denial. About a year ago, I started getting a few more clogged pores and stubborn zits than I usually did and chalked it all up to stress (as one does). After a few months and a cluster of breakouts on my forehead that simply wouldn’t go away, I finally admitted to myself that for the first time in over a decade, I was dealing with acne.
I had heard it from my older friends countless times: Around age 25, their skin started to change and act up, and as mine started around 24, I realized that this is what so many of them had been talking about. I booked a trip to my longtime dermatologist, but the solution wasn’t as easy as it was when I was 14. I went on four different prescription combinations and finally have found a routine that has been working for me after 18 months of trying different things—but throughout my journey, one thing has been clear: I’m definitely not alone in experiencing acne as an adult.
How Hormones Can Be To Blame
“As we hit the prime years for fertility, our hormones are fluctuating in conjunction with our menstrual cycles,” explained Dr. Fatima Fahs, board-certified dermatologist and founder of Dermy Doc Box.
“In my four decades of dermatology practice, I’ve found that adult acne into the 20s and 30s is much more common in women than in men,” Dr. Ciraldo said. “Breakouts on the chest, shoulders, and back, called folliculitis, are more common in adult men than women.”
If you’re dealing with acne as an adult, you’re not alone—and it isn’t your fault.
Dr. Fahs emphasized the importance of keeping track of your acne flare-ups and what may be causing them.
“You’ll want to take note of what makes your acne flare. Many women find that their acne is worse the week before their period,” Dr. Fahs said. “If you are experiencing irregular or no periods or even excessive hair growth on the face and chest, you might also want to make an appointment with a gynecologist to be evaluated for an underlying condition that could be contributing to your acne, like PCOS (polycystic ovarian syndrome).”
Identifying Other Triggers
While hormones can be the culprit of adult acne in women, both Dr. Fahs and Dr. Ciraldo noted that many other factors can be causing your skin to act out.
Dr. Ciraldo explained that diet can play a role, but it’s generally variable and can affect some greatly and others not at all. Some other triggers she recommended keeping an eye out for are:
- Haircare products (especially if you have chin acne or if you see the breakouts under your chin or on your neck)
- Diet triggers, including milk (even skim), sodas, sugary food
- Hormonal fluxes: If you don’t have a normal menstrual cycle, you should have tests done to rule out PCOS, which can cause adult acne
- A new medicine or supplement like biotin, which recently got buzz for causing acne, or a change in your contraception
- Makeup or skincare
While all of the above can lead to acne flare-ups, Dr. Ciraldo emphasized how common it is for her to see patients whose acne is being caused by hair care products.
“Almost every day that I see patients, I have a new patient coming in whose adult acne we trace back to a haircare product. I suggest they switch to a 3 percent salicylic shampoo and cut their conditioner half and half with Infusium 23 Leave-In Treatment.”
Prevention and Treatment
When you begin experiencing adult acne, both Dr. Fahs and Dr. Ciraldo emphasized the importance of making an appointment with a dermatologist. From there, start taking notice of your triggers, patterns of flares, and treatments you’ve attempted so you can give your dermatologist as detailed information as possible.
“Even before you see the dermatologist, you should consider what you may have changed that could be the cause of your acne,” Dr. Ciraldo said. “It may be stress from a new job or a relationship, haircare or makeup products, or a change in your diet. If you’re aware of any of these changes, you can try to tweak these and see if your acne improves as you await your dermatologist visit.”
We’ve all heard it a million times, but no matter how much we want to, Dr. Fahs emphasized how important it is to not pick at or pop any pesky zits that might appear, as it increases the risk of scarring and inflammatory hyperpigmentation.
If you’re tempted to pick your acne, Dr. Ciraldo recommended putting a pimple patch on it to help prevent touching it and irritating it further or turning to spot treatments containing benzoyl peroxide, salicylic acid, and sulfur.
Both Dr. Fahs and Dr. Ciraldo highlighted the same point: If you’re dealing with acne as an adult, you’re not alone—and it isn’t your fault.
“Do not ever feel hopeless about acne,” Dr. Ciraldo said. “Acne is a skin disorder. Like most health disorders, acne may be cured. And, especially in the case of adult acne, it often needs long-term treatment to remain acne-free.”
If you’re unable to get to a dermatologist, there are several dermatologist-approved over-the-counter treatments you can turn to. Salicylic acid and benzoyl peroxide are both readily available, and Differin gel has been known as one of the most tried-and-true over-the-counter options.
No matter which route you choose, consistency is key when it comes to managing acne as well as making sure you aren’t overdoing it with products. You shouldn’t expect results right away, and often, things slightly worsen before they get better. Find what your skin responds well to, cut out the things it doesn’t, and then stick to a routine.