Acne is an inflammatory skin condition that causes spots, blemishes, and oily skin. While it’s a normal part of growing up for many people, acne can affect adults too.
Acne can have a significant impact on body image and self-esteem. And, for those still struggling with it later in life, it can feel particularly frustrating. However, the good news is that there are a number of treatment options available, as well as lifestyle changes that may help.
Below, we’ll explore exactly what adult acne is and what causes it – as well as treatment options and ways to cope.
What is adult acne?
Acne is an inflammatory skin condition that causes spots, blemishes, and oily skin – usually on the face, neck, shoulders, and/or the upper back and chest.
According to statistics, acne is the eighth most common skin disease worldwide. And while it most commonly appears during puberty, acne can affect adults too.
In fact, research shows that the number of adults affected by acne has increased over the past two decades.
Some adults first get acne during puberty and it continues into their 30s, 40s, and 50s – while, for others, the condition can first appear during adulthood, even if they’ve never previously suffered from acne. Dermatologists often refer to this as ‘adult-onset acne’, and it’s most common among women going through menopause (largely due to hormonal changes).
Adult acne is sometimes confused with another skin condition called rosacea – but the two differ. For example, the redness associated with acne tends to appear just around a spot or pimple, while redness caused by rosacea typically covers larger areas.
What impact can adult acne have on body image and self-esteem?
Whether mild, moderate, or severe, acne can have a significant impact on a person’s body image, confidence, and self-esteem.
Many people with acne report that the condition affects their social life, because they worry about others looking at their skin.
For example, research has linked acne with higher rates of depression, anxiety, and an inability to thrive in social environments.
What causes adult acne?
Acne occurs when the pores in our skin don’t function properly. Pores are tiny openings around hair follicles and sweat glands that help liquids and gasses to move through the skin’s surface.
Pores that don’t function properly can become clogged and lead to acne breakouts. For example, there may be an overproduction of sebum (oil), or the pores might be ineffective at eliminating oil.
The reason behind your acne will usually determine which type of acne you have. Dermatologists recognise that there are two main causes of acne: hormones and bacteria. We’ll cover these below…
Note: The best way to determine what type of acne you have is to see a dermatologist. They’ll be able to perform an in-depth exam and consider your medical history.
Hormonal acne
Hormonal acne is triggered by fluctuations in hormone levels that occur throughout different stages of life.
Examples include: puberty, the menstrual cycle, pregnancy, menopause, perimenopause – and medical conditions such as polycystic ovary syndrome (PCOS).
Hormone levels that fluctuate or are imbalanced can cause various bodily changes – such as pH imbalances, inflammation, and increased production of sebum – all of which can play a role in the development of adult acne.
Acne that’s caused by fluctuating hormone levels typically appears as deep, cyst-like lumps that are tender and painful to touch. They most commonly appear on the lower parts of the face – particularly around the chin, neck, jawline, and cheeks.
Bacterial acne
When present in the skin, bacteria called Propionibacterium acnes can cause acne – particularly if it builds up.
This is because, if left unchecked, P. acnes increases oil production in hair follicles and causes inflammation.
P. acnes accumulates underneath the skin, which means it can’t always be reached by surface cleansing. In other words, it can’t be removed by simply washing your face.
Bacterial acne most commonly appears as inflamed pimples and pustules on oily skin regions like the nose, forehead, and chin.
What are some of the risk factors for developing adult acne?
Whether hormonal or bacterial, there are a number of different factors that can increase a person’s risk of developing adult acne – or impact its severity.
We’ll cover some of these below…
Being female
As highlighted above, fluctuating hormone levels are a major cause of adult acne.
While men can develop acne, due to factors like the menstrual cycle, menopause, and perimenopause, women are more at risk.
In this study of 454 adults with acne, 85% of the participants were female.
Family history
Unfortunately, research shows that some people are genetically predisposed to have acne.
According to dermatologists, when someone has acne, it’s likely that another family member also experienced breakouts – either as a teenager or adult.
This study found that people with close relatives (such as a parent or sibling) who suffered from adult acne were more likely to develop it themselves.
Even having a more distant relative, such as an aunt, uncle, or cousin, can increase a person’s risk.
One reason for this is that genetics can determine how effective your immune system is at warding off P. acnes – the type of bacteria that promotes acne.
Hair and skin products
Various hair and skin products, like shampoo, conditioner, makeup, and styling products, have the potential to clog pores and trigger acne breakouts – particularly products that are oil-based.
Stress
Research shows that stress can cause biological changes in the body that may trigger acne.
For example, when we feel stressed or anxious, our adrenal glands (small, triangular-shaped glands located on top of the kidneys) produce more of the stress hormone, cortisol. This can increase production of sebum, which is known to worsen acne.
Environment
Research has found that placing physical strain on your body can trigger inflammation and hormonal changes, and weaken immune function – all of which can increase the risk of acne.
Examples of physical strain include a lack of sleep, dehydration, extreme weather, and exposure to environmental irritants like air pollution.
Research has also found that people who smoke or suffer from allergies or migraines are more likely to develop adult acne.
Diet
There’s evidence to suggest that diet may play a role in the severity of acne.
Experts are yet to reach any firm conclusions on whether specific foods can cause breakouts, but a number of studies are worth taking note of.
For example, a potential link has been drawn between severe acne and eating dairy products, as well as high glycemic foods like white bread, pasta, cake, processed foods, and sugary drinks.
What treatment is available for adult acne?
There are a number of treatment options for adult acne.
Sometimes, over-the-counter remedies like topical treatments are effective. However, in more severe cases, prescriptions of antibiotics, hormonal birth control pills, or professional treatment like blue light therapy, may be suitable.
If you’re struggling with acne, it’s important to speak to your GP or dermatologist. They’ll be able to advise you on the best treatment options for your skin.
You can read more about treatment for adult acne on the NHS website.
7 tips for coping with and improving adult acne at home
Some people find that they’re able to improve their acne at home with simple daily changes…
1. Wash your face twice a day and be gentle with your skin
Washing your face as part of your morning and evening skincare routine is important, particularly if you have acne.
In this study, participants were asked to wash their face with a mild cleanser one, two, or four times a day for six weeks. At the end of the study, those who washed their face twice a day had significant improvements in acne, while those who only washed their face once a day had the greatest increase in pimples.
Gentle, unscented cleansers are recommended as they’re less likely to aggravate the skin. This advice also extends to being gentle with your skin by avoiding picking at spots or constantly touching your face. Doing so exposes pores to even more bacteria and can increase the risk of infection or scarring.
2. Moisturise properly
Many people who struggle with acne tend to avoid moisturising their skin because it’s a common belief that drying out breakouts is the only way to treat them.
However, according to dermatologists, dry skin can actually worsen acne and encourage a continued breakout cycle.
3. Keep skincare simple and allow products enough time to work
Many people with acne want a quick fix, and it can be frustrating when skincare products don’t seem to work right away.
But research shows that skincare products need a minimum of four to six weeks to work. This is because skin cells need enough time to turn over and replenish.
Keeping your skincare routine simple may also be important. Research shows that too many products can increase the risk of redness, breakouts, and general skin irritation.
4. Take care of yourself
Taking care of yourself by getting enough good quality sleep and managing stress levels can be beneficial if you suffer from acne.
For example, this study found that over 65% of participants who said they felt tired also had acne.
If you’d like some help with this, you might find our collection of articles on how to deal with stress, anxiety, and depression useful.
5. Add more anti-inflammatory and low GI foods to your diet
As mentioned above, diet may play a role in the severity of adult acne.
Though more research is needed, evidence suggests that adding more anti-inflammatory and low glycemic (GI) foods to your diet, and limiting processed foods, may be beneficial. This study found that 87% of participants had less acne and 91% required less acne medication when they followed a low GI diet.
If you’d like to learn more, check out our articles; 14 anti-inflammatory foods and Low glycemic (GI) diet – what is it and are there benefits?
It can also be worth keeping a food diary to help you recognise potential triggers of breakouts.
6. Remember that you’re more than your physical appearance
Society can easily make us feel that our self-worth is based on our physical appearance. If your acne is impacting your self-esteem, it’s important to approach yourself with kindness and compassion.
Remember that your physical appearance has nothing to do with who you are as a person. Kindness, loyalty, generosity, and humour are some of the most beautiful qualities to have – and you are more than your skin.
If you’d like some help with putting this approach into practise, have a read of our articles; 16 ways to improve your confidence and self-esteem and 15 things you can do to start loving and accepting your body. You might also like to read our article on self-affirmations. While this article was written in the context of finding love, it can just as easily be applied to the relationship we have with ourselves.
Final thoughts…
Acne can be frustrating and distressing to live with, and have a significant impact on self-esteem. It’s important to remember that you’re not alone and there are lots of treatment options available.
For further reading head over to the general health section of our website. Here, you’ll find information on everything from heart and lung health to important health checks.
Have you got any experience with adult acne? Are there any other tips you’d like to share? We’d be interested to hear from you in the comments below.
