Adult Acne

An article in the International Journal of Cosmetic Science, 2004 states that “there appears to be an increase in post-adolescent acne, and that the disease is lasting longer and is requiring treatment well into the mid forties.” 
Adult acne affects 25% of adult men – and often is the same stubborn acne that occurred during their teens that returns.
On the other hand, Adult Onset acne – acne which develops for the first time in a person’s 20s or later – is more likely to affect women than men.
If a man does experience adult onset acne, it is likely due to some sort of prolonged irritation of the skin or comedogenic product he is using – so this will be asked about at consultation.

How is Adult acne different from Adolescent acne?


The root cause of adult acne is the same as what causes teenage acne – the final common pathway of excess skin oil secretion, blockage or occlusion of pores (the exits) and bacteria. Just as in teenagers, changes in hormones, such as during pregnancy and menstruation, can trigger excess oil and sebum secretion.

Acne tends to run in families, along with the type of skin you inherit, so if a parent had adult acne, you’re at higher risk. We still do not know exactly why we are getting more acne after clearing our adolescent years – but strong contenders include:

  • constant irritation we cause our skin by applying layers of colour and reflective products in make-up
  • slowing or stopping the skin’s natural exfoliation and regeneration by covering it with occlusive products all the time.
  • shutting down the skin’s natural production of moisturisers by regular external moisturisation.

Hormones: Different levels of sex hormones (like testosterone and estrogen) cause your sebaceous glands to produce sebum at different levels. As your body matures, your hormones fluctuate at different levels. For some, acne is the byproduct. For women, this is common during pregnancy, perimenopause and menopause.

Adult acne is more often seen on the face, along the jaw line and neck, and is usually accompanied by dryer skin. Also, adult acne tends to be characterized by more red bumps or cysts than adolescent acne. The body’s anti-inflammatory response changes with age as there are more reasons for background inflammation and the skin takes longer to regenerate. So breakouts are more likely to become and stay inflamed than teen acne.

Treatment for adult acne: There is no magic bullet

Treating adult acne can be more complicated than treating that of adolescents.
Most over-the-counter acne products address the oily skin causing teenagers’ acne. These are not an appropriate choice for drier adult skin.
Effective treatment requires a clear understanding of how everything we apply to our skin affects it, how quickly (or slowly) the skin regenerates, and how any treatment affects the way the skin behaves.
If we wish to do anything more than camouflage or apply concealer, we need to work with the duration of the skin cycle, in order to transform it.
A combination of OTC and prescription medications such as benzoyl peroxide (OTC) combined with topical retinoids, like tretinoin (prescription only).
Other effective treatments include the use of oral and/or topical antibiotics – if there is inflammation.

So what can you do about adult acne?
It is a myth that “acne should run its course”. It is not advisable to leave acne untreated, as it can lead to change in skin pigmentation, scarring and infection. For the occasional pimple, OTC products can prove effective. If you have moderate to severe acne, you most likely need prescription strength medication, and the advise of a trained professional.