Most recently updated 1/12/21

While humans are capable of great things — exploring the moon and calculating the weight of an electron, for starters — one thing has managed to stump many of us: acne. While acne seems like a uniquely teenage-era problem, it can happen long after you graduate into adulthood and last well into your 30s and 40s, both as a continuation of acne or for the first time ever.

It can feel near impossible to treat, and properly addressing it goes beyond just washing your face at night. Rather, it can help to take a good look at your current skincare routine as well as your overall habits. “Adult acne has so much to do with what we put into our bodies and the lifestyle we live rather than the products we put on our face,” explains NakedPoppy skin specialist Tara Parenti. “Diet, stress, and sleep are huge components to adult acne and its persistence.” Here, what to know so you can best handle it.

Consider this your adult acne cheat sheet:

  • Adult acne is acne that occurs after the age of 25
  • Stress, hormones, and diet can exacerbate adult acne
  • Look for willow bark extract, lactic acid, and retinol
  • Don’t forget to moisturize
  • Popping pimples is not ideal, but can be done properly

What Is Adult Acne?

Adult acne describes breakouts that occur after the age of 25. It can be broken down into two types: Persistent and late onset. Persistent acne means that the acne first appeared in adolescence and continued or relapsed in adulthood, whereas late onset appears for the first time after 25. Persistent acne is the more common form of adult acne — which, by the way, affects women disproportionately. 

Adolescent and adult acne have similar roots. “While hormones are the catalyst for both teen and adult acne, the onset and timeline are different,” says Parenti. During puberty, hormones called androgens cause a spike in oil production, leading to breakouts. “For many, once the normal wave of puberty subsides and stabilizes, breakouts will clear,” she notes.

For others, however, “hormonal fluctuation that occurs around pregnancy and even menopause can cause breakouts,” Parenti explains. “Adult acne tends to be more inflammatory, persistent, and slower to heal, as our wound healing process slows down and collagen degradation increases.”

No matter the age, acne includes a relatively big spectrum, from mild to severe and either inflammatory or non-inflammatory. Blackheads and whiteheads are non-inflammatory, and thus don’t usually cause swelling. Meanwhile, “papules and pustules — what we think of as pimples — are one step beyond and can be inflamed, causing sensitivity and often redness,” says Plescia. “Beyond mild to moderate acne, more severe acne includes nodules and cysts. These can be large, inflamed, and even infected.” (Severe cases are best left to professionals; more on that in a bit.)

What Causes Adult Acne?

On a surface level, acne occurs when a combination of sebum, bacteria, and dead skin cells clog a pore, trapping debris inside and leading to signs of inflammation — think swelling, redness, and tenderness. However, other factors can contribute to or trigger it, especially for adults. “The role of hormones, stress, and diet can definitely play more of a role in the factors of adult acne compared to adolescent acne,” says Plescia.

In fact, these other factors can play such a big role that if your acne regimen doesn’t work, it’s worth taking a much closer look at them. Rather than blaming a product, “it may just require a tweak in a step, modification of a particular food you’re consuming in excess, and getting more sleep,” says Parenti.

Adult acne may also be related to:

  • Hormones
  • Stress
  • Personal care products that can potentially clog pores, such as comedogenic formulations
  • Damaged skin barrier
  • Certain medications
  • Diet (while its role is unclear, there does seem to be a connection)

Hormones

The fluctuation of hormones — which starts during puberty and never really stops — is a major contributor to acne, which is why you may experience new breakouts during your menstrual cycle, during or after pregnancy, during perimenopause and menopause, and as you start and stop using hormonal birth control. They can trigger everything from increased oil production to inflammation in the skin. In many cases, we can reduce hormone fluctuations by getting adequate sleep, eating a healthful diet, and keeping healthy circadian rhythms (more on this below).

Skin Barrier Damage

When your skin barrier is damaged, be it from over-cleansing or age, it’s more vulnerable to microbes — including the bacteria, P. acnes, that causes acne. Plus, it can lead to a cycle of creating more breakouts. Since pimples are often (and inaccurately) seen as a matter of hygiene, those with acne-prone skin may be tempted to cleanse or scrub skin too frequently or with harsh ingredients. That will only further damage your skin barrier, leaving you that much more susceptible to acne.

Diet

While the exact role diet plays in the development of acne is unclear, the connection is definitely there. It ties back to those hormones, since refined sugar and processed carbohydrates can impact certain hormone levels in your body — particularly that of insulin, which your body releases when you eat sugar. “An increase in insulin levels leads to an increase of IGF-1 signaling and production,” Plescia explains. “IGF-1, or the insulin-like growth factor is an important growth hormone during puberty and increases sebum, or oil, levels. Since acne is associated with excess sebum production, studies have correlated an increase in IGF-1 to acne, especially in women.”

Gut Health

Your gut could also contribute to acne — specifically, the microbiome, or makeup of bacteria in your digestive tract. When factors like stress, a diet high in processed foods, and an underlying food intolerance throw your microbiome out of whack, “this imbalance involves an overgrowth of harmful bacteria,” says Parenti. That causes a cascade of inflammation throughout the body, including in your skin. “When you have a healthy and balanced gut, it helps your whole body — hormones, brain function, energy levels, regularity and of course, your skin — thrive,” she explains.

Stress

Is stress keeping you up at night? Same. That could be a factor in stubborn breakouts, too — since, as with diet, stress interferes with your hormones, so much so that it can exacerbate or even trigger acne. “With stress comes increased levels of hormones in the body, and recent studies have shown that skin reacts to the endocrine system stress-response by activating the immune system, which can lead to a variety of skin problems,” says Plescia. Also, cortisol (a.k.a. the “stress hormone”) leads to an uptick in sebum production on the skin.

How to Address Adult Acne

For mild to moderate acne, at-home solutions can help, alongside addressing the lifestyle-related variables above. (If you’re dealing with cystic acne, however, you may want to schedule a visit with a board-certified dermatologist.)

First, consider your topical products. Salicylic acid is a mainstay in terms of acne-fighting ingredients (if you’ve never used it before, do a patch test first to make sure you don’t have any reactions!). It helps unclog pores, and is especially helpful in addressing whiteheads.

Willow tree bark is a gentler version of salicylic acid found in willow tree bark; it can help clear pores and may reduce the size of pimples. 

Plescia is also a fan of lactic acid, which is created naturally via the fermentation of carbohydrates, like sugars. “Lactic acid is an alpha-hydroxy acid that helps exfoliate the skin and is antibacterial,” she says. You can find it in serums, where it also doubles as a hydrator.

Next up, retinol is another mainstay in acne treatment. “Retinol works by more quickly turning over skin cells, which can help prevent clogged pores,” Plescia says. (On the market for a clean retinol? Here’s what you need to know.)

Though adding oil to oil may seem counterintuitive, the trick is a matter of choosing non-comedogenic oils (meaning they won’t clog pores). “Facial oils with oils that are high in oils with higher concentrations of omega-3, or linolenic acid, and omega-6, or linoleic acid, are great for acne-prone skin,” Plescia explains. “Studies indicate that individuals with breakouts are deficient in linoleic acid.” You can find both in the NakedPoppy Revitalize Organic Facial Oil.

Last but certainly not least, moisturizer is key, because it can promote a healthy skin barrier. “Having a healthy barrier function is key to a balanced epidermal microflora, acid mantle, and fortified lipid barrier — all critical in the control and treatment of adult acne,” says Parenti. 

If you don’t see overnight results, that’s okay. “Everyone’s skin and response to treatment is different, but on average adult acne — if treating properly — will begin to improve within four to 12 weeks,” says Plescia.

A Word on Popping Pimples

If you’ve been dealing with acne for awhile, you likely don’t need us to tell you about the temptation to pop your pimples. 

“While I don’t encourage it, if you plan to manually extract a whitehead blemish, make sure you have cleansed your skin, done any necessary exfoliation, and that your hands are clean,” says Parenti. “Wrap your index fingers with soft gauze or tissue. Using the pads of your fingers, ground your fingers at the base of the blemish and with a lifting motion and gentle pressure, wiggle your fingers back and forth until the white impaction comes out.”

Try doing it immediately after a shower, which may soften skin and make the clog easier to remove. Once it’s out, cleanse the extraction area with an antiseptic toner before continuing with your usual routine. (Parenti recommends either Odacité Blue Aura Cleansing Water or Indie Lee CoQ10 Toner.) If you’ve tried it two or three times without success, call it quits — it may just not be ready.

Also, be selective. “Inflammatory blemishes without a whitehead cannot be popped,” says Parenti. “The best thing to do would be to ice it and treat it with a spot treatment. Avoid heat and friction, which will only worsen the blemish.” There’s literally nothing to pop if you don’t see a whitehead, and doing so anyway will only traumatize your skin and delay healing. (Want to learn more about treating breakouts? Click here.)

Ultimately, when it comes to adult acne, keeping things gentle (versus piling on a ton of harsh products) is a good rule of thumb. “The most important thing is to reduce or remove things that induce inflammation,” Parenti says. It’ll help ensure that you’re addressing your acne — without making it worse in the process.

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