Adult Acne: Causes, Treatments, and Solutions

Table of Contents

• Key Points
• What Is Adult Acne?
• What Causes Adult Acne?
• Conditions Associated with Acne
• Types of Adult Acne
• Adult Acne vs. Teenager Acne
• Adult Acne Treatment
• When to See a Dermatologist for Adult Acne
• Get Clearer Skin at Any Age
• References

 

Key Points

• Adult acne is more common than many people realize. 
• While there are some basic commonalities with acne in adolescents, adult acne often has distinct underlying causes and requires unique approaches to treatment. 
• Understanding the triggers of adult acne and available approaches to treatment is the first step toward achieving clearer skin. 

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When you hear the word “acne,” you might immediately picture teenagers. That is because the condition is often caused by hormones prevalent during puberty.¹ But adults can experience acne as well. 

In fact, according to recent studies, between 3 and 5 percent of men experience adult acne. The rate of occurrence is even higher in women: upwards of 22 percent of adult women report some level of acne (one study shows incidence over 40 percent).²

Regardless of the statistics, if you are someone who has acute or chronic adult acne, you are probably wondering, “Why am I breaking out and what can I do about it?” Understanding the unique challenges of adult acne, its causes, and the most effective treatments is essential for anyone looking to achieve clearer, healthier skin.

What Is Adult Acne?

For reporting purposes, “adult acne” refers to the occurrence of pimples, blackheads, whiteheads, and cysts in individuals over the age of 25. Unlike teenage acne, which is often linked to puberty and hormonal surges, adult acne can be more persistent and sometimes more difficult to treat. 

Many adults are surprised to find themselves dealing with breakouts long after their teenage years have passed, leading to frustration and confusion about the circumstances. There is often a significant emotional toll, as adults may find themselves dealing with embarrassment stemming from an ostensibly juvenile condition.³

What Causes Adult Acne?

There are four main sets of circumstances that can cause acne (in adulthood or adolescence). These include:

1. Excess Sebum Production: Sebum is an oily substance that the body naturally produces to lubricate the hair and skin.⁴ Hormonal fluctuations common in puberty are a culprit of adolescent acne, but menstruation, pregnancy, or certain medical conditions can stimulate an overproduction of sebum as well, which clogs pores and causes adult acne. 
2. Clogged Hair Follicles: Human skin regularly sheds dead skin cells. If shedding is excessive, these dead skin cells can clog hair follicles, leading to acne. 
3. Bacteria: A certain type of bacteria called Cutibacterium acnes naturally lives on the skin and within hair follicles.⁵ Trapped sebum in a clogged hair follicle can create an anaerobic environment where the bacteria multiply and produce byproducts that cause irritation. 
4. Inflammation: The body’s immune system naturally tries to fight off bacteria and clear the debris of dead skin cells. Often combined with blocked follicles, excess sebum, and the proliferation of bacteria, the body’s inflammatory response can trigger or exacerbate conditions that lead to irritation and acne. 

There are other causes of acne that are less common:

• Fungal acne: Caused by an overgrowth of yeast in the hair follicle. It often presents as small, uniform bumps, often on the chest and back (though they can exist on the face as well). The condition requires distinct treatment from bacterial acne. 
• Acne Conglobata: This is a rare and severe form of acne that involves many inflamed nodules that are connected under the skin. It is a distinct condition that often affects many different parts of the body, including the neck, chest, arms, and buttocks. 

Conditions Associated with Acne

There are many underlying conditions that can influence the circumstances described above. 

• Hormonal changes: As mentioned, hormonal shifts can trigger or worsen acne. 
• Stress: While it does not cause acne directly, stress may influence hormone levels that can, in turn, trigger acne. 
• Medications: Drugs like corticosteroids, lithium, androgenic steroids, and some anti-epileptic medications are known to trigger acne.⁶
• Diet: The relationship between diet and acne is complex. Some studies suggest that diets high in refined sugars and certain dairy products can worsen acne in certain individuals.⁷
• Pressure and friction: Repeated pressure or rubbing of the skin from tight clogging, helmet straps, backpacks, or even cell phones can irritate hair follicles and lead to acne. 
• Cosmetics and skincare products: Makeup and skin care products can clog pores and lead to or worsen adult acne. 
• Smoking: Some studies suggest a link between smoking and acne, especially in adult women.⁸
• Underlying health conditions: Disorders like polycystic ovary syndrome (PCOS) can cause hormonal imbalances that lead to persistent adult acne.

It is a common misconception that acne is caused by dirty skin or poor hygiene. This is not the case, as most of the underlying causes of acne happen below the skin’s surface. In fact, aggressive scrubbing or over-washing the face can irritate the skin and make acne worse.

Types of Adult Acne

Acne can manifest in adults in many different forms. These can be condensed to non-inflammatory and inflammatory acne. Non-inflammatory acne is the result of circumstances described above that lead to clogged pores or follicles, resulting in:

• Blackheads: Blackheads occur when an excess of sebum mixes with dead skin cells, forming a plug (called a “comedone”) that blocks the opening of a hair follicle.⁹ If the plug is open to the air, it oxidizes, forming a dark appearance. 
• Whiteheads: Whiteheads are the result of the same conditions as those that result in blackheads, except where the plug remains closed off to the air by a thin layer of skin. 

Inflammatory acne is characterized by redness or swelling, indicating (as the name suggests) an inflammatory response in the skin—most often due to bacteria. This manifests as:

• Papules: Small, red, tender bumps that do not contain pus. 
• Pustules: These are what people commonly think of as a “pimple.” They are similar to papules but have a visible white or yellowish center filled with pus, sitting atop an inflamed base. 
• Nodules: Larger, solid, and often painful lumps that form deep beneath the skin’s surface. These are more severe than papules and pustules and often can lead to scarring. 
• Cysts: The most severe form of acne, these are large, painful, pus-filled lesions that develop deep in the skin. They appear similar to boils and carry the highest risk of scarring. 

Adult Acne vs. Teenage Acne

While both teens and adults can experience acne, there are some key differences:

• Location: Adult acne often appears on the lower face, jawline, and neck, while teenage acne is more common on the forehead and cheeks.
• Persistence: Acne in adults tends to be more persistent and may not respond as quickly to over-the-counter treatments.
• Scarring: Adults are more prone to post-inflammatory hyperpigmentation and scarring than adolescents. 

Adult Acne Treatment

As with acne in teenagers, effective approaches to adult treatment are varied and depend on the causes and underlying causes described above. Below are some of the most common approaches. 

Over-the-Counter Solutions

Some non-prescription medications can aid in the treatment of adult acne. 

• Benzoyl Peroxide: Kills acne-causing bacteria and reduces inflammation.
• Salicylic Acid: Helps unclog pores and exfoliate the skin.
• Retinoids: Promote skin cell turnover and prevent clogged pores.

Prescription Treatments

Prescription medication is often needed and, in general, is more effective than over-the-counter remedies.

• Topical Retinoids: Stronger versions of the over-the-counter option.
• Oral Antibiotics: Reduce inflammation and combat bacteria, but are typically used for short periods.
• Hormonal Therapies: Birth control pills and anti-androgen medications can help regulate hormones in women with acne.
• Isotretinoin: A powerful oral medication for severe or cystic acne in adults.

In-Office Procedures

Your dermatologist can also provide in-person treatment for certain types of adult acne.

• Chemical Peels: Help exfoliate the skin and reduce breakouts.
• Laser and Light Therapy: Target bacteria and reduce inflammation.
• Corticosteroid Injections: Used for large, painful cysts to reduce swelling quickly.

Lifestyle and Skincare Tips

While often not sufficient for eliminating adult acne on their own, combined with other treatments, some lifestyle and skincare practices can aid in acne healing. 

• Gentle Cleansing: Wash your face twice daily with a mild cleanser. Do not scrug or apply accessive pressure to affected areas. 
• Moisturize: Use a non-comedogenic (pore-clogging) moisturizer to keep skin hydrated.
• Sun Protection: Always use sunscreen, as some acne treatments can make your skin more sensitive to the sun, potentially irritating acne further.
• Avoid Picking: Picking or squeezing pimples can lead to scarring and worsen acne in adults.

When to See a Dermatologist for Adult Acne

If you have tried over-the-counter products and lifestyle changes without success, it is time to consult a dermatologist about your acne. A skin expert can help identify the underlying causes and develop a personalized treatment plan to help you treat adult acne effectively.

During the appointment, your dermatologist will examine your skin and ask about your medical history. They will put together a treatment plan tailored to your skin type and acne severity. Going forward, they can also help you track progress and adjust treatments as needed.

Get Clearer Skin at Any Age

Adult acne can be frustrating, but it is important to remember that you are not alone and that effective treatments are available. By understanding the unique causes of acne in adults, debunking common myths, and working with a dermatologist in Greenville, SC, you can find the right adult acne treatment for your skin. 

If you are struggling with acne as an adult, do not hesitate to reach out to us for expert guidance and support. Our practice leverages decades of experience treating acne in both adolescents and adults. With the right care, we can help you achieve the confidence and comfort that comes with a clear complexion. 

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References

1. Mayo Clinic Staff, “Acne,” Mayo Clinic, July 2024, https://www.mayoclinic.org/diseases-conditions/acne/symptoms-causes/syc-20368047. 
2. Marco A. Rocha and Edileia Bagatin, “Adult-onset acne: prevalence, impact, and management challenges,” Clinical, Cosmetic, and Investigational Dermatology, February 2018, https://pmc.ncbi.nlm.nih.gov/articles/PMC5798558/. 
3. John S. Barbieri, MD, MBA; Rachel Fulton, BA; Rebecca Neergaard, BS; et al., “Patient Perspectives on the Lived Experience of Acne and Its Treatment Among Adult Women With Acne,“ JAMA Dermatology, Vol. 157, No. 9, July 2021, https://jamanetwork.com/journals/jamadermatology/fullarticle/2782440. 
4. “Sebaceous Glands,” Cleveland Clinic, December 2022, https://my.clevelandclinic.org/health/body/24538-sebaceous-glands. 
5. Marlee J. Elston, John P. Dupaix, Maria Opanova, and Robert E. Atkinson, “Cutibacterium acnes (formerly Propionibacterium acnes) and Shoulder Surgery,” Hawaii Journal of Health and Social Welfare, November 2019, pmc.ncbi.nlm.nih.gov/articles/PMC6874694/. 
6. Dan Kern, “What Medications Can Cause Acne?” Acne.org, May 2025, https://www.acne.org/what-medications-can-cause-acne. 
7. “Can the Right Diet Get Rid of Acne?” American Academy of Dermatology Association, retrieved on June 18, 2025, from: https://www.aad.org/public/diseases/acne/causes/diet.
8. Jing-Zhan Zhang, Fang Xiang, and Shi-Rong Yu, “Association between acne and smoking: systematic review and meta-analysis of observational studies,” Chinese Medical Journal, January 2021,
    https://pmc.ncbi.nlm.nih.gov/articles/PMC8367059/.
9. James Roland, “How to Deal with Sebum Plugs in the Skin,” Healthline, January 2019, https://www.healthline.com/health/beauty-skin-care/sebum-plugs.