The truth about adult acne

When it comes to adult acne, there’s a lot of misinformation out there. Here are the facts and treatment options.

Although we tend to associate acne with our high-school years, it can happen in adulthood, right up to your 30s and 40s – even if you didn’t have it in your teens.

More than just a stray pimple, acne is a skin condition – known by the scientific name acne vulgaris – that occurs when multiple breakouts emerge on the skin. Like pimples, acne typically results from skin cells that become clogged with oil and dead skin cells. If you are experiencing constant breakouts of pimples, you might be suffering from acne.

And while it’s common to point the finger at stress and chocolate for what’s called ‘late-onset acne’, dermatologist Dr Cathy Reid says hormones are the more likely culprits. 

“Your 20s would be the most common time for late-onset acne. It tends to peter out as you get older and head towards menopause,” says Dr Reid, a spokesperson for the Australasian College of Dermatologists.

“Probably the reason it’s much more common in women is because of hormonal factors. Starting the pill or stopping the pill can cause acne. Some people develop acne for the first time in pregnancy. Often women will give a history of their acne flaring in the week before their period.”

Because acne is so visible, it can have a major effect on your confidence. “It does have a significant impact emotionally, so that’s something not to be underestimated,” Dr Reid says.

“It can affect all areas of your life – your employment, your socialising. And you will often see when you fix people’s acne, they develop more confidence in themselves.”

What causes adult acne?

Acne happens when your skin pores get clogged, usually by excess oil, dead cells or bacteria, resulting in pimples, whiteheads or blackheads forming.

As well as hormonal factors, certain medications, including cortisone or epilepsy medication, can make adult acne more likely, Dr Reid says.

While stress may worsen an existing breakout, it isn’t considered a cause of adult acne. And before you demonise that block of chocolate, Dr Reid says science doesn’t support a link with chocolate.

“Studies have shown people who have diets with a high glycaemic index – people eating a lot of carbohydrates, people who are fast food junkies – there’s probably some association with acne,” she explains.

High-glycaemic carbohydrates include potatoes, white bread and ultra-processed foods (like some breakfast cereals).

Treatment options for adult acne

The first step for treating adult acne is seeing your GP. They may prescribe creams or lotions in combination with an antibiotic, Dr Reid says. Or, if you’re a woman who menstruates, some oral contraceptive pills are known to be effective on acne.

“None of these treatments are going to work overnight,” she warns. “We’re generally talking treatment over a period of months.”

In severe cases, more aggressive adult acne treatments are required, meaning you may be referred to a dermatologist.

“Isotretinoin (a prescription medicine) has really revolutionised the treatment of acne so people shouldn’t end up with scarring,” Dr Reid says.

If the problem is ongoing, it’s worth getting a GP to investigate any underlying causes, like polycystic ovary syndrome.

Regardless of severity, your personal circumstances may determine the best course of action.

“You may have mild acne, but if it’s having a major emotional impact you might need to be a little more aggressive with treatment,” Dr Reid says.

Preventing adult acne

These tips may reduce your chances of experiencing an adult acne breakout:

• Use makeup, skincare or haircare products labelled as non-comedogenic or oil-free – they’re less likely to clog up your skin pores.
• Keep your skincare regimen simple. “Often adult acne patients are using lots of lotions and potions and scrubs and toners,” Dr Reid says. “You don’t need to use a lot of different things – and sometimes it’s better if you use less.”
• Remove makeup before you go to sleep at night.
• Avoid a diet that is heavy in high-glycaemic-index foods.

Always consult a healthcare professional if you are concerned about symptoms or the impact on your mental health.

Words by Trudie McConnochie
First published November 2021