Acne is supposed to be something that only teenagers get. Right?
Wrong.
We hate to break it to you, but while most people experience an episode or two of at least a mild form of acne inflammation, adults can get acne too. Like it or not, acne is one of the most widespread conditions affecting humans around the world. A study in the National Center for Biotechnology Information has found that acne is the eighth most common health condition worldwide. That means that out of nearly 7 billion people on the planet, almost 1 billion have acne or had it in the past.
But what about adult acne? A research article in the Journal of Clinical and Aesthetic Dermatology notes that adult acne is on the rise. In fact, the number of people experiencing adult acne seems to have doubled in the past two decades. The same journal published another study, and it turns out that adult acne largely affects women. The ratio is pretty out of whack - only 15 percent of men have acne, as opposed to 85 percent of women.
And while we’ll discuss adult acne causes and treatment further on, let’s clear things up a bit.
What is Adult Acne?
Long story short, adult acne is pretty much the same thing as ‘ordinary’ or ‘adolescent’ acne. Acne can appear on your face (including your cheeks and chin), on your neck, along your hairline, and even on your chest and shoulders, and last but not least - on your butt too.
First, the pores become clogged or inflamed and form comedones. There are different types of comedones you need to watch out for.
Comedones
Blackheads are open comedones. Sebum, dirt, dead skin cells, and bacteria that clog up the pores come into contact with open air and oxygen. The oxygen oxidizes these substances, making for a dark appearance at the tip of the spot.
Whiteheads are clogged pores covered by the surface layer of the skin called the epidermis.
Since the epidermis is thin and largely translucent, it prevents the sebum (the white or yellowish skin oil inside the pore) from coming into contact with air and oxygen. This keeps the tip of the clogged pore whiteish.
Whiteheads are much more noticeable and prominent than blackheads, making them more difficult to cover.
Papules Acne
When a blackhead or a whitehead becomes popped, irritated, infected, or inflamed, you get the first ‘proper’ manifestation of acne vulgaris, the so-called pimple, technically known as papules acne.
These boast a white or yellowish tip and a pink or reddened surrounding area and are often hard and painful to the touch. All of those changes are most likely the results of a bacterial infection with the notorious Cutibacterium acnes (formerly known as Propionibacterium acnes, or P. acnes in short).
Cutibacterium acnes is an otherwise normal and well-behaved citizen of the largest organism in the human body - the skin. However, it can find its way inside pores, gorge on sebum, and multiply until it clogs and disfigures the entire pore.
And that’s only the lowest, mildest form of it! If left untreated, or if it’s persistently popped and touched, these pimples can become larger, nastier, and more severe. Squeezing the spots can worsen acne and lead to scars and persistent skin discoloration.
Papules acne can escalate to pustules, a fairly serious type of acne that affects the deeper levels of the skin, leaving deeply red, black, and even blue marks. Pustules often leave deep wounds, which create large acne scabs. The pustules can then transform into the most severe type of acne: cystic acne.
Cystic Acne
Cystic acne resembles cysts. They’re large, round, and sometimes run so deep that they can be covered with a completely healthy patch of skin. Cystic acne is notoriously tricky to get rid of and may sometimes even require risky procedures such as draining the cyst with a needle.
Cystic acne and pustules are the most severe types of acne in existence and are prone to leaving long-lasting scars on your skin and face. These scars can sometimes be difficult to repair or remove and can even last a lifetime. Treating cystic acne and pustules often requires the aid of medical professionals and strong prescription medications.
For example, the effective but somewhat risky treatment of cystic acne is isotretinoin therapy, commercially known as Accutane (or Roaccutane). Accutane for acne is a powerful solution, but the therapy takes up to six months and shouldn’t be taken lightly.
Don't despair - if you only suffer the occasional pimple, there are a lot of skin care routines and treatments that can help you get clear skin and keep it.
What Isn’t Adult Acne?
Some skin conditions can be mistaken for acne. Confusion usually happens because the phenomena appear fairly similar to acne.
The two most common skin conditions mistaken for acne are rosacea and folliculitis.
Rosacea
Rosacea is a chronic skin disease estimated to affect hundreds of millions worldwide. Rosacea can be easily mistaken for acne due to its similar appearance. The skin affected by rosacea acquires a reddish, pimpled texture. There are four types of rosacea, but its trademark symptom is always the same - dozens or hundreds of small, red bumps filled with pus, usually around the eyes, nose, cheeks, and chin.
Medicine is still lagging behind a full understanding of this skin condition. The cause of rosacea is still unknown, and so far, there is no cure. However, research keeps advancing and has helped doctors and dermatologists devise treatments to minimize its symptoms.
It's possible to have both acne and rosacea simultaneously, but a professional will be able to tell you for sure.
Folliculitis and Ingrown Hairs
Folliculitis is a fairly common skin condition where the hair follicles become inflamed. The most common causes are either bacterial or fungal infections. People often mistake an inflamed hair follicle for a pimple because it looks like a small, red bump on the skin. White-headed pimples can also form around the affected hair follicles. If left untreated, the infection can spread and mutate into chronic, crusty sores.
While not life-threatening, folliculitis can be unbearably itchy, sore, and embarrassing. Severe infections can cause permanent scarring and hair loss.
A less intense form of hair follicle disorder is the infamous ingrown hair. Ingrown hairs often look exactly like a pimple. Due to friction (such as tight pants), the hair bends back on itself, becoming stuck in its own follicle. This clogs the follicle, closing it shut, which makes the pore swell with sebum, bacteria, and dead skin cells.
Adult Acne Causes
To treat acne, we have to understand what causes it first.
As we mentioned before, nearly all cases of acne are caused by a few well-known reasons. Blocked pores, bacterial infection, or inflammation of the pores are the most prevalent acne-prone skin causes. But what drives these developments, to begin with? What creates the imbalance so a pore becomes clogged, inflamed, or infected? Are there any underlying reasons that lead to the eventual appearance of adult acne?
Adult Acne Can Be Caused By Hormones And Hormonal Fluctuations
One of the main causes of acne is hormones and hormonal changes.
This is especially pertinent to women - due to the monthly menstrual cycles, women experience hormonal fluctuations more frequently than men. In addition, once women reach their 40s and 50s, they enter the perimenopause phase, followed by menopause and postmenopause periods, introducing even deeper hormonal changes in women.
This accounts for the drastic prevalence of adult acne among women compared to men. In men, acne is mostly correlated with the dysregulation of their testosterone levels.
There are dozens of male and female hormones. Testosterone, estrogen, endorphins, serotonin, dopamine, and so on and on - the list is long and complex.
While some hormones, like dopamine and serotonin, generally affect our moods, others control the physical, sexual, metabolic, and physiological processes. Hormones like estrogen and testosterone regulate the physiological processes that also affect the skin's environment. The loss of balance between male and female hormones can shift the pH value of the skin, affect circulation, cause inflammation, and even cause the oil glands to overproduce sebum.
Moreover, as the body ages, hormones shift and reorganize to tend to the body’s ever-changing needs. Aging can lead to drier skin, but it can sometimes lead to intense periods of oily skin, which can, in turn, cause the appearance of adult acne.
Certain activities and bodily processes promote hormonal fluctuations as the chief adult acne causes in women. The following activities can contribute to a change in hormones and the appearance of adult acne:
- Menstruation and ovulation
- The period during pregnancy
- The period after the pregnancy (postpartum)
- Breastfeeding
A woman undergoing a significant hormonal change can develop acne. Hormonal acne is different than an ordinary pimple. These pimples resemble large cysts, often painful or tender to the touch. It's strongly advised that you don't try to pop hormonal acne. The damage can spread to the deeper layers of the skin and lead to scar tissue that can be extremely hard to repair.
Hormonal acne is one of the most severe types of acne and can be very complicated to treat.
Adult Acne Can Be Caused By Irritated Skin
For example, scratching your head may irritate your skin and cause pimples.
To put it shortly, every little thing that irritates the skin can weaken its defenses, which can cause a reaction. This kind of wayward defensive reaction is known as inflammation. It’s when the body reacts so extremely against a perceived threat or injury that the defensive reaction itself is harmful to the body.
Rubbing your skin too hard when washing your face, using harsh soaps and cleansers, or even shaving with a certain type of razor can irritate the skin.
If you want to prevent acne, be careful about what you expose your healthy skin to.
Hats and Haircare
For example, do you have acne along your hairline? This may be caused by wearing hats and headbands or using certain shampoos and conditioners. It could also be due to your hair. If your hair rubs against your sensitive skin, it can drive it mad with irritation. In addition, hair collects microscopic pieces of dirt and oil during the day, acting like a magnet due to static electricity.
If you suspect that wearing your hair over half of your face may be causing your acne, tie it in a ponytail.
But here’s another scenario - suddenly, your acne gets really bad. What if you go to bed and wake up with a large pimple on your cheek?
Bedding
First, check your pillows. Are they clean? Maybe try to figure out when you last gave them a good wash, and if you can’t remember, throw them in the washing machine. Unclean pillows, sheets, and blankets are a grossly underestimated cause of inflamed pores and irritated skin.
Try not to sleep on a pillow covered with a coarse fabric. After all, we spend nearly a third of our lives sleeping. Make sure that your pillowcases are comfortable and not irritating to your skin.
But what if your pillows are clean, and your pillowcase is silky smooth?
Smartphones and Gadgets
It could be your smartphone. If you love having long phone calls with your friends, family, or significant other, you’re probably spending a lot of time with your smartphone slapped to your cheeks and ears. But think about all the places you put your phone down. Park benches, bus seats, fast food joints, toilets, tables, chairs, and even out in nature.
Nowadays, we take our smartphones everywhere with us. Is it any wonder you have this persistent case of acne on your cheeks? Whether you like or hate phone calls, make sure you clean your phone every couple of days.
Keep Your Hands Clean
Each little touch makes your skin drier, oily, or even more sweaty. That messes with the skin's natural function and can lead the oil glands to overproduce sebum and clog pores. And that’s even if you’re touching your face with sterile gloves.
Intense Emotional Stress Can Cause Adult Acne
Besides hormones, their fluctuations, and irritating physical contact, the third most prevalent cause of adult acne is intense emotions and emotional stress.
Do you always seem to come down with adult acne or pimples after, or sometimes even before, a very stressful event? Whether it’s that dreaded Thanksgiving dinner with your family, an important job interview, a long-awaited promotion, or even an intense fight with your partner, your face might flare up.
As we mentioned above, hormones are a super important feature of the human body. When a person is under intense emotional stress, the body undergoes biological changes, causing mild, moderate, or severe acne.
Whenever you feel intense emotional turbulence, the adrenal glands produce larger quantities of the stress hormone cortisol. Cortisol kicks off a dozen processes that eventually affect the sebaceous glands in the pores, leading to acne.
But how?
The sebaceous glands in our pores and hair follicles are tasked with excreting tiny amounts of skin oil (otherwise known as sebum). We need sebum to moisturize our skin and keep it smooth, elastic, and waterproof. But when we face intense emotional stress or turbulence, our adrenal glands produce cortisol to prepare us for freeze, fight, or flight.
Our pores overflow with sebum, become clogged by dead skin cells, dirt, or bacteria, and lead to acne or make acne worse.
Intense Physical Stress May Lead to Adult Acne
Physical stress can lead to hormonal changes and more severe acne. Not only that - but physical stress can also weaken your immune system, creating all sorts of inflammatory processes and infections.
But what is physical stress, exactly? Climbing up the stairs? Exercising vigorously?
While extreme physical training can lead to exhaustion and fatigue, that’s not what we mean by physical stress. Exercise is known to reduce stress and help prevent the appearance of adult acne and acne in teenagers. Activities that cause physical stress, impact your body negatively, mess up your hormones, and lead to acne are the following:
- Prolonged lack of sleep
- Exposure to extreme weather
- Physical illness or disease
- Dehydration
- Environmental irritants, such as polluted air or water
Like a musical instrument, the body depends on fine-tuning to function harmoniously. When our hormones are in disorder, it’s like someone taking a guitar and tightening and loosening its strings randomly.
When our bodies lose hormonal harmony, various processes go haywire, and coordination is lost. This leads to increased sebum production, blocked pores, and acne.
Studies indicate that physical stress can be a specific risk factor for you, especially if you’re a woman prone to allergies and migraines. Additionally, other research shows that adults who smoke, regardless of their sex and gender, are more prone to developing acne as well. Some of these factors can be mitigated - for example, some people have reservations about vaping and acne, but it’s a much safer alternative to smoking.
Adult Acne Can Also Be Caused By Poor Personal Hygiene
A person can have the oiliest skin possible, but barring hormonal imbalances, they will not have acne. But add to that poor hygiene, an unhealthy lifestyle, and bad habits, and suddenly the onset of adult acne becomes far more plausible.
Why?
Here’s the answer - poor hygiene means your skin retains more material that can clog your pores, especially if you’re a person with oily skin whose sebaceous glands are already producing lots of sebum. Clogged pores become far more likely if you don’t wash all the dead skin cells, dirt, and smoke particles away.
Neglecting your personal hygiene also enables acne-causing bacteria Cutibacterium acnes (also known as Propionibacterium acnes) to multiply.
So if you want to prevent the appearance of acne, maintain good personal hygiene along with an acne treatment regimen. If you're looking for the perfect acne routine, try this.
Too Much Makeup Can Lead to Acne
What is makeup made of? And can it clog your pores?
It very much can.
Additionally, if you don’t wash your makeup brushes periodically or dispose of old makeup products, you risk giving yourself a bacterial infection. And that’s just the basics. For an in-depth look at the role of makeup in causing acne, head over to our article.
Certain Foods Can Contribute to Acne
Did you have a sweet tooth? Or maybe you’re addicted to cheese? And what about your coffee problem? That fast food itch? Maybe you always get a pimple or two after that super spicy Thai takeout on Tuesdays?
Even the most everyday, mundane foods and beverages play a role in the skin’s health.
While no single food will make you come down with an intense case of pimple plight, each food contributes to the dysregulation of your metabolic processes. By nudging a hormone here or there, certain foods and drinks prepare the terrain for the landing of acne.
Too Much Coffee Can Make Your Skin Prone to Acne
Coffee has become super prevalent, and there’s hardly a person that doesn’t drink it. But what’s the danger of coffee when it comes to acne? Problem number one is that we rarely drink pure coffee. Nowadays, coffee resembles a creamy soup with lots of milk, sugars, creams, caramel, spices, and other ingredients.
Most commercial coffees are processed sugar bombs designed to appeal to your taste buds instead of just offering a beverage to keep you alert. Processed sugars, combined with milk and coffee, can be a recipe for disaster for your skin.
The wild variety of coffee makes it difficult to describe a single metabolic pathway that sums up the effects on the skin. So should you stop drinking coffee?
Find the answers to that question and more in our in-depth article on the role of coffee in causing acne.
Foods High in Processed Sugars Can Contribute to Acne
Foods high in processed sugars can also contribute to the appearance of acne. Namely, the ingestion of sugars messes with our hormones and the body’s regulation mechanisms. The hormone in charge of receiving all the sugar is called insulin. Insulin also decides how much sugar should be allowed in your bloodstream and how much should be stored in the body.
Insulin is caught off guard when we ingest too much sugar too quickly. The best thing your body can do is put a dam between your intestines and your bloodstream. This defense mechanism prevents you from getting poisoned by too much sugar. But where does all the excess sugar go?
Well, it gets sent to different organs in the body, which transform all that sugar into fat. A portion of that goes to your skin. The resulting hormonal imbalance and poor sugar handling lead to an overproduction of sebum. Which, as we have pointed out, can clog pores and give you acne.
We all have our guilty pleasures, but why not experiment a bit? If you’re a fan of sweet and sugary foods, try to avoid them for a few weeks and see how your skin reacts. Maybe adjusting your diet slightly will solve or reduce your acne problem. It's worth a try.
Does Fast Food Cause Acne?
You'll have heard this before - stop eating fast food if you want to get rid of acne. But something doesn’t feel right.
Could you be a part of a tiny minority allergic to fast food, so you come down with acne? Perhaps, but that’s not very likely. So what gives?
The notion that fast food (barbecue, mayo, butter, bacon, french fries, and so on) leads to acne is a myth. Although science hasn’t found any correlation between eating fatty foods and an increased frequency of acne breakouts, people still believe that it does.
Our bodies need fats, and they'll take them, one way or another. It’s either butter or too much sugar (which transforms into fats in the body).
But, the myth persists. And there is a good reason why. You know how whenever you eat a burger, some french fries, or something else greasy, the area around your mouth and sometimes your entire face feel… sort of sticky? We feel oilier after eating greasy food. And so far, so good - the myth is onto something.
But here’s where it gets it wrong: eating fast food isn't the problem. You can eat ten times as much fat and still won’t get acne. So if eating fat isn’t the problem, what is?
Whenever you eat or cook something greasy (say, you decide to fry some french fries), tiny particles of cooking oil and grease get dispersed in the surrounding air.
Your mouth, chin, nose, and sometimes even cheeks come into contact with cooking oil, spices, and grease. Incidentally, those parts of the face are the most prone to acne.
That’s why we feel like our faces are sticky with grease after eating such foods - because they actually are. And what did we say was one of the main causes of acne? Blocked pores. And what does all that grease do to our skin? Clog our pores.
Fast food, barbecue, mayo, french fries, steaks, butter, and even salads doused in vegetable oil can all contribute to adult acne. Not because of us ingesting the foods themselves but because we inadvertently cover our skin with a fine layer of oil and grease.
So, do you want to enjoy the occasional fast food meal, french fries, or a well-oiled salad? No problem - just wash your face and hands after the meal.
What About Milk and Other Dairy Products?
Does dairy cause acne? As is the case with most foods, the answer is pretty much no.
No single food can make a person develop acne. However, as we've seen above, foods can interact with our metabolism, and sometimes, it can lead to a dysregulation of our hormonal balance. As we have seen, that can create all the necessary conditions for an adult to experience acne.
That said, there's no shortage of anecdotal evidence on the internet claiming that milk and dairy cause acne. This could very well be the case in some individuals, especially lactose-intolerant people. Everyone has specific genetics and predispositions different from others.
But you can find anecdotal evidence for almost everything on the internet nowadays. Clearly, when it comes to human health, there is hardly a one-size-fits-all solution to the problem.
But what does science say? There is no shortage of studies finding direct, albeit weak, associations between diet and acne. An overview of the research conducted by the American Academy of Dermatology in 2009, and published by the US National Institute of Medicine in 2010, concluded that: “Compelling evidence exists that high glycemic load diets may exacerbate acne. Dairy ingestion appears to be weakly associated with acne, and the roles of omega-3 fatty acids, antioxidants, zinc, vitamin A, and dietary fiber remain to be elucidated.”
However, a study from 2005 found a more direct link between the total intake of milk and skim milk in teenage girls and boys and the incidence of acne. The study concludes: “We found a positive association with acne for intake of total milk and skim milk. We hypothesize that the association with milk may be because of the presence of hormones and bioactive molecules in milk.”
A study conducted among Malaysian teens in 2012 confirmed these findings, adding ice cream and milk combined with sugar to the list of acne-causing risk factors. While scientists are still unable to deduce the exact cause of dairy’s contribution to acne, the presence of growth hormones in cow milk and the added sugar seem to be the main suspects.
So, what should you do? As with the rest of the risk factors, experimenting pays off. If you have a problem with adult acne, give milk and dairy products a time-out and see what happens. Even better, you can try replacing milk with a plant-based alternative, such as almond milk.
Adult Acne Causes: Summary
The list of acne causes seems infinite. But the main reasons for blocked pores are the following: hormonal imbalances, poor personal hygiene, and certain diets (that lead to hormonal imbalances).
Occasionally, the odd medicine or pill may be causing this. If that seems probable to you, schedule a visit to your doctor as soon as possible.
Adult Acne Treatments
From conventional treatments to skin care products and anti-acne solutions to home remedies, the choice is truly immense. Remember that there is no one-size-fits-all solution for acne - what works for you will not work for someone else, and vice versa.
Home Remedies For Adult Acne
When in doubt, go natural. From honey masks to green tea, egg whites masks, and banana peels, there is a lot to choose from. Home remedies for acne, especially those based on natural ingredients, are some of the safest methods for acne prevention and treatment out there.
Their pros outweigh the cons by a long shot, so they’re worth a try. Because they’re natural, you risk nothing, and since they’re super affordable, you spend almost nothing too. They can improve your skin health immensely and even prevent another bout of stubborn acne breakouts.
Here is a list of some of the best DIY practices and natural home remedies for acne that we recommend:
- Coconut oil
- Turmeric
- Vegetables
- Egg whites
- Green tea
- Emu oil
- Oatmeal masks
- Rice water
- Apple cider
- Tea tree oil
- Olive oil
- Castor oil
- Papaya
- Banana
- Shea butter
- DIY natural spot treatments
- Natural home remedies
- Vitamin C
- Vitamin B5
- Vitamin B12
- Vitamin E oil
- Vitamin E capsules
- Zinc
Conventional Acne Treatments
As we mentioned above, this category covers a broad selection of prescribed medications, cosmetic treatments, birth control pills, and over-the-counter supplements designed to treat acne and acne scars.
For some of these acne treatments, you might need a doctor’s approval, an official diagnosis, and prescriptions. For others, such as salicylic acid and benzoyl peroxide, that won’t be necessary. Our team at Misumi has prepared the following guides for you:
- Guide to acne medications
- Antibiotics for acne
- Accutane and Roaccutane (isotretinoin) for acne
- Microdermabrasion for acne
- Chemical peels for acne
- L-Lysine for acne
- Salicylic acid for acne (guide)
- Retin A for acne
- Hyaluronic acid for a healthy skin
- How to treat hormonal acne
- Diindolylmethane (DIM) for acne
Acne Causes and Treatment: Summary
If you're suffering from acne, you’re not alone.
The main cause of acne comes down to blocked pores. Many things can clog pores and hair follicles. Mostly, acne comes down to hormonal imbalances, poor personal hygiene, or even your diet.
The number one rule is to refrain from touching your face. In addition, keep your pillows, sheets, smartphones, tablets, and computers clean. Developing useful morning skin care routines and healthy habits seems simple but can go a long way. Incorporate a great facial cleanser, toner, and moisturizer.
Discuss any treatment with your doctor or dermatologist before trying it, especially if you have untreated acne vulgaris or a severe case. Only a dermatologist can treat severe acne.
While adult acne may be an annoying situation to deal with, plenty of solutions can solve the problem. It comes down to determining which adult acne treatment works best for you. Don’t be afraid to experiment, especially with nature’s gifts. And remember - you’re not alone. Sooner or later, you’ll find a solution that makes your skin clear, fresh, glowing, and vibrant.
References
High school dietary dairy intake and teenage acne
Adult-onset acne: prevalence, impact, and management challenges
Understanding the Burden of Adult Female Acne
Adult Acne Versus Adolescent Acne
Understanding the Burden of Adult Female Acne
High glycemic load diet, milk and ice cream consumption are related to acne vulgaris
