Why do we get acne as adults and what can be done about it?

Close-up of woman's acne on her face
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Why do adults get acne?

There are many reasons why adults get acne. Fluctuating hormones in women is major factor, and a hormone imbalance, especially around the time when women are menstruating, going through menopause or pregnant, can all play a part.

Acne can also be caused by stress. The science behind the reasoning is varied, however, research has demonstrated that there is a correlation between increased stress levels and acne. A common theory is that stress triggers the release of cortisol, a hormone that helps the body deal with stress. Excess cortisol caused by increased stress levels stimulate the sebaceous glands in your skin to produce more sebum, a natural oil that lubricates your skin. Sebum protects the skin keeping it moist and acts as a protective barrier. However, an overproduction of sebum can clog pores and create an environment for bacteria associated with acne to grow. Increased stress levels can also have a negative impact on the quality of your sleep and your diet. This can compromise your immune system and lead to breakouts.
Genetics can also play a part in adult acne. Whilst there is no specific gene linked to acne, certain genetic mutations can increase your chances of getting acne as an adult, for example, your immune system may not respond well to dealing with bacteria associated with acne or you may have inherited an oily skin type making you prone to getting acne or you may be genetically predisposed to hormone imbalances that can cause acne.

Certain medication or cosmetic skin care products can also be the cause of acne. The contraceptive pill, steroids and lithium used in the treatment of bipolar disorder are all notorious for causing acne. Certain skin care products that make your skin too oily or too dry (dry skin encourages the sebaceous glands to produce more sebum) can contribute to adult acne. There may be certain ingredients contained in products that you’re using that your skin may react to, causing acne.


What impact does acne have on confidence and mental health?

Unfortunately, for many people, acne doesn’t just affect their skin. Acne can have a negative impact on your mental well-being. I’ve come across numerous studies that have looked at the effects of acne on mental well-being, that has highlighted links between acne and mental health issues such as depression, low self-esteem and anxiety. I’ve spoken to many patients about how acne has knocked their self-esteem and confidence. This is especially worse for patients who have tried to do everything they can to get rid of their acne, but it won’t go away. It can change the way you think that others see you, which can in turn, change the way you see yourself. This in itself can be the start of a viscous cycle causing social phobia, anxiety, depression and loss of confidence.


What steps can someone take to improve their acne?

Over the years, I’ve read numerous research papers, articles, blogs and most importantly, spoken to thousands of people that suffer from acne. Out of the umpteen products that are sold, and all of the different lifestyle changes you can make, all of which claim to cure acne, the reality of the situation is that you have to find what works for you. There are definitely products that help to restore skin moisture (for dry skin) or products that can remove excess oil (for oily skin), but we all have different skin types, and what works for someone else, may not necessarily work for you. Therefore, frustrating as it may seem, it’s a process of trial and error.


Some generic advice that can benefit all people who suffer from acne would be to:


Know your skin type and deal with it accordingly.

Those who suffer from oily skin would benefit from a product that reduces excess oil produced by the skin. Be careful to ensure that you use such products in intervals to avoid drying your skin which can have a reverse effect and also cause acne. The same advice applies to people that suffer from dry skin (but the other way round). Don’t be afraid to try home remedies such as turmeric and apple cider vinegar. Some natural ingredients may actually prove to work better than cosmetic products and won’t contain any of the unnecessary nasties that are potentially unkind to skin.


Cleanse your skin twice a day.

You should try to look for cleansing products that are hypoallergenic and free from fragrances. Cleansing your skin can help to get rid of bacteria and dirt associated with causing acne. You should apply the most appropriate cream to your face after, depending on your skin type. For more information regarding acne of the face, take a look at our our dedicated 'Acne Face Map' or 'Face & Body Acne' guides.


See your GP or pharmacist.

Adult acne can be caused as a side-effect of medication you are taking, or could be a result of a hormone imbalance. Your GP or pharmacist can offer advice and support you in making clinical decisions that are better for your skin. You can also be prescribed acne treatment that can help. Retinoids are ingredients that regulate skin turnover, so that dead skin cells do not clog pores. It also serves as an anti-inflammatory, reducing swelling and redness cause by acne. Products such as Differin and Epiduo are effective and you should speak to your doctor if your acne is getting worse. There are also antibiotic creams that are available on prescription such as Duac gelZineryt or Treclin. These creams contain antibiotics along with another ingredient such as a retinoid or an anti-inflammatory agent that can help to clear acne. If your acne is caused by a hormone imbalance, your doctor may prescribe you with a certain contraceptive pill, which can bring your hormones back into sync and improve your acne. You should make an appointment with your GP to discuss treatment options.


Make lifestyle changes.

Tweaking your diet to include more water and vegetables, and less sugar could help to improve your skin. Clinical research has suggested that certain food which cause a spike in insulin levels, such as sugar, white rice, white bread can contribute to acne. Research has also demonstrated that foods high in saturated and trans fats and dairy products, can stimulate an over production of hormones that can contribute to acne. Limiting your intake of these foods and increasing your consumption of foods that are “kinder” to skin such as lentils, quinoa and slow releasing carbs (sweet potatoes, brown rice) may help to improve your skin. Getting a good night’s sleep and managing stress levels can keep your immune system healthy and also help in reducing acne. Research also suggests that smoking can contribute to adult acne, and you should try to stop smoking if you do.

For additional acne resources relating to other areas of the body that acne might effect, why not take a look at our guides that focus on 'How To Get Rid Of Back Acne' and 'How To Get Rid Of Chest Acne'.

Whilst all of our content is written and reviewed by healthcare professionals, it is not intended to be substituted for or used as medical advice. If you have any questions or concerns about your health, please speak to your doctor.