You survived your teenage years with the hope that once you made it to adulthood, you would finally be free of the troublesome acne that you had during your youth. Unfortunately, people can have acne in their 20s, 30s, 40s and even, 50s. If you’ve noticed your acne has followed you into the adult years or if you’re experiencing adult acne for the first time ever, there’s a lot you need to know about what’s going on underneath your skin. Here’s what’s really happening inside your skin.


To understand adult acne, it’s first important to go back to your high school days and understand what’s going on with adolescent skin. Though chocolate and pizza get a lot of blame, it’s really the changing hormones that make teenage acne appear. As you begin puberty, the surge of hormones stimulates the sebaceous glands to make more sebum. Sometimes your skin produces more oil than needed and your pores get blocked leading to breakouts. These types of breakouts are treated differently than adult acne, where certain treatments can leave skin dry, flaky and red.


Adult acne is a bit more complicated. If you had acne as a youth and have found it followed you into adulthood, you may be perplexed by what is going on with your skin. There are two different forms of adult acne. First, there’s persistent acne, which means it was present in your teenage years and has followed you onto your new journey of life. The second is known as late-onset acne which appears sometime in your 20s and beyond. You may notice bumps on your chin or along your jawline most commonly. But adult acne can show up anywhere on your body. Unlike acne in puberty, adult acne is more common in females and can occur on normal or dry skin. There are many reasons why adult acne can form, including fluctuating hormone levels, stress, lack of sleep, diet (dairy products), genetics, skin and hair products and certain medications. Let’s take a closer look at some of the reasons you might be seeing these new breakouts on your face. Here’s what’s going on.


Hormonal variations definitely bring changes to your skin. Normally, when all hormones are in check, everything in your body runs like a well-oiled machine. But during times of hormonal imbalance, like menopause or peri-menopause, pregnancy or the use of birth control pills, or prior to starting your period, your body can get out of sync. With estrogen and progesterone in regression and testosterone constant, the extra male hormone could overdrive the sebaceous glands, blow up pores and create cystic zits here and there.


Studies have shown a link between stress and a lack of sleep with increased breakouts. Stress is one of the major causes of adult acne. Stress comes in two forms: psychological stress or physical stress, both of which can cause the release of cortisol, the primary stress hormone in your body. Cortisol binds to its receptors in sebocytes and increases sebum production. In addition, cortisol works in immune cells in the skin, exacerbating the inflammation.
Lack of sleep is connected with cortisol as well. Normally, cortisol levels undergo daily oscillation with peak levels occurring in the early morning with the lowest point happening around midnight. Staying up too late or dealing with insomnia can significantly disrupt your cortisol levels and oscillation curve, resulting in excessive oil production and possibly acne.

Try to manage your stress level by exercising and getting a full eight hours of sleep each night so your body has time to rebuild, replenish and rehydrate the skin.


Research has not concluded anything about chocolate, pizza and fatty foods backing up in your sebaceous glands, but a healthier diet can make you feel like a healthier you. Eating your fruits and veggies and drinking plenty of water is very good for your skin, which after all, is your largest organ.


Researchers have found that genetics do play a large role in adult acne. If both of your parents suffered from acne as a child, you are more than likely going to experience acne at some point in your life as well. There are quite a few acne-contributing factors that can be blamed on your genetics. An overactive sebaceous gland, overactive immune system, accelerated skin shedding,  and the acidity of your skin all have ties to your genetic roots.


Certain skin and hair products can make your acne breakouts worse. For instance, if you are constantly spraying hairspray on your forehead, you may not realize how much is actually making it into your pores and causing a backup when the hairspray is trying to be removed through the skin. Smoking and certain drugs to treat depression and seizure can also cause adult acne to pop up uninvited on the skin. Certain products may also contain dimethicone and mineral oil which are both known to increase buildup. In certain case, acne may be the result of a separate medical condition. If you treat said condition, the acne usually clears up too.


No matter what the causes are, acne takes the following steps to form. Old skin cells and keratin begin to accumulate in the skin. After that, the shed keratin and sebum accumulate in the skin. Finally, as the buildup occurs, mild inflammation begins to happen. Next comes marked inflammation of the skin, followed by possible scarring. In many cases of adult acne, Propionibacterium acnes, the bacteria causing acne in puberty, is actually not the culprit, a clogged pore and inflammation are more commonly to blame.


So up until now, it’s been a complicated process to get a blemish from the starting point to the finish line on your skin. But while looking at all the evidence, it really boils down to a buildup in the pores as the leading cause of adult acne breakouts. A pore can be clogged in many ways: whether it be excessive oil production, abnormal epidermal differentiation, accelerated cell turnover, or ingredients in personal care products (dimethicone, mineral oil, etc.) The hard part is those clogged pores lead to inflammation that can be seen on the skin. Inflammation is the body’s way of healing what has been injured or damaged.

Even though you were sure you would grow out of your acne, it’s important not to get too down about having to treat it as an adult. There are actually several ways you can treat adult acne. To prevent acne from leaving pigment or scars behind, the inflammation needs to be treated first. Adult acne is more than just bothersome, it can have a big impact on your self-confidence. It’s tough when you begin looking at various treatment options for adult acne. How will you know where to look or what ingredients can make your acne worse? In our next article, we’ll discuss the best ways to treat adult acne.

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