Adult Acne: Why It Happens and How to Treat It Effectively

Adult acne is more common than many people realise. Although most people associate spots with adolescence, around one in ten UK adults experience acne at any given time, and many more have had it at some point in their lives. It can appear for the first time well into your 20s, 30s or 40s, or continue from teenage years that never fully cleared.

Unlike teenage breakouts that often focus on the T-zone, adult acne typically affects the jawline, chin and neck, with deeper, more inflamed spots that may linger for weeks. These breakouts can be painful and stubborn, often leaving dark marks or scarring. Beyond the physical symptoms, adult acne can affect confidence, work life, and overall wellbeing.

Importantly, acne is not caused by poor hygiene or failing to wash properly. It’s a complex medical condition involving hormones, oil glands, bacteria, and inflammation. The good news is that, with the right approach, adult acne can be managed effectively and safely - usually without needing aggressive treatments.

This article explores why acne appears in adulthood, what makes it different from teenage acne, key triggers, emotional impacts, and how best to manage it.

Why Adults Get Acne

Acne begins when hair follicles become blocked by excess oil (sebum) and dead skin cells. Inside these blocked pores, Cutibacterium acnes bacteria multiply and trigger inflammation. This causes the familiar red bumps, whiteheads, and occasionally deeper, cystic lesions that can be sore to touch.

In teenagers, acne is driven by the surge of sex hormones during puberty. In adults, the triggers are more varied and often cyclical.

Hormonal changes

Fluctuating hormone levels are one of the main reasons acne persists or returns in adulthood.

Menstrual cycles: Many women notice breakouts in the week before a period when progesterone falls and androgens become more dominant.
Pregnancy: Hormone levels fluctuate significantly, which can either calm or worsen acne.
Perimenopause and menopause: Falling oestrogen and relatively higher androgen levels can reactivate oil glands and cause breakouts - sometimes for the first time in years.
Polycystic ovary syndrome (PCOS): A common cause of stubborn adult acne, driven by elevated androgen levels that increase oil production.

Stress and cortisol

Chronic stress raises cortisol, which increases sebum production and inflammation. It can also delay healing and disrupt the skin barrier - creating a feedback loop where acne causes stress, and stress worsens acne.

Age-related skin changes

As we age, cell turnover slows, and skin can become both oilier and drier. Dead cells shed more slowly, increasing the risk of blocked pores, while a weakened barrier makes skin more reactive to irritation.

Genetics and environment

If your parents had acne, you’re more likely to experience it too. Environmental factors such as pollution, humidity, tight clothing or face coverings, and friction from mobile phones can also trigger breakouts.

These overlapping influences explain why adult acne tends to be persistent but manageable - it’s usually a combination of hormonal, genetic, and lifestyle factors.

Adult vs Teenage Acne

Understanding the difference between adolescent and adult acne helps guide realistic expectations and treatment.

Feature	Adolescent Acne	Adult Acne
Prevalence	Most teenagers (up to 80%)	Around 1 in 10 UK adults
Typical areas	Forehead, nose, T-zone	Jawline, chin, neck
Lesion type	Blackheads, whiteheads, surface spots	Deeper, inflamed, often cystic
Triggers	Puberty hormones, genetics	Hormonal cycle, menopause, stress, cosmetics
Course	Peaks mid-teens, often resolves by early 20s	Can persist for years, often cyclical

Teenage acne tends to spread across the central face where oil glands are most active. Adult acne clusters around the lower face and jawline, where oil glands are particularly hormone-sensitive. Adult breakouts also tend to heal more slowly and are more likely to leave pigmentation or scars.

Common Triggers in Adults

Adult acne can flare up for many reasons - some beyond control, others manageable with awareness and routine.

Hormonal fluctuations: Linked to the menstrual cycle, pregnancy, or menopause.
Stress and lack of sleep: Both raise cortisol, a stress hormone that increases oil and inflammation.
Comedogenic cosmetics and hair products: Thick, oily, or fragranced products can block pores.
Pollution and humidity: Environmental irritants clog pores and increase oxidative stress.
Friction and occlusion: Helmets, masks, or even frequent phone use against the cheek can cause "mechanical acne."

Simple prevention habits:

Choose non-comedogenic ("won’t block pores") skincare and remove makeup before bed.
Cleanse gently twice daily with a mild, pH-balanced product.
Keep mobile phones and pillowcases clean, and avoid touching the face unnecessarily.

These changes don’t cure acne but help reduce flare-ups and improve treatment results.

The Emotional Side

Acne is often dismissed as a cosmetic issue, but for many adults it’s an emotional one too. Studies from UK dermatology groups show that over half of adults who have ever had acne say it affected their self-confidence, and nearly a quarter say it impacted social life or relationships. Many report anxiety, embarrassment, or frustration - especially when others assume spots are "teenage problems."

The impact can extend to work life and self-image. In an age of video calls and social media, visible breakouts can lead to self-consciousness and avoidance behaviours. This emotional burden often improves once effective treatment starts, but it’s important to acknowledge early.

"Adult acne can be particularly distressing because people often feel they ‘shouldn’t’ be getting spots anymore. I remind patients that acne is a medical condition driven by hormones and inflammation - and with the right consistency, it’s very manageable," says Alessandro Grenci, Superintendent Pharmacist at Medino.

If acne is affecting your confidence, self-esteem, or mental wellbeing, it’s perfectly reasonable to discuss this with your GP or pharmacist. Support for both skin and mood makes recovery faster and more sustainable.

Managing Adult Acne

While there’s no instant cure, adult acne responds well to steady, evidence-based care. The key is consistency - not constant product changes. Most treatments need 8–12 weeks to work.

1. Skincare

Use a gentle cleanser twice daily - avoid harsh scrubs.
Apply a light, non-comedogenic moisturiser even if your skin is oily.
Wear daily broad-spectrum SPF 30–50, especially if using active treatments that make skin sensitive.
Avoid switching products too often; give each at least two months.

2. Lifestyle support

Stress reduction, regular exercise, balanced sleep (7–9 hours), and a diet rich in vegetables and whole grains all support skin balance. While no single food "causes" acne, diets high in sugar or highly processed foods may worsen inflammation in some people.

3. Treatment and escalation

Mild acne: Start with pharmacy options such as benzoyl peroxide or salicylic acid gels. Your pharmacist can recommend safe strengths and usage.
Persistent or moderate acne: See your GP. Prescription creams combining retinoids and antimicrobials may help.
Severe or scarring acne: GPs can refer you to a dermatologist for oral medicines (like short-course antibiotics, hormonal therapy, or isotretinoin under supervision).

Setting expectations matters - skin often looks slightly worse before improving as pores clear. Stick with a plan for at least 12 weeks before judging results.

When to Seek Professional Help

Consult a pharmacist, GP, or dermatologist if:

Acne hasn’t improved after 8–12 weeks of self-care
You have painful, cystic, or scarring spots
It affects your confidence or daily life

Pharmacists are an excellent first step - they can guide product choice and spot when GP referral is needed. GPs can prescribe stronger treatments and assess hormonal or emotional aspects. Dermatologists handle resistant or scarring acne and can access advanced options.

Early help prevents both physical scarring and emotional distress, so don’t delay if acne persists or worsens.

Summary

Adult acne is a common, treatable medical condition - not a reflection of poor hygiene or lifestyle. Hormones, stress, genetics, and environment all play a part. With consistent skincare, healthy routines, and professional guidance when needed, most adults achieve clear, balanced skin within a few months.

If acne is affecting your confidence or comfort, seek advice early. Effective treatments and compassionate support are readily available through UK pharmacies, GPs, and dermatology services. Clearer skin - and renewed confidence - are well within reach.

Sources

Written by Christian Jakobsson