Adult acne: Why do people over 30 still get blemishes?

Having acne as a teenager was one thing, but you thought you’d grown out of it. And now those pimples are back again.

It may seem unfair, but adult acne is more common than you think. This article looks at what causes and triggers it to help you get to the root of the problem. You can find out how to care for your skin Which skincare products and routine are best for acne-prone skin?

You may find it reassuring to know you’re not alone. Acne isn’t just for teenagers. Experts estimate that up to 40% of adults over the age of 25 have blemished, acne-prone skin¹ and that 75 - 85% of them are female².

Adult acne (also known as Acne Tarda) is particularly common amongst women who have taken the pill since the onset of puberty and come off it to try another method or start a family. Soon after they stop taking the pill, blemishes appear.

The symptoms of adult acne are usually only mild to moderate, but those who experience blemishes when they’re over 30 suffer just as much − if not more − than younger patients. The reasons are clear: teenage pimples are annoying, but are considered completely normal. Society expects you to have grown out of acne by the time you’re an adult, and can judge you if you still have spots.

Adult acne develops in the same way as teenage acne, and it starts with micro-comedones. Micro-comedones is the name given to the microscopically small precursors of comedones (a comedone being a blackhead or a whitehead). Everyone has micro-comedones but, in skin that isn’t blemish-prone, they dissolve. If your skin is prone to acne small inflammatory reactions occur − one of the underlying causes in the development of acne^3,4.

At the same time, acne-prone skin produces excess sebum. This sebum is unable to drain away because the pores are clogged and the excretory ducts are blocked. Comedones (blackheads and/or whiteheads) develop as a result and are most commonly found on the face, neck, chest and back. Acne bacteria gets to work in the blocked sebum, leading to red and inflamed pimples. You can read more about how blemishes develop into acne in What causes blemishes and how do they develop into acne?

There is no definitive research on the causes of adult acne but it is thought to be associated with hormones and fluctuations in hormone levels. Teenage acne is linked to the hormonal fluctuations of puberty. The causes of adult hormone fluctuations are, clearly, different and you can find out more about the relationship between acne and hormones here.

Other important influencing factors include a genetic predisposition, smoking, inappropriate skincare and make-up and stress^5,6. You can read more about these, and other potential causes and triggers, in What causes acne?

Women are subject to much stronger and more frequent hormonal fluctuations than men. The female menstrual cycle causes hormone levels to rise and fall continuously and skin is affected differently depending on the time of the month. 

• Coming off the contraceptive pill to use alternative methods or to start a family can affect female hormone levels and trigger adult acne.
• Pregnancy has a major impact on women’s lives, and their hormones are no exception. Hormone fluctuations during pregnancy can impact on skin condition with nearly half of all pregnant women experiencing acne at some point⁷
• Many women also report skin problems such as dryness, rashes, blemishes and acne during the menopause.

Many experts believe that stress is a major cause of adult acne. Stress causes the body to produce stress hormones which lead to an increase in the production of skin cells and sebum - necessary factors in the development of acne. You can read more about these factors in What causes blemishes and how do they develop into acne?

Modern life often involves juggling career, family, partners and hobbies. Many women (and men) struggle to get the balance right and suffer from stress. Find out more in How are acne and stress related?

While research into the relationship between nutrition and acne is inconclusive^8,9, a healthy, balanced diet is a key contributor to healthy skin. Most scientists agree that a high Glycemic Index and too many dairy products can exacerbate acne9. You can read more about this, and the possible influence of other foods, in What impact can diet have on acne-prone skin?

Smoking has also been proven to trigger blemishes¹⁰. Exercise, on the other hand, can have a positive impact on acne by helping to reduce stress and clear clogged pores.

Inappropriate skincare products and make-up can also influence acne. Products with a high oil or fat content are unsuitable for acne-prone skin. They can clog the sebaceous glands preventing sebum drainage and encouraging the formation of acne.

You can find out more in Which skincare products and routine are best for acne-prone skin? and How should I choose and apply make-up to my acne-prone skin?

Medicines such as antidepressants, antiepileptics and certain steroids are known to trigger acne.

As with acne at most life stages, adult acne tends to affect people in two ways: physically and psychologically.

Physical impact 
Acne alters someone’s appearance and can be difficult to live with. Even after the blemishes have healed pimple marks (caused by post-inflammatory hyperpigmentation) and acne scars can remain. Our advice is to consult your doctor as soon as your acne becomes a problem. Early medical intervention can reduce the severity of your blemishes as well as the chances of marks and scars.

Psychological impact
Living with acne can be very stressful. Research shows that people with acne are more likely to suffer from depression, anxiety and social phobias than those without acne¹¹. People with acne don’t like what they see in the mirror and may suffer from low self-esteem and an inferiority complex. Behaviour can change and they may hide behind too much make-up, appear shy and even stop socialising. You can find out more about this in The psychological impact of acne.
 
For additional tips for how to care for acne-prone skin as it ages take a look at the ideal skincare products and routine for blemish-prone skin.