The best way to treat adult acne is to get the facts about what causes it, who gets it, and which treatments work best for which skin types. Adult acne can be stubborn, but it doesn’t have to last forever.
If you have adult acne, you aren’t alone. It’s a growing problem, affecting over 25% of adult men and over 30% of adult women. But do you have persistent adult acne, or adult-onset acne? Are you more susceptible to acne scarring, or acne hyperpigmentation, and how do you prevent both? To find the best treatment for your adult acne, it’s important to know the answers to these questions, and more.
Adult acne is the same type of acne as adolescent acne.
There are some important differences between acne in adulthood and acne in adolescence, but they are still the same skin condition. Unlike acne rosacea, which is a separate condition very different from typical acne (also known as acne vulgaris), acne in adults is the same condition as acne found in adolescents.
Regardless of age, acne is caused by the same three main triggers: inflammation, bacteria, and oil production. These factors combine in a variety of ways to create blackheads, whiteheads, pimples, and cysts, but no matter what kind of acne you have, inflammation is at the very start of it all.
Recent research has found that acne is primarily an inflammatory condition. Prior to this research, dermatologists believed it to be a bacterial condition, but it turns out acne-causing bacteria, also known as p. acnes, can actually help reduce acne—as long as inflammation is kept at bay. P. acnes bacteria always live on the surface of our skin, and their main food source is oil, so p. acnes can consume some of the excess oil on our skin and prevent clogged pores.
Oil is also blamed for acne quite often, but it too has benefits for non-inflamed skin. Our skin needs a thin layer of oil to protect it from irritation, which can cause inflammation and a burst of excess oil production. When the skin produces a normal amount of oil, this oil is usually a good thing.
However, oil production and p. acnes bacteria aren’t much help if the skin is inflamed. Inflammation causes the skin to swell slightly, forcing the pores to constrict, trapping oil, dead skin cells, and sometimes p. acnes bacteria. Oil and dead skin cells cause blackheads and whiteheads when trapped in a pore, and if p. acnes get trapped as well, a pimple or cyst can form.
Adults usually get acne in the “U-zone.”
You may have heard of the “T-zone” in your teenage years because that is where most teens get the majority of their acne: the forehead and nose. Adults, on the other hand, get the majority of their acne in something called the U-zone: the cheeks, jawline, and chin.
This difference traces back to the shift in hormones from the teenage years to adulthood. Fluctuating hormones can lead to increased oil production, which clogs more pores and causes more acne. This oil is produced in sebaceous glands, which then release the oil through sebaceous filaments in the pores. The T-zone contains more sebaceous filaments than any other area of the body, so teenagers are particularly susceptible to T-zone acne.
Adults, on the other hand, are typically producing less oil, so the drier part of the face, the U-zone, gets even drier, and that can also lead to acne. Dry skin lacks that protective layer of oil that can actually be good for the skin, so it is very easily irritated. When the skin on your cheeks, jawline, and chin gets irritated, it tries to produce an extra burst of oil to protect itself, but it also triggers inflammation to protect itself, and what usually ends up happening is the extra oil gets trapped in an inflamed pore.
This is a very common problem for those with dry skin types, especially adults with dry skin. The best treatment for acne caused by dry skin is an intense, water-based moisturizer, like our signature Moisture Complex.
There are two main types of adult acne: persistent, and adult-onset.
Sometimes people have acne as an adolescent, and it just never seems to go away and continues into adulthood as well. This is called persistent adult acne. Other times, people have little to no acne in adolescence, only to suddenly start getting pimples in their 20s and 30s, which is known as adult-onset acne. Both types are still the same condition, and both can be hard to deal with emotionally. Getting acne out of the blue at age 30 can be confusing and make people feel like they’re doing something wrong, and continuing to have acne past the “normal” age can have the same effect.
But it doesn’t have to. The truth is, dermatologists are seeing more and more adults with acne, but researchers aren’t sure why. If your dad didn’t have acne in his 40s but you do, it doesn’t mean you’re doing anything incorrectly, it means that acne in adulthood is on the rise.
Persistent acne is by far the more common type of adult acne: around three-fourths of adults with acne also had acne in their teenage years. It is also far more common in men than it is in women. Persistent acne holds true to its name; it can be very difficult to get rid of for good. Studies also show that people with persistent acne show more significant symptoms, and women with persistent acne typically have worse flare-ups before their period. The other one-fourth who have adult-onset acne typically have less severe acne, and they are predominantly women. It’s important to note that people with either type of adult acne can achieve clear skin with the right treatment.
Adults typically have more inflammatory acne.
Regardless of whether your acne is adult-onset or persistent, most adults have more “inflammatory acne.” As we just learned, all acne is inflammatory, but some acne becomes more inflamed with time.
Blackheads and whiteheads are generated when mild inflammation causes pores to constrict, but no further inflammation occurs after they form. Pimples and cysts, on the other hand, generate their own inflammation after they form. Pimples start when the skin becomes inflamed and traps oil and p. acnes bacteria in a pore. Because p. acnes consume oil, their number can grow quite quickly when they are trapped in a pore with excess oil.
Once the bacteria grow to a sufficient number, the immune system takes notice and comes to shut down the infection. It does this by sending immune system cells to kill the bacterial cells, but it also triggers even more inflammation. That’s where pimples get the label “inflammatory acne,” because it involves even more inflammation after the initial inflammation that caused the acne in the first place.
This type of acne is more common amongst adults than with teenagers. This may be because blackheads and whiteheads are caused by excess oil, which is typically a bigger problem in the teenage years.
Adult acne usually results in more scarring.
Increased scarring in adults goes hand in hand with increased inflammation. This is because of how the body heals an inflamed wound. It might sound excessive, but inflamed acne does technically qualify as a “wound.”
Your body treats a pimple or cyst like any other infected wound, which means it sends extra melanin to speed the healing process. You may know melanin for one of its other purposes: depositing color. Even when your body sends melanin to heal, it deposits color as well. The longer it takes for a pimple or cyst to heal, the longer melanin stays and makes that particular area of skin a bit darker, and the longer the melanin is there, the darker the spot becomes. This is known as post-inflammatory hyperpigmentation, often just called hyperpigmentation for short.
Because adult skin doesn’t produce new skin cells as quickly as teenage skin, the cells affected by the melanin stick around longer and hyperpigmentation can take quite a while to fade. This is an especially prominent problem for Latinx and African skin types.
This is obviously a broad statement, seeing as how people from Latin America, Africa, or members of the African Diaspora have a vast array of skin types and skin colors. Generally, when studies refer to Latinx and African skin types, they mean particular skin types on the Fitzpatrick Skin Phenotype Scale. Skin that qualifies as a IV, V, or VI are also known as olive skin tones, brown skin tones, and deep brown/black skin tones. These skin types already have a significant amount of melanin in the skin cells, so additional melanin can take much longer to fade. Many people of color report that the hyperpigmentation following acne can be even more frustrating than the acne itself.
Latinx and African skin types typically have more acne in adulthood than other skin types.
If you have an olive, brown, or black skin tone, unfortunately you are more likely to have adult acne then those with medium, fair, or pale skin. This could be connected to the fact that people with dark skin tend to have more inflammatory acne and fewer blackheads and whiteheads at any age. Because most acne in adults is also inflammatory, people with dark skin may be predisposed to continued acne.
If you have acne as an adult, but it seems to be primarily located around your hairline or at your temples, you may be able to solve your acne problem by switching hair products. If you use a pomade or oil, it may be clogging the pores around your hairline and causing acne. To get rid of this particular kind of acne, commonly called pomade acne, try switching to a glycerin- or water-based pomade rather than an oil-based one. Look up the comedogenicity scale (a scale measuring how likely a substance is to clog pores) and avoid products that contain ingredients with a rating of 3 or higher.
Adult acne fades with age.
If you had acne as a teenager, adults probably told you it would fade when you got older. But here you are, 20 years later, and you still have acne. So you might be hesitant to trust us when we say adult acne fades too. Studies show that after age 20, the likelihood of having acne steadily goes down. 45% of women in their 20s have acne, but only 12% of women in their 40s have acne. If you’re in the 12%, it might be helpful to know that the percentage continues to drop, and there are definitely ways for you to get clear skin for good.
The best treatment for adult acne is a skin care system that treats the skin gently.
Because many of us believed our acne would fade when we grew up, and then it didn’t, treatment can feel a little hopeless. But it doesn’t have to be. It comes as no surprise to us that many typical acne treatment systems don’t work for adults—it’s a small miracle they work for teenagers. Many other acne companies use concentrations of ingredients that are far too high to be safe for the skin. These ingredients are meant to dry out the excess oil of the teenage years, but they usually just irritate the skin and cause more problems. This is particularly true for adults, who generally produce far less oil than teenagers. If you haven’t had luck with other products, they were probably too harsh for your skin. You need a gentle skin care system that can kill p. acnes, exfoliate the skin, and prevent inflammation without causing irritation.
At Exposed Skin Care, we are dedicated to truly healthy skin. All of our products contain responsible concentrations of both scientific ingredients and natural ingredients to provide a healthy balance of acne-fighting and skin-nurturing properties. We use benzoyl peroxide and tea tree oil to fight p. acnes bacteria, salicylic acid and glycolic acid to exfoliate the skin, and green tea extract and aloe vera to reduce inflammation and prevent irritation. You can get our 3-step system in our Basic Kit, can add a premium moisturizer with our Expanded Kit, or you can get our full suite of products with our Ultimate Kit.