Adult Acne Can Return at Any Age: Dermatologists Explain Why Breakouts Still Happen
Acne Can Start Later
Acne is often thought of as a teenage problem, but it can appear at many stages of life. Stephanie Criscione, a licensed esthetician and Face Reality education director, says a 35-year-old may need a different approach from a 15-year-old, even when their breakouts look alike.
One writer, who had been mostly acne-free as a teenager, began experiencing breakouts at 22. She used oral spironolactone and a Face Reality skin-care program to get them under control.
Hormones And Other Triggers
During puberty, hormonal changes can increase oil production, contributing to clogged follicles and inflammation. Teenage acne commonly includes blackheads, whiteheads and inflamed lesions, and may affect the face, chest and back.
In adulthood, oil production and inflammation can shift with menstrual cycles, pregnancy, starting or stopping contraceptives or other medications, and perimenopause. Susca also identifies stress, lifestyle, travel, genetics and an unsuitable skin-care routine as possible contributors; perimenopause can begin as early as the 30s.
Different Breakouts, Different Risks
Comedonal acne includes blackheads and whiteheads, which Criscione links to excess oil and dead skin cells. Susca says it can also appear as skin-colored bumps beneath the surface and is often associated with hormonal acne in teenagers and people in their early 20s.
Deep, hard and painful inflammatory lesions are described as nodular or cystic acne, and may carry a higher risk of scarring or pigmentation, Susca says. Dr. Lal notes that many lesions commonly called cysts are technically inflammatory nodules.
Treatment Should Fit The Skin
For teenagers, Dr. Lal says treatment often begins with a simple, consistent routine. Benzoyl peroxide may help inflammatory acne, while salicylic acid may be useful for clogged pores; more severe cases may need prescription therapies.
For people in their 40s and beyond, Dr. Lal emphasizes balancing effectiveness with tolerability because skin may be drier or more sensitive. Options may include a lower-strength retinoid, applying it less often or adding more supportive moisturizer.
Key points
- Acne can emerge or return well beyond the teenage years.
- Hormonal changes, stress, medications, genetics and skin-care habits may contribute to adult breakouts.
- Some adult acne is persistent or cyclical and may leave pigmentation or scars.
- Treatment choices can vary with age and skin sensitivity.