10 Reasons Why You Have Adult Acne and What You Can Do About It

Dr Justin Boey

"Doctor with interest in Aesthetics and Lasers"

“I have acne and I’m in my 30s. Is that even possible?”

Yes! It is possible to get acne even when you’ve reached adulthood. In fact, it is possible for you to not have acne during your teen years and then suddenly develop it during adulthood.

Read on to find out some of the causes of adult acne and how you can treat it.

What causes acne in adults?

There are a few reasons for having acne even as an adult:

1. Hormonal imbalance


Hormonal imbalance is one of the most common reasons for developing acne as an adult.

When you have fluctuating hormones or too much of them, acne may develop. This will also lead to:

  • pH imbalance
  • excessive oil production of sebum
  • skin inflammation

Unfortunately for the ladies, adult acne is especially common in women. Their hormones usually fluctuate during [1]:

  • pregnancy
  • menstruation — often during the first few early cycles and the post-partum period
  • breastfeeding
  • starting and stopping birth control pills

Hormonal adult acne usually forms on the lower part of the face, often around the jawline and on the cheeks.

This is unlike acne that forms during puberty, which occurs in the T-zone — nose, forehead and chin. Also, adult acne is often painful as it is deep and appears cyst-like.

2. Stress


When you are emotionally stressed, your body’s response is to create more hormones called androgens. These hormones stimulate the oil glands and hair follicles in our skin [2].

When you don’t clear your pores of the excess oil produced, it results in:

  • blackheads
  • whiteheads
  • acne.

When you are physically stressed, your immune system weakens, which then causes your skin to be easily inflamed.

Here are some conditions that may cause physical stress in your body:

  • allergies
  • lack of sleep
  • too hot/cold weather
  • dehydration

Apart from that, research has shown that those who have allergies are more prone to getting adult acne [3].

3. Genes


Genes can play a role in the development of acne. They can determine how easily your pores clog, i.e. you may have genes that cause you to produce a lot of dead skin cells, which then clog your pores.

If your family has a history of acne development, you will have a higher risk of it.

4. Hair and skincare products


Some of the products you use may clog your pores or make your skin more oily rather than moisturised. Therefore, choosing products that are non-comedogenic, non-acnegenic and oil-free might help to reduce acne from developing. When trying to prevent acne, make sure that the products are not prone to clog up the pores.

5. Makeup


Some of you may love to use and experiment with makeup products. However, some products can clog your pores and lead to acne if you’re not careful.

Acne caused by makeup is also known as “acne cosmetica” [4]. They typically look like little bumps that commonly develop on the face and neck. Additionally, using makeup to hide your existing pimples may also make them worse!

However, that’s not to say you can’t wear makeup when you have acne. You should look out for products that do not contain ingredients that clog your pores. Ingredients you may want to avoid include:

  • almond oil
  • acetylated lanolin
  • isopropyl palmitate
  • lauric acid
  • ethyhexyl palmitate

6. Certain medications


Unfortunately, while some of us do have to take medication, some medications have the side effect of causing acne. If you plan to stop your medication because it is causing acne, it is advisable to consult your doctor before you do so.

During your consultation, ask if the medication is actually the cause of the acne. Additionally, ask if there is any alternative medication you can take. Some of these medications may contain corticosteroids, testosterone or lithium.

7. Illness


Acne may be a symptom of an illness that you might have. If it is accompanied by other worrying symptoms such as irregular menstrual cycles and hair loss, you may have an endocrine disorder.

One of the most common endocrine disorders is polycystic ovary syndrome (PCOS).

8. Lifestyle


The type of lifestyle you lead may be one of the reasons why you have acne as an adult. As mentioned above, stress from a hectic work schedule can cause acne. Also, if your work is causing you to lose sleep, it could also make you more prone to developing acne.

Not getting enough quality sleep triggers the body to produce more cortisol. It causes oil production to increase, which in turn, leads to breakouts. In addition, a lack of sleep also doesn’t give your existing acne a chance to heal.

Poor hygiene after an intense workout may also contribute to acne as an adult. When you exercise, your body produces sweat. If you don’t wipe away the sweat with a clean towel, oil, dirt and sweat may clog your pores and lead to acne.

To avoid this, make sure you take a shower immediately after your workout and change into clean and dry clothes.

9. Diet


Your diet might be a reason for developing acne as an adult.

You may want to limit your intake of foods that may raise your insulin-like growth factor-1 (IGF-1) hormone. This hormone is believed to be responsible for increasing the production of oil in the skin [5]. Foods that may raise IGF-1 levels include:

  • high glycemic index (GI) foods
  • dairy products

Foods with high GIs commonly include:

  • bread
  • rice
  • potatoes
  • pasta

10. Tobacco use


Studies have shown that those who smoke are more likely to develop adult acne [6].

Treatments available for acne in adults

If your condition is persistent, it is better to consult a specialist. Fortunately, most types of acne can be cleared up with treatments such as:

  • topical acne cream
  • oral antibiotics
  • oral retinoids

Hormonal acne treatment

Listed below are a few treatment methods that may help with hormonal acne. Do remember to consult a dermatologist/doctor on what treatment option is most suitable for you.

1. Acne Creams

  • Benzoyl peroxide gel
  • Clindamycin gel
  • Clindoxyl
  • Retinoic acid
  • Epiduo

2. Oral Medicines

  • Antibiotics
  • Isotretinoin

3. Lasers

  • Cortisone injections
  • Chemical peels

Cystic acne treatment

Cystic acne is a less common and severe form of acne. It mostly occurs on the chin, cheeks and forehead. As cystic acne tends to be severe, you may want to consult a dermatologist/doctor for help.

Over-the-counter medication may not be as effective as medical-grade treatments that can be obtained only when prescribed by a doctor.

Treatment for cystic acne may include [7]:

  • Benzoyl peroxide
  • Isotretinoin
  • Steroid injections


Developing acne as an adult is something that happens to many of us. Whether you should seek treatment depends on whether or not your acne is bothersome to you. Consult a dermatologist/doctor so that he or she may assess what is causing your acne. They will then determine what treatment options will work best for you.

Dr Justin Boey is a medical doctor with Sozo Aesthetic Clinic. Dr Boey has a special interest in facial aesthetics relating to pigmentation, acne scars and facelifts, as well as hair loss.

Read more from Dr Justin Boey in his Q&A here. 



1. Soares CN, Zitek B. Reproductive hormone sensitivity and risk for depression across the female life cycle: a continuum of vulnerability? Journal of psychiatry & neuroscience : JPN. 2008;33(4):331-343. Accessed January 13, 2020.

2. Zari S, Alrahmani D. The association between stress and acne among female medical students in Jeddah, Saudi Arabia. Clinical, Cosmetic and Investigational Dermatology. 2017;Volume 10:503-506. doi:10.2147/ccid.s148499

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All content posted is for general informational purposes only and is not a substitute for professional medical advice. This Q&A is not a patient consultation and any information provided herein is not intended to replace consultation with a qualified medical professional. If you think you may have a medical emergency, call your doctor immediately. Always seek the advice of your doctor before starting or changing treatment.

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