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What Causes Adult Acne?

The lower half of a woman's face has adult acne on the chin and cheek.

Most of us can relate. You wake up in the morning to see a giant, inflamed zit calling for attention on your face. Where did this pesky pimple come from? And why are you still getting acne as an adult?

As it turns out, it’s common for people to experience adult acne. Several factors can lead to these annoying breakouts, so we talked with skincare experts about how adult acne happens and how to get your breakouts under control.

What Causes Adult Acne?

A woman examines a pimple on her lower chin.

“At the most basic level, acne is caused by inflammation in the skin,” said Dr. Joshua Zeichner MD, the Director of Cosmetic & Clinical Research in Dermatology at Mount Sinai Hospital in New York City.

A build-up of excess oil, dirt, and bacteria can clog up pores on your skin, leading to inflammation. Sometimes, simply cleansing or exfoliating your face can clear up your clogged pores. Other times, however, additional factors might create inflammation in your body, causing these annoying breakouts to occur.

When it comes to those causes, here’s what the experts had to say:


“Just as hormonal changes can trigger the onset of acne during puberty, hormonal shifts later in life can cause imbalances that set the stage for breakouts, even if you’ve never had acne before,” said Desiree Stordahl, Paula’s Choice Director of Applied Research and Education.

Hormonal fluctuations can increase the amount of sebum your body produces. Sebum is the waxy, oily substance made in your sebaceous glands that protects and hydrates your skin. Too much sebum, however, can lead to oily skin, clogging up your pores and resulting in those pesky pimples.

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For women, hormonal changes can occur around your period, during menopause, going on or off birth control, or if you’re pregnant. However, hormonal imbalances can also affect men. Testosterone levels can start to rise, produce more sebum, and trigger acne.


“The same hormones that prepare our bodies for the flight or fight response also activate our sebaceous glands,” Dr. Zeichner said.

Cortisol is the hormone that alerts our body when we’re feeling stressed. It partners with your brain to control your mood, regulate your blood pressure, and boost your energy. But too much cortisol can lead to an increase in sebum, triggering your acne breakout.

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“Stress acne is a real phenomenon where there is extra oil and inflammation as a result of stress hormones,” said Dr. Zeichner.

In other words, when you feel stressed, your body creates extra cortisol to combat your stressful situation. This increases the oil production on your skin, clogging up your pores and producing acne.


For some people, diet can largely factor into their breakouts.

Dr. Zeichner noted that foods with a high glycemic index can cause acne, such as white bread, crackers, and sweet treats. Dairy could also cause acne, but varying research has no conclusive evidence at this point.

Over the years, studies have led to mixed results, making this topic highly debatable. But, if your body struggles to digest certain foods, your stress hormones could trigger the excess oil that leads to acne.

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“You can also discuss the link between diet and acne with your doctor,” Stordahl said. “Some people find reducing or eliminating certain food types such as wheat, shellfish, sugar, or dairy improves their skin to a noticeable degree.”

When it comes to acne, clogged pores are one of the main culprits. Hormones, stress, and diet can play into excess oil clogging your pores.

How Do You Treat Adult Acne?

People hold up different bottles of skin care products.
Orawan Pattarawimonchai/Shutterstock.com

While the causes of adult acne might be difficult to narrow down, both experts agree there are several tactics to help combat it.

First, start with essential ingredients you can add to your skincare to help clear up your complexion. Of course, you can also partner with a board-certified dermatologist to help. As for those ingredients, our experts recommend:

Benzoyl Peroxide

Benzoyl peroxide is a common ingredient used to treat acne. It reduces bacteria and inflammation and helps decrease those bumpy, red pimples.

You can purchase it in over-the-counter formulas or in prescription products. If you have sensitive skin, start with a lower dose. Stordahl recommended beginning with a 2.5% concentration, like Paula’s Choice Clearing Treatment. She suggests moving up to 5% if you need a stronger dose.

Salicylic Acid

Salicylic acid exfoliates the skin and removes dead skin cells and excess oil. This ingredient helps keep your pores clean and clear.

“This is a game changer for anyone with acne-prone skin,” Stordahl added. “It offers additional benefits, including smoothing skin’s texture and enhancing your complexion’s natural glow by removing built-up, dead skin on the surface.”

She also noted that salicylic acid is anti-inflammatory. It can soothe active pimples and treat redness associated with acne. She recommended Paula’s Choice Anti-Redness Exfoliating Solution with 2% salicylic acid.

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Topical Retinoids

Topical retinoids create new skin cells that push the dead skin and excess oil from clogged pores. They’re also anti-inflammatory and prevent excess oil growth.

“Topical retinoids, like Adapalene, normalize cell turnover and prevent skin cells from sticking together and blocking the pores,” said Dr. Zeichner. “I like to think of them like pipe cleaners.”

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Oral Medications

Sometimes, medications are the best way to treat your acne, specifically if your hormones trigger excess oil.

“You can speak to your dermatologist about options like oral contraceptive pills or spironolactone, which help balance the impact of hormones on the skin,” Dr. Zeichner said.

These medications decrease excess sebum production in your body, eliminating those annoying breakouts.

How Can You Prevent Adult Acne?

A woman examines her skin the mirror for adult acne.

Both experts agree that the best way to prevent adult acne is by washing your face every day. Additionally, Dr. Zeichner mentioned cleaning your entire face—not just where the pimple currently resides.

“Your face is made up of thousands of pores,” he said. “We can’t predict which one will become clogged enough to lead to a pimple. So, rather than playing catch-up after you have a pimple, prevent the pimple from occurring.”

Both experts also suggested minimizing your stress and maintaining a well-balanced diet to help keep acne at bay.

If you struggle with adult acne, there are ways to combat it. From stress management to dietary changes to your skin care routine, if you want to eliminate breakouts, you’ve got options.

Kelsey Opel Kelsey Opel
Kelsey Opel is a freelance writer and digital storyteller based in Austin, Texas. She enjoys writing for food, entertainment and mental health spaces. Off the clock, she loves indulging in an avocado margarita and chips and queso at her favorite Tex-Mex spot in town. Read Full Bio »
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