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Stage 3 acne with hypertrophic scar and redness from macular acne scars

How to treat adult acne (plus learn what causes it to begin with)

Editorial note: an earlier version of this article was first published on October 20, 2011. It was updated on August 27, 2020.

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Adult acne is just as terrible as teen acne. However, it can be more painful – literally. Adult acne is more likely to be cystic, which leads to sore bumps under the skin that can’t be popped, even if you wanted to do so (though you shouldn’t!).

Severe acne is something we treat at our Surrey, B.C. skin care clinic – both with and without lasers. So, in this article we wanted to share some tips on how to treat adult acne, and how to find out what causes it in you, to begin with.

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Is adult acne different from teen acne?

The answer to this is: yes and no. The underlying mechanism of acne is not different from age to age. Meaning: excess oil (sebum) production clogs your pores, where skin and bacteria get trapped, thus forming a pus-filled pimple. Pimples are an inflammatory response, and are basically infections, which your body wants to heal. A pimple can be of various kinds: open comedones (blackheads), closed comedones (whiteheads), pustules, papules, nodules and cysts.

types of acne diagram for Surrey acne solutions page

You can learn more about what causes acne, in detail, here.

The thing that makes post-adolescent acne different is the underlying reason the body ramps up sebum production, which then leads to acne. This is usually related to an imbalance of hormones in the body (outside of puberty, of course). Hormones can signal your skin to start making more oil.

And, as you may have guessed, adult acne affects women far more than men. This is due to the many life changes that many women go through, which affect their hormones. Puberty, taking birth control, going off birth control, pregnancy, childbirth, perimenopause, menopause – it can all affect acne. That’s not even getting into polycystic ovarian syndrome (PCOS), diet, and just ‘regular’ health issues that can come and go.

Up to 25% of women in their 40s can still suffer from acne – whether severe or not. That’s a long time to live with this condition!

Someone can even have a clear complexion in their teens, and then suddenly suffer from acne in their 20s and 30s. This is called adult-onset acne.

While hormones are not the only factor at play with adult acne, they are usually the core culprit. They are certainly a first-look item. So, even if diet and cleansing routines help, the need for those actions can be rooted in hormone activity (or lack thereof). Medications can also disrupt hormones, which can lead to acne.

If you notice other signs of hormonal imbalance in your life, such as hair loss or growth (anywhere), rapid weight loss or gain, irregular menstruation, fatigue or depression – these all could be signaling the root cause of your acne, too.

Another key ‘trick’ to identifying hormonal acne, is to note where it is located on the face and body. If it is happening on the lower part of the face, below the eyes, and downwards (including the chest and back), this is a sign that it is related to hormones. If it is painful, deep and cystic, this could also indicate hormone problems.

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How can adult acne be treated at home?

There are many ways to go about treating adult acne. One way is to start with what you can do at home. This can narrow down any ‘big’ medical issues that may be at play (or not). When a doctor knows what you’ve tried (seriously – with all your might), and what you haven’t, they can more easily lead you down a path to healing. If you haven’t ‘tried it all,’ you will likely be sent home with a list of basic steps to kickstart your acne treatment journey.

Of course, we say the above by assuming that acne is your only symptom. If your health is adversely affected in other ways, a doctor should be doing more tests to treat those other symptoms too.

For that reason, it’s good to see a doctor early on, when you first start noticing outbreaks that won’t go away. Hopefully, your condition can be put to a head sooner, leading to less suffering, and less severe acne down the road.

Below are the typical basics you’ll likely be asked to try, to get rid of adult acne:

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Practice smart acne hygiene

Woman at home performing skin care routine for skin health and youthfulness

Yes, you should wash your face twice, daily, with a very good acne cleanser. However, you don’t want to over-dry your skin, nor do you want to over-exfoliate.

Your skin should not be dry; some oil is needed for it to function. Part of that function is to be able to heal the pimples you have – let’s not forget that. Plus, if your skin becomes too dry, this could also signal your pores to create more sebum, which can lead to more acne.

For a proper cleaning and moisturizing routine, follow our steps at the following article:

In addition, be sure not to touch your face. You may be transferring bacteria or dirt, which can further exacerbate the issue. If you have the temptation to squeeze or pop your pimples, don’t! This could lead to scarring, which can be permanent.

If you work out, be sure to cleanse your skin immediately afterwards. Don’t let your face touch exercise mats, and always use a clean towel to wipe away your sweat. Keep phones away from your face, too.

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Use the right skin care products

All Calm redness skin care by Colorescience with mineral tinted SPF

The products you use can play a big part in whether or not you experience adult breakouts, and even how quickly you heal from them.

Firstly, be sure to look for oil-free, non-comedogenic, or non-acnegenic products. This also applies to makeup. Don’t assume that if you use non-comedogenic moisturizer, that you can top it off with clogging makeup to cover your redness. Mineral makeup is best for acne-prone skin, but even that should be made of quality ingredients.

Also note that hair products can also cause breakouts. So, you may need to switch out your shampoo, conditioner, hair spray, gels, etc.

When you have narrowed down your skin care products to the ‘no-breakouts’ kind, you’ll also want to look for the following ingredients, which can be real acne helpers and calmers:

For exfoliation and oil reduction:

  • Salicylic acid
  • Benzoyl peroxide (also a bacteria killer – use sparingly)
  • Glycolic acid
  • Lactic acid
  • Azelaic acid
  • Sulfur
  • Gluconolactone
  • Lactobionic acid
  • Retinoids (Vitamin A derivatives including retinol, retinaldehyde, retinoic acid, etc.)
  • Tea tree oil

For antioxidants, oil regulation and healing:

  • Niacinamide
  • Zinc
  • Vitamin A
  • Collagen and collagen-boosters (peptides, growth factors, etc.)

For hydration:

  • Aloe vera
  • Hyaluronic acid
  • Panthenol (pro-vitamin B5)
  • Cetyl alcohol
  • Stearyl alcohol
  • Squalane
  • Rose water

For calming redness and post inflammatory hyperpigmentation (dark spots):

  • Zinc
  • Liquorice
  • Niacinamide
  • Hydroquinone
  • Green tea
  • Oatmeal
  • Centella asiatica

And more. The above items are not meant to be comprehensive, but only a guide.

However, even if you use products that contain the above ingredients, you still want to be sure they are not drying out your skin to an excessive degree, by virtue of what else is in them.

Try from our shop:

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Use sunscreen daily to prevent further skin damage

Colorescience Sunforgettable brush on sunscreen being applied on face

Along with your arsenal of non-comedogenic skin care, please don’t forget to apply sunscreen daily. Then, reapply every two hours for full protection. Whether it’s sunny or cloudy outside, sunscreen protects against UV rays that damage skin cells through free radicals.

When you have sore, open skin from acne, UV exposure can lead to dryness and more scarring. The dryness itself can also increase oil production. Retinols and other exfoliants can leave you extra sensitive to sun damage.

Overall, these factors can also prevent your skin from being able to heal, since it will be working ‘overtime’ to try to address dryness and free radicals.

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See related on our blog:

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Eat acne-fighting foods, while avoiding common acne-causing foods

It’s possible that foods you eat could be leading to acne breakouts. Ultimately, a test will be needed to determine what your dietary acne triggers are. However, research can give us plenty of clues, which are good places to start. If you can’t afford a food intolerance test, an elimination diet can reveal a lot, too. Sometimes, an elimination diet is the only way to really narrow down your ‘food vs health’ list of things to eat, or not. And that goes for other health issues too, not just acne.

Before we list common adult acne food triggers, we will ask that any dietary change you make is done in a responsible way. Speak to a dietitian or doctor first. Whether for acne or not, there are a lot of diets fads on the internet; don’t let these be your only guide. They may not be right for you, even if they were right for someone else.

Here goes…

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Common foods that cause acne by affecting hormones

  • Foods with a high glycemic index. These are sugars and simple carbohydrates (this is where your chocolate, pizza and other popular culprits come into play, but it also includes white pasta pasta, white bread and white rice). These sugars boost an insulin-like growth factor in your body, which is a hormone (surprise, surprise!).
  • Dairy, especially low-fat dairy. Low fat dairy is thought to have more sugar, and more progesterone-style hormones, than full-fat milk. This could be why it leads to acne in some people.
  • Saturated and trans fats (including red meat).

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Foods that are believed to help reduce acne

  • Fresh fruits and vegetables.
  • Foods high in zinc (turkey, beef, seafood, lentils, cashews, pumpkin seeds).
  • Foods high in vitamins A and E.
  • Omega-3 fatty acids. This includes fish and eggs, especially if they contain Docosahexaenoic acid (DHA), which can balance the effects of sugar intake on acne.
  • Whole grains.

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Reduce stress; it can cause acne by messing with your hormones!

A major health-deteriorating factor that is often overlooked is stress. Many people can get ‘busy’ with life, not realizing the toll that stress is taking on their body, physically. It’s not just in the mind! Stress leads to many other health problems.

When it comes to acne, stress affects your adrenal glands, which are responsible for a hormone called cortisol. Cortisol is the ‘stress hormone.’ When it is not regulated, it starts to affect immunity, among other things. Your skin can take a part of the brunt in this immune response.

Stress affects the balancing of other hormones too, which can trigger oil production. These include testosterone, oestrogen and progesterone.

Be it through meditation, exercise, counselling or otherwise, try your best to ‘let go’ of the stress that you’re bearing.

The catch-22 here is that severe adult acne, in itself, is extremely stressful to live through…We get it; it can take over everything. Your entire mood, your relationships, your willingness to go outside… All we can say for these cases, is to have a good human support system in place while you go through this journey. Seek a doctor’s help, and don’t give up!

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What can be done for adult acne by professional treatment?

If you have tried a new skincare routine and made appropriate lifestyle changes, but still don’t see results, it may be time to seek professional treatment for adult acne. That said, you don’t need to wait months and months after your adult acne breakout to see a doctor or hormone specialist. It’s ok to get their advice early on, to guide your at-home practices.

Professional treatments for adult acne can be hard on your body, not to mention more costly than the above steps you can take at home. However, they can be totally worth it. Not only can they relieve you of the pain that comes with cystic acne, they can release you of the stress that is caused by the acne itself!

Of course, you should see a doctor to learn about all the options that apply to you. However, common pathways to treating adult acne are listed below.

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Prescription medications

Prescriptions for acne can aim to target the skin’s activity, or hormonal activity – either of which can affect acne. These include:

Oral medications like:

  • Birth control pills – some are designed specifically for acne, and all of them help to regulate hormone cycles.
  • Spironolactone – this was originally made for high blood pressure, though it can be an androgen blocker, too.
  • Isotretinoin – a vitamin A derivative sold under the brand name, Accutane. This is a serious drug that should only be taken in extreme cases.
  • Antibiotics.

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Topical medications like:

  • Tretinoin – sold under the brand name, Retin-A.
  • Adapalene – sold under the brand name, Differin.

And others.

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Laser treatments (photodynamic therapy)

er yag laser treatment in surrey for skin tag or mole removal

Some lasers can help with skin rejuvenation and acne treatments. More often, they help with scarring related to cystic acne. At our clinic, we offer:

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Hot microneedling and other facials

Lutronic Infini RF microneedling hand piece in surrey

Other routine facials and facial procedures can help to keep acne infections under control, by keeping the skin healthy. These can include hot microneedling (better for scars), and pore exfoliation techniques. At our clinic we offer:

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Chemical peels

Dark activated charcoal carbon peel applied by a professional in a clinical office - available in Surrey near Vancouver

These should be done in-office, by professionals. Learn about chemical peels at the following links on our site:

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Cortisone injections

Injection of cystic acne nodule with steroid to reduce inflammation and prevent acne scarring

If you get big, painful cystic acne that can not be released any other way, cortisone injections may help to reduce them. These injections require that you come into a doctor’s office. So, they are not that practical.

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Other medical practices relating to hormones and diet

doctor lab coat arms crossed no face showing

Of course, if your adult acne problem is primarily hormonal, other types of doctors and health practitioners will need to be involved. Specialist appointments may be recommended. Be it to see an endocrinologist, a functional medicine practitioner, a dietician, or otherwise, getting to the root of your problem will also be important.

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Adult acne is treatable, but it takes patience

In conclusion, we’ll note that adult acne can require a long road to healing. It can feel like a mystery, especially when it starts later in life. If it persists from teenhood, it can be worth exploring treatments you may not have pursued earlier. Whether you choose an ‘all natural’ or medicated route, there is likely a solution to your adult acne out there, somewhere.

When you seek help, keep your options open. It can be frustrating to try one thing after another, and feel like nothing works, or that no one is listening. These days, however, treatment options can reach further than ever before. That’s because doctors and health practitioners can give online consultations, and then refer you to local services if you need them (such as for laser treatments). So, don’t give up! Your adult acne can be addressed!

If you live in the Vancouver area, we’d be happy to have you come in for a consultation regarding your teen or adult acne. If you live outside the area, we can also perform virtual consultations. Contact us to get started, and we’ll reply as soon as possible!

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