Why Your Acne Won't Go Away: Persistent Adult Acne Explained

One of the most common complaints I hear is, 'I'm an adult. Why do I still have acne?' Adult acne is increasingly common, affecting up to 50% of women and 25% of men in their 20s and 30s.

Unlike teenage acne, which is primarily driven by hormones and excess sebum production, adult acne often has multiple contributing factors.

Hormonal fluctuations are a major player, especially in women. Acne often worsens around menstrual cycles, during menopause, or with hormonal contraceptive changes. Polycystic ovary syndrome (PCOS) is another common culprit.

Stress is another significant factor. Cortisol elevation during stress increases sebum production and inflammation, triggering or worsening acne. Many of my adult patients notice their acne flares during stressful periods.

Diet can also play a role. While the relationship between diet and acne is complex, high-glycemic foods and dairy products may exacerbate acne in susceptible individuals.

Skincare habits matter too. Many adults use products that are too harsh or irritating, which can actually worsen acne. Over-treating the skin creates a compromised barrier, leading to more inflammation and breakouts.

Understanding your specific acne triggers is crucial for effective treatment. This might involve hormonal evaluation, dietary assessment, stress management, and appropriate skincare.

Treatment options for adult acne include topical retinoids, benzoyl peroxide, salicylic acid, oral antibiotics, hormonal contraceptives, spironolactone, or isotretinoin for severe cases.

In my practice, I take a comprehensive approach to adult acne, addressing not just the symptoms but the underlying causes. This often results in much better long-term outcomes than treating acne in isolation.