Today, let’s talk about the key ways acne changes as you get older.

There are lots of things from our teenage years that we eventually outgrow—misguided hairstyles, lowrise jeans, unrequited crushes (if we’re lucky).

Unfortunately, for many of us, acne isn’t one of those things. 

There’s a myth that acne is something most people leave behind in adolescence, but the reality is, many adults continue to experience breakouts well into their twenties, thirties, and beyond. 

But why is adult acne so common? Are there ways it’s different from teen acne? Does acne have different causes or treatments depending on how old we are? (Hint: The answers have a lot to do with another thing we’ll never outgrow: hormones. )

Let’s take a closer look at acne, where it comes from when we’re teenagers, why it keeps showing up even after we’ve grown up, and what can be done about it.

Where Does Adult Acne Come From?  

Let’s get one thing straight right off the bat: the physiological process that creates acne is the same no matter how old you are. 

Pimples occur when your skin’s pores—small holes that connect to oil-producing sebaceous glands, which help keep your skin hydrated—get clogged with dead skin cells, bacteria, and excess oil. The clogged pore swells up, resulting in pimples.  

While this process stays the same, what changes is your body’s hormones, which affect the sebaceous glands’ oil production at different points throughout your life. 

Why Do Teenagers Get Acne? 

If we’re going to talk about how hormones affect oil production, it’s helpful to start with the time when your body is supercharged with them, which is, you guessed it, during puberty. 

Puberty isn’t just about physical growth. The body undergoes enormous hormonal changes during this time, including a major increase in the production of androgens, or sex hormones.

Testosterone and progesterone in men and women are among the hormones that most directly affect sebum production – that’s the oil your skin makes, the one that can sometimes make your skin look shiny. This increase in androgens during puberty means your sebaceous glands are working overtime, producing excess amounts of oil and leaving your pores even more vulnerable to clogging than usual. 

That’s why you have more acne as a teenager: your body is primed for it.

So Then, Why Do Adults Get Acne? 

Here’s where things get more complicated. While it’s true that sex hormone production stabilizes as we exit puberty, our bodies don’t stop changing just because we turned eighteen. We can trigger hormone fluctuations that in turn trigger acne. 

Here are a few things that affect hormone production in adults.

High-Glycemic Diets

All foods contain nutrients that affect hormone levels. Foods that raise your blood sugar, like white bread, soda, or pastries, release all the same hormones that increase sebum production. Changes to your diet can help mitigate these risks. 

Pregnancy or Menstruation

Women can experience acne during either or both of these hormonal events. Androgens, as well as estrogen, insulin, and pituitary hormones all affect the sebaceous glands. For a more detailed list, check out this study from 2016.

Chronic Stress

Studies have shown that if you’re prone to acne already, stress can make it worse. Among other effects, stress can release cortisol, which impacts your skin’s oil production. 

Family History

A 2018 study of more than 1,100 patients showed that a family history of adult acne is one of the main risk factors of adult acne. 

Choosing the Wrong Products

Unfortunately, there are a whole host of products on the market that do more harm than good to your acne situation.  Finding a gentle cleanser or moisturizer can go a long way toward keeping those pores clean. 

And It’s Not All Hormones

While hormones alone make up a lot of the reason behind teen acne, bacterial overgrowth and microbiome imbalances on the skin and especially in the gut – which can also affect your hormones – are major contributors to adult acne. 

Diet can affect sebum production but can also boost inflammation-causing bacteria, making acne more difficult to beat. That’s why we highly recommend incorporating acne-fighting products rich with pre- and probiotics that get to the root of acne by reducing your body’s count of acne-causing bad bacteria. 

When Should People With Adult Acne See A Doctor?

It’s important to note that acne is a side effect of some medications, including corticosteroids, anabolic steroids, and lithium. If you’ve recently started a new medication and are experiencing sudden breakouts, talk to your doctor about other options. 

Acne can also be a sign of an underlying medical condition. Harvard Medical School says to watch out for things like rapid weight gain or loss paired with acne, as well as irregular menstrual cycles or sudden hair loss. Let your doctor know if you’re experiencing additional symptoms. 

Adult Acne Can Be Defeated

 In short, adult acne can be a real pain. It can feel like you’re battling something that you’re supposed to be past by now. But the reality is, many, many people suffer from breakouts way past their teen years. And it looks and feels different, which can be frustrating – the causes change and so do the types of zits you get and locations of those zits, for many people. 

Take a look at these causes of adult acne to see if there’s anything you can do to make a change – and consider adding a skin-friendly probiotic into your skincare routine.