It can be disheartening to get regular pimples in your twenties, thirties, and beyond – especially if you thought your spot-popping days were behind you.
It might just be a breakout. But it could also be adult onset acne.
In this article, you’ll find out what adult onset acne is and its four common signs. And we explain how you can treat it using over-the-counter remedies and prescription medication.
What is Adult Onset Acne?
Getting acne in adulthood is known as adult-onset acne.
Adult onset acne is hormonal. It tends to appear more severely in targeted areas such as the jawline, lower face and back. This is unlike teenage acne, which is caused mostly by excess oil in the glands and is more widespread – typically appearing on the face, back, chest and shoulders.
It’s more common in women than men. One French study found that up to 40% of adult women suffer from persistent breakouts. But adult acne can affect both genders.
Is My Breakout Adult Acne? 4 Key Signs
Adult acne is classed as acne that affects someone past the age of adolescence and is persistent.
There are ways to tell apart adult acne from the odd breakout. Here are four common signs you have adult acne:
- You Had Acne as a Teenager: The majority of adult acne sufferers will have had acne symptoms in their youth, which have either continued into adulthood or flared up years later. So if you had acne in your teens, it may be that your pimples are more than just random breakouts.
- You Have a Relative with Adult Acne: Almost half of adult acne patients will have at least one first-degree relative who’s had adult acne. Your chances of getting acne are higher if you have a family history.
- You See a Pattern of Occurrence: Adult acne is hormonal in the majority of cases, so it will peak at times where there is high hormonal activity. E.g. just before your period or at times of high stress. When you’re stressed, your adrenal gland produces the stress hormone cortisol, while releasing testosterone. For women, this hormone can drive the oil glands to produce more oil.
- You Have Other Symptoms of Hormonal Imbalance: Our bodies are complex. Therefore, most cases of adult acne are a symptom of other underlying conditions. One of these is Polycystic Ovary Syndrome (PCOS). Symptoms include excessive facial and bodily hair, irregular periods and fertility problems.
In rare cases, adult acne can signal more serious conditions. So it’s best to visit your GP if your adult acne is persistent.
What Treatments Are Available for Adult Acne?
There are a variety of treatments available for adult acne. How effective these treatments are will depend on the severity of the acne, skin sensitivity, past medical history, and previous experiences with acne treatments.
Some acne treatments which worked well on your oily teenage skin might actually be drying or irritating on your adult skin.
Here’s a list of the most common treatments for adult acne. They include home and over-the-counter treatments, prescription treatments, and oral contraceptives and anti-androgen therapy.
See our range of acne treatments
Home and Over-the-Counter Remedies
For milder cases of adult acne, there are a number of over-the-counter acne remedies you can pick up from your local pharmacy or from beauty stores in the skincare section. Some of the most potent and successful remedies will contain one of the following:
- Salicylic Acid: This is mild enough to use all over the face and general body areas, and is readily available in cleansers, toners and acne-targeted treatments.
- Benzoyl Peroxide: This is available over the counter in a variety of concentrations, usually 5% or 10%. However, it’s quite drying and is usually recommended only for spot treating to avoid dry, irritated or flaky skin.
- Retinol: A vitamin-A derivative usually found in anti-ageing products. However it’s a great ingredient for treating adult acne. Particularly for people with mature skin types, who may find other acne treatments harsh or irritating.
These ingredients will help to unclog pores or dry out existing spots, so are good for spot treating. However, they won’t necessarily prevent hormonal acne or treat it completely from the source.
Prescription Treatments
In some cases, your GP may recommend you try something stronger than over-the-counter options.
Topical treatments include a higher concentration of:
- Benzoyl peroxide: Duac Gel is an example of Benzoyl Peroxide combined with an antibiotic for clearing up adult acne. It’s available via our online doctor service, so no need to book a GP appointment just for a prescription.
- Azelaic acid: Azelaic acid reduces the growth of the keratin surface skin cells that can block pores. This helps to unblock the pores and sebaceous glands (glands which secrete sebum). As a result, the sebum can escape. This reduces the formation of blackheads and spots.
- Topical retinoid: Topical retinoids such as adapalene are a commonly prescribed form of adult acne treatment. Differin is an effective topical treatment which takes 4-6 weeks to see results. It’s available directly via our online doctor service.
These are usually enough to treat mild to moderate adult acne. However, if your acne is more serious, a doctor might recommended you combine a topical treatment with an oral antibiotic such as isotretinoin. This has a high success rate in reducing adult acne with a low risk of serious side effects.
Take an assessment to order Differin Gel Online from £24.95
Oral Contraceptives and Anti-Androgen Therapy
There are a few oral contraceptives which can help to regulate hormones and reduce the occurrence of adult acne. Contraceptives used for acne treatment contain ethinylestradiol and either drospirenon or norgestimate.
Together, these ingredients target the hormones that can contribute to acne. This can be especially helpful during peaks in hormones, such as during ovulation.
However oral contraceptives may not be an option for you if you have a history of blood clots, high blood pressure, or breast cancer. You also shouldn’t take these if you smoke.
Anti-androgen drugs are also an option. While androgens are present in males and females, females with high levels may end up with high levels of sebum, leading to hormonal acne.
The anti-androgen drug spironolactone is sometimes prescribed in cases where high androgen levels are causing the acne, alongside other side effects of high androgen levels.
Key Takeaways
- Adult onset acne primarily affects women and can be triggered by hormonal changes, stress, or genetics.
- The main indicators include having a history of acne in adolescence, a family member with adult acne, breakouts that follow a hormonal pattern (like during stress or menstruation), and other symptoms of hormonal imbalance (such as PCOS).
- Over-the-counter treatments like salicylic acid, benzoyl peroxide, and retinol can help with mild acne. However, persistent cases may require prescription medications such as Duac Gel, azelaic acid, or topical retinoids.
- In cases of severe acne, a doctor may prescribe hormonal treatments like certain birth control pills or anti-androgen therapy (e.g. spironolactone) to target the hormonal causes. However, these are not suitable for everyone due to potential side effects.
