What Causes Adult Acne?

You May Not Have Left Breakouts Behind With Puberty

Woman cleansing her face
Photo: David De Lossy / Getty Images

You'd have thought that by your age you would have outgrown acne. So why are you breaking out now? The fact is that acne can happen in both adult men and women, it's not something reserved for teenagers.

Acne is the most common skin disorder in the United States, but what causes acne during adulthood? If you thought you left skin problems behind in high school but find yourself dealing with pimples, exploring the possible causes may help you find a solution.

Hormonal Factors

Just like during your teen years and the changes associated with puberty, fluctuating hormones can cause acne flare-ups.

Androgens are hormones released by the adrenal glands, the ovaries, and the testes. These hormones stimulate the sebaceous glands, also known as oil glands, increasing oil production and creating skin that is more prone to pore blockages and breakouts.

Adult-onset acne affects about 12 percent of women, primarily because women are more "hormonal" than men. Sharp hormonal fluctuations occur during ovulation and menstruation, pregnancy, perimenopause, and menopause, and can also be caused by using certain birth control medications. Women may see their acne suddenly develop or worsen during these periods of life.

Adult acne may strike women at a greater rate than men, but that doesn't mean men are immune to acne. For the guys, acne usually starts in the teen years and then lingers into adulthood.

Young men tend to have more severe and longer lasting acne than young women. This is primarily due to the higher levels of testosterone within the body. It is not uncommon for acne in men to last 10 years or more, if left untreated.

Your Cosmetics

If you suffer from adult-onset acne, you may want to take a closer look at your cosmetics.

This includes cleansers, moisturizers, makeup, and hair care products.

Certain products, especially those with an oil-base, can block pores and create an impaction within the follicle. This blockage is called a comedo, and it's the very beginning of a pimple.

Comedones (the plural of comedo) are non-inflamed acne blemishes and look like little bumps or blackheads on the skin. When these blemishes become inflamed, your typical pimple is formed.

To keep pore blockages from forming, try to avoid oily skin care products, and use only those marked as noncomedogenic. Be aware, however, that even noncomedogenic products can trigger an acne breakout.

Medications and Medical Conditions

Sometimes, adult acne can be a symptom of an underlying problem, like polycystic ovary disease (PCOS). For this reason, if you experience other symptoms such as increased hair growth and weight gain, in addition to acne, you should talk to your doctor.

The use of steroids, certain birth control treatments, hormone therapies, and other medications can also cause acne breakouts. Again, talk to your doctor if you believe your prescription medications are triggering or worsening your acne.


Acne tends to run in families.

If one of your parents had acne at any point in their lives, your chance of hitting the adult acne "jackpot" is higher. And, while it may seem obvious, adults with oily skin types are more likely to get blackheads and blemishes. Skin type is hereditary as well.

What You Can Do

Adult acne can be frustrating, but don't give up hope. Nearly every case of adult-onset acne can be successfully controlled with the right treatment

Mild breakouts can usually be cleared with over-the-counter (OTC) acne treatments. But, be prepared, adult acne can be stubbornYou very likely will need help from a dermatologist to get your adult breakouts under control.

A Word From Verywell

By understanding some of the potential causes of adult acne, you can begin to be proactive about treating and preventing it. Keep in mind that it does take time for acne to clear up after starting a new treatment, so do your best to be both patient and persistent. Also, if you have any questions, talk to your dermatologist about stronger options if OTC treatments are showing no improvement.


Del Rosso JQ, et al. Status Report From the American Acne & Rosacea Society on Medical Management of Acne in Adult Women, Part 1: Overview, Clinical Characteristics, and Laboratory Evaluation. Cutis. 2015;96(4):236-41.

Tanghetti EA, et. al. Understanding the Burden of Adult Female Acne. The Journal of Clinical and Aesthetic Dermatology. 2014;7(2):22–30.

Zaelnglein AL, et al. More From the Acne Guideline. American Academy of Dermatology. 2016.