Red, bumpy skin plagued you throughout your teens-and just when you thought those pesky zits were gone for good, they’ve come back to haunt you well beyond puberty.
While adult acne is incredibly annoying, it’s pretty common well into your 30s, 40s, and even 50s, especially if you’re a woman, according to the American Academy of Dermatology (AAD).
In fact, some research has found that adult acne has plagued up to 45 percent of women aged 21 to 30, 26 percent of women 31 to 40, and 12 percent of women 41 to 50.
The frustrating part? Reaching for the face wash the helped you fight zits 10 or 15 years ago may not do anything at all or even make your complexion worse, since your skin naturally loses moisture as you age.
To truly get to the root of the problem, you need to figure out what’s triggering your bumps in the first place. But what causes adult acne, exactly? A variety of factors-from your diet to your hormones to your daily skin care routine-could be to blame. Here, dermatologists break down the most common adult acne causes and what you can do to banish those pesky pimples for good.
Your hormones influence your entire body, including your skin. “Acne, at its most basic level, is caused by hormonal stimulation of oil production,” explains Joshua Zeichner, MD, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. This is why so many women experience acne during their period, pregnancy, and menopause.
Certain health conditions can also lead to hormonal imbalances, the most common being polycystic ovarian syndrome, a condition in which women produce excess androgens (aka testosterone), explains Michele Farber, MD, a board-certified dermatologist practicing at Schweiger Dermatology Group in New York. These hormones boost oil production, resulting in clogged pores where acne bacteria flourishes. Hello, pimples.
How to clear up hormonal acne: This type of adult acne commonly develops on the lower third of your face, along the jawline, chin, and mouth, says Dr. Zeichner. If you suspect your acne may be hormonal and topical drugstore treatments aren’t helping, talk to your dermatologist about prescription medications like spironolactone (which actually blocks androgen receptors) or even birth control pills, which can help regulate hormonal fluctuations during your menstrual cycle.
We’ve all been there: You’re going through an incredibly difficult week at work and then, bam, Mr. Giant Angry Zit shows up to make things even worse. While the correlation has long been suspected, researchers are just now starting to study the link between stress and adult acne.
Case in point: In a 2017 study of 144 female medical students, researchers used an acne grading system and a self-reported stress test to analyze the link between the two. They found that women who had higher stress scores experienced significantly worse acne lesions. You can once again blame hormones for this one. “Stress leads to a surge in hormones that promote oil production,” explains Dr. Zeichner, such as cortisol and androgens. “This, in turn, blocks the pores promoting breakouts.”
How to clear up stress-related acne: Chill out! Finding a way to reduce stress-whether it be through exercise, meditation, or taking 20 minutes to read a book each day-is not only beneficial for your physical and mental health, but it may also help keep your skin clear, says Dr. Farber.
The relationship between diet and acne is complicated, but there is evidence that eating foods high on the glycemic index (GI)-which are typically rich in refined carbs-may mess with your skin, according to a 2016 review of research.
“One study from the United States demonstrated that 91 percent of patients who adopted a low-glycemic diet required less medication for their acne,” explains Meghan Feely, MD, a board-certified dermatologist in New Jersey and New York City who serves as a clinical dermatology instructor at Mount Sinai. “Less acne was reported by 87 percent of patients in the study.”
The possible reason? Eating a high-GI diet spikes your insulin levels, which triggers excess inflammation and oil production in the skin, potentially leading to more breakouts, says Dr. Feely. What’s more, people who eat a lower-GI diet tend to have lower levels of IGF-1, a hormone similar to insulin that may trigger acne production, according to a 2018 study. Still, the connection has been inconsistent, and more research needs to be done to understand how sugar really impacts acne.
How to clear up sugar-triggered acne: If you sense your skin gets worse after downing carbs, consider limiting high-GI foods-like white bread, rice, and potatoes, sugary drinks and snacks, fries, and donuts-from your diet to see if you notice an improvement. You’ll get the best results working with a doctor, since you can work together to slowly eliminate foods and identify triggers. “On an individual basis, it is important to monitor how certain foods flare skin and to cut these out-and make a regimen for acne with your dermatologist,” says Dr. Farber.
Got breakouts? Your daily glass of milk could be a culprit, according to a growing body of research on diet and acne. “Dairy, particularly cow’s milk, has been shown to be associated with acne breakouts,” says Dr. Zeichner. “The highest association has been shown with skim milk. It is unclear whether it is a high level of sugar in the milk, or whether it is hormones passed onto the milk from the lactating cows that lead to inflammation in the skin.”
It’s a bit of a lose-lose situation. The p. acnes bacteria responsible for those annoying pimples increases inflammation in the skin, but the foods you eat also have the potential to make that inflammation even worse, spiking oil production and clogging your pores even further.
How to clear up dairy-related acne: “If you suffer from acne, consider a milk alternative like almond milk. Interestingly, cheese and yogurt has not been associated with acne breakouts,” says Dr. Zeichner. Just be sure to consult with a registered dietitian if you plan on making any dramatic changes, especially if you have a health condition closely linked to your diet.
Dealing with acne can be a bit of a confidence killer, and it’s only natural to want to cover it up. But packing on the foundation, concealer, and powder may be the reason your skin is freaking out in the first place.
Adult acne caused by makeup will often take the form of tiny bumps or whiteheads alone the cheeks, chin, or forehead, the AAD says. The kicker? There often isn’t just one culprit. Products that contain pore-clogging oils or drying alcohol, sleeping in your makeup, and using dirty makeup brushes can all spur pesky pimples.
How to clear up makeup-triggered acne: Letting your skin breathe can help, but you don’t have to go bare-faced 24/7 to clear up acne caused by makeup–you just have to choose your products carefully and be extra-hygienic when putting it on and taking it off.
As a general rule of thumb, look for makeup that is labeled oil-free and noncomedogenic to avoid clogging your pores, says Dr. Feely. Compared to liquids, powder products contain larger pigment particles, so they also won’t clog your pores as easily, adds Dr. Zeichner. Then, always be sure to remove your makeup and clean your skin thoroughly before you sleep or exercise with a gentle cleanser or acne face wash.
Another pro tip: “Do not share makeup or makeup applicators with others, as these may contain oil, bacteria, and dead skin cells,” says Dr. Feely, adding that you should wash your brushes frequently to limit the buildup of acne-triggering gunk.
The world of skin care is vast and complicated, and finding the right routine for acne-prone skin can be a struggle. Just like makeup, oil-based products (including the ones you use on your hair!) can clog your pores and lead to breakouts, says Dr. Feely.
But more often than not, people with adult acne are too harsh with their skin in an effort to clear it up. Scrubbing your face, applying harsh astringents, and washing too often can irritate your skin barrier, strip necessary moisture, and spur inflammation-all of which can worsen acne, says Dr. Feely.
How to clear up skincare-related acne: The most important thing to remember is to take it easy with your skin. It’s important to wash your face first thing in the morning and right before bedtime, says Dr. Feely, but opt for a gentle, noncomedogenic cleanser. If you aren’t using an adult acne treatment prescribed by your dermatologist, here are a few helpful ingredients to look for in OTC products:
Salicylic acid gently sloughs away dead skin to unclog pores. Find it in various face washes, masks, and spot treatments.
Benzoyl peroxide kills acne-causing bacteria that promotes inflammation. It can be a bit drying, so it’s often best tolerated as a spot treatment.
Ceramides are natural fats that help strengthen the skin’s barrier, and can be found in many moisturizers for acne-prone skin.
Sulfur, when applied topically, can help reduce acne-causing bacteria and excess oil. It’s not as potent as other active ingredients, so it’s worth a try for especially sensitive skin.
Hyaluronic acid is humectant that draws water to the skin’s surface, combatting dryness caused by harsh acne medications.
Retinoids are typically only available through a prescription but are very effective in treating acne because they speed up skin cell turnover. The only OTC retinoid available is Differin’s raved-about adapalene gel.
SPF should be applied daily to reduce the formation of acne scars.
Niacinamide is a form of vitamin B3 that’s often added to moisturizers, serums, and cleansers. It calms inflammation in the skin, reducing redness in the process.
Think about it: If pollution can kick dirt up into the air, imagine what it may be doing to your skin? Research shows that people who live in areas with high air pollution, such as big cities, may experience worse acne, say Dr. Feely. That’s because these various particles can crank up inflammation and sebum (aka oil) production in your skin, spurring clogged pores that eventually develop into pimples.
How to clear up environmentally related acne: The best way to prevent pollutants from aggravating your skin is to keep them out, says Dr. Feely. People with acne-prone skin should form a protective barrier against pollution by applying a moisturizer and a broad-spectrum sunscreen daily.
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