If you're an adult experiencing breakouts, you may have chalked them up to a change in skin care products, dry winter skin or over-exfoliation — because acne is only meant to pop up on teenagers, right? Unfortunately, one survey of nearly 3,000 women found that 45 percent of those aged 21-30, 26 percent of those aged 31-40 and 12 percent of those aged 41-50 struggle with clinical acne.
Adult acne refers to breakouts that occur after the age of 25, and there are a variety of things that can cause it. We spoke to dermatologists about what causes adult acne and rounded up some acne-fighting products that they recommend, as well as some highly rated options based on their guidance, including one we tried ourselves and highly recommend.
What is adult acne?
According to Dr. Joshua Zeichner, director of cosmetic and clinical research in the department of dermatology at Mount Sinai Medical Center, there are three types of adult acne: adult onset acne, persistent acne and recurrent acne.
- Adult onset acne refers to "people who never experienced acne when they were younger and developed it for the first time as an adult," Zeichner said.
- Persistent acne refers to those who "had acne as a teenager and it persisted into adulthood."
- Recurrent acne refers to "those who experienced acne in adolescence, but it recurred as an adult after a period of having clear skin," Zeichner said.
Adolescent acne can develop anywhere on the face, including the cheeks, temples, forehead, chest and back. Adult acne, however, typically manifests on the lower third of the face, which includes the jawline, chin, and upper cutaneous lip, board-certified dermatologist Dr. Erum Ilyas explained.
Adult acne products in 2022
Salicylic acid and benzoyl peroxide are the main acne-fighting ingredients dermatologists told us to look out for. Other ingredients they mentioned include azelaic acid, niacinamide and hyaluronic acid. Below, we rounded up dermatologist-recommended products, as well as highly rated options formulated to combat adult acne based on advice we got from the skin care experts we talked to.
If you're dealing with discoloration as a result of breakouts, Ilyas said this brightening cream can be a welcome addition to your routine. "Azelaic acid is a naturally occurring dicarboxylic acid that has the benefit of addressing both breakouts and discoloration," she said. The brand says that the lightweight cream also helps balance uneven tone and texture. To use the cream, apply it morning and evening after your serum.
Ilyas recommended this face moisturizer from La Roche-Posay, explaining that it’s soothing, applies easily and hydrates the skin. According to the brand, it offers 48-hour hydration and can be used on the neck and hands in addition to the face. Its hero ingredient is niacinamide, which Ilyas noted is hydrophilic, meaning it loves water or moisture. The ingredient is also "anti-inflammatory and features anti-itch properties as well as antimicrobial activity," she said, which can help those dealing with these as a side effect of inflamed breakouts.
Board-certified dermatologist Dr. Eileen Deignan previously recommended the Neutrogena Oil-Free Acne Wash to Select, deeming it her top choice for a salicylic acid acne-fighting product. It contains a 2 percent concentration of salicylic acid, and the brand says it cleanses away dirt and oil that can build up over time. Neutrogena also says it's oil-free, residue-free, and non-comedogenic.
This concentrated formula uses 5 percent benzoyl peroxide to curb hormonal flare-ups and reduce the risk of future blemishes, according to the brand. It also contains medical-grade aloe vera that the brand says helps to soothe hormonally imbalanced skin.
If your issue is blackheads and whiteheads, this pick from AcneFree is a good option. It contains both charcoal and 2 percent salicylic acid, which work to whisk away pore-clogging oil, dirt, and debris, according to the brand.
Select editor Morgan Greenwald — who often struggles with hormonal breakouts — is a big fan of this cleansing balm from Peace Out, which is formulated with salicylic acid, niacinamide and hyaluronic acid. According to the brand, the balm minimizes the appearance of pores plus moisturizes the skin, preparing it for the other products in your skin care routine.
What causes adult acne?
Zeichner said dermatologists still don’t quite understand exactly why acne develops in adulthood, but it likely has to do with hormones, diet and stress. "Hormonal fluctuations stimulate oil glands, increasing sebum production and promoting inflammation in the skin," he explained. "This explains the cyclical breakouts that women typically get around the time of their period."
When it comes to diet, Zeichner explained that certain dairy products like skim milk and foods with a high glycemic index are associated with acne breakouts. Several studies have also found a link between stress and excess sebum production, which can lead to breakouts.
"The same hormones that prepare our bodies for stress also stimulate our oil glands," Zeichner explained. "CRH, known as corticotropin releasing hormone, is responsible for increasing cortisol as part of our flight or fight response. At the same time, it has a direct effect on sebaceous glands."
How to treat and prevent adult acne
When it comes to treating acne, there are two main over-the-counter ingredients to look out for: benzoyl peroxide and salicylic acid. "Benzoyl peroxide helps lower levels of acne-causing bacteria on the skin while salicylic acid helps to remove excess oil and dead cells from the skin that may contribute to blockages of the pores," explained Zeichner. Other ingredients Ilyas recommended seeking out are azelaic acid (to clear acne-causing bacteria from pores), niacinamide (to regulate oil and reduce inflammation associated with acne) and hyaluronic acid (to soothe redness and hydrate the skin).
Ilyas recommended taking a "less is more" approach if you're on the quest to combating adult acne. "Many of my patients figure this out the hard way after spending money on numerous products only to find out that they either do not help or they just make [the condition] worse," she said.
Ilyas also noted you may want to avoid makeup wipes, as they can be drying, irritating and/or aggravating on skin that's experiencing adult acne. Instead, she suggested using just soap and water or micellar water on a cotton round to remove makeup.
Ultimately, Ilyas said that adult acne presents itself as inflamed comedones or clogged pores with a potentially cystic component, and it can be treated like most other acne.