Adult acne: why now and what you can do

Heather Stephen

Just when you thought you were too old for spots – they make a come back. Heather Stephen looks at some of the reasons why and what you can do to get rid of them.

Spots are an unwelcome but normal part of teenage life but sometimes they can carry on or even start for the first time in adulthood.

According to the British College of Aesthetic Medicine acne starts during puberty because of a surge in the male hormone testosterone causing skin cells to become abnormally sticky and clog hair follicles. Spots occur as the body produces inflammation to get rid of the bacteria trapped in these excess oils and are most common on the face, shoulders, back and chest.

As a youngster you might have been one of the lucky ones but even if you have had clear skin all your life acne can still strike unexpectedly in your late twenties or even into your fifties.

Women are much more likely than men to suffer from adult acne and account for more than eight out of ten cases.  Although Dr Shirin Lakhani, advanced aesthetic doctor at Elite Aesthetics, in Kent believes the figures may be higher among women as they are more likely to seek help.


What is adult acne like?

  • Adult acne is very persistent and can go on for years.
  • It tends to be mild to moderate
  • Affected people often have large pores
  • Some reports have suggested it is more common in those with olive skin
  • Large whiteheads are more common than in younger adults and these are mostly found on chin, cheeks and forehead.

What are the causes?

Hormonal changes: Some women have acne flare-ups before their period, in the first three months of pregnancy or during menopause, all of which affect hormone levels.

Medicines:  Some medicines may cause acne so check the patient advice leaflet inside the box. You might need to talk to your doctor about switching medication or for advice about acne management.

An undiagnosed medical condition: Sometimes acne is a side effect of conditions such as polycystic ovary syndrome, and it often resolves when the underlying problem is treated. Speak to your GP if acne springs up out of the blue as it might be a sign of an underlying condition.

Stress: Researchers have found a direct link between stress and acne flare-ups. When anxious our bodies produce more androgens – a type of hormone which stimulates the oil glands and hair follicles leading to higher bacteria levels on the skin.

Family history: Acne tends to run in family so if you have a close relative such as a parent or sibling has it the chances are you will too. Although not everyone will inherit their Dad’s dodgy skin studies suggest that people who have a genetic predisposition for acne are most likely to develop it in adulthood.


How is it treated?

Adult acne is managed in a similar way to younger people.

Mild cases can be kept under control with over the counter antibacterial face wash and topical medications containing benzoyl peroxide which target bacteria on the skin.

Some people find laser therapy effective at reducing lesions. Although studies have shown cosmetic treatments such as this are not useful for severe inflammatory acne, the British College of Aesthetic Medicine says they are beneficial for improving the appearance of acne scars.

Antibiotics such as tetracylines which reduce bacteria and inflammation are sometimes prescribed, although Dr Lakhani says practitioners are increasingly reluctant to do this due to increasing antibiotic resistance.

The contraceptive pill is widely used in treating persistent cases.  But as these tablets increase the risk of blood clots they are not recommended for people who smoke, who are overweight or who have a family history of clots.

Oral retinoids such as Isotretinoin – a prescription only form of Vitamin A – may be prescribed for people who have severe acne that hasn’t responded to other treatments. As this treatment can lead to birth defects, women of childbearing age are advised to use contraception for at least four weeks before treatment starts, for its duration, and for at least four weeks after the treatment finishes. These should not be taken during pregnancy.

Over-the-counter products such as cleanser with Salicylic Acid or night creams with Vitamin A can also help. The Salicylic Acid fights the bacteria and exfoliates while the Vitamin A helps keep oil production under control.

Harley Street Emporium recommends Dr Nick Lowe’s acclenz range of products, Dr Johanna Wards’s ZENii Salicylic Exfoliator and Beaute Pacificque’s Clinical Super 3 Booster 


How can I help myself?

  • Try not to pick or squeeze your spots to avoid scarring
  • Expect to use treatments for at least two months before seeing an improvement
  • Some over-the-counter creams containing retinoids (vitamin A) may cause, tingling, redness or flakey skin to start with. If you have these symptoms, try using the product every second or third day until you build up a tolerance
  • Makeup can help confidence but choose oil-free products and keep brushes and sponges clean and bacteria free
  • Use a gentle cleanser on your face, remembering not to scrub as this will irritate the skin and make your spots worse
  • There is no evidence particular foods affect acne but your health will benefit generally from a balance diet rich in fruit and vegetables
  • For more advice contact the Acne Academy – UK charity set up by healthcare professionals to help people with acne – at





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