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Acne in Adulthood: What Men and Women Should Know

Written by Martha Juco, MD · Aesthetics

Updated Jun 14, 2023

Acne in Adulthood: What Men and Women Should Know

While acne is commonly associated with adolescence, it may persist well into adulthood. Acne typically manifests around the age of 11, peaking at about the age of 16. However some people will experience acne continually in their 20s to 50s1,2.  What cause adult acne? As in adolescent acne, what causes acne in adults starts with the pores of the skin becoming clogged by excess oil production, dead skin cells, and bacteria3. Adult onset acne is more commonly related to underlying issues of hormonal imbalance.

Acne in adulthood is not just potentially irritating. It can also negatively impact one’s self-esteem and psychological well-being. Acne has been associated with depression and anxiety, as well as difficulty in concentrating on work or studies6.

More Severe Acne in Women

Even though adult acne can manifest in both genders, it affects females more significantly compared to males4. One study suggests that half of women in their 20s, a third in their 30s, and a quarter in their 40s will experience acne flare-ups. Acne is also more likely to appear along the jawline, and the T-zone connecting the forehead, chin, and nose7.

Among factors that cause adult acne in women are hormonal changes during the menstrual cycle, which can influence oil production1. One survey showed that 62% of pre-menopausal women asked noted that their acne becomes more severe around the time they get their periods5

Hormonal fluctuations during pregnancy, menopause, or after stopping using birth control use may also result in acne2.

What Causes Acne in Adults?

What causes acne in adults? Some of the things that can cause or exacerbate acne in adulthood are the ff:

What Causes Adult Acne #1: Oil-Based Products

Using certain hair and skincare products may result in more acne. These include products that are oil-based. Instead, adults can use non-comedogenic or non-acnegenic products, which have ingredients that will not clog the pores.

What Causes Adult Acne # 2: Certain Medications 

Oral corticosteroids may increase the proliferation of acne-causing yeast within the hair follicle8.

Anabolic steroids can cause severe acne including cysts and nodules, which are deep and sometimes painful pimples.

Some contraceptive medications may also make acne worse by reducing sex hormone binding globulin.

Other medications may result in acne due to their effect on the immune system, directly affecting the hair follicle, or stimulating insulin and insulin-like growth factor. These include halogens, antiepileptics, antidepressants, some B vitamins, and antituberculous drugs8.

What Causes Adult Acne # 3: Stress 

stress and diabetes

Though stress does not directly cause acne, it contributes to the worsening of the skin condition5.

In fact, acne severity has been found to correlate with increasing levels of stress, including emotional stress. Some investigators believe that this is because the body releases certain hormones during periods of stress that are known to increase oil production, inflammation, and worsen acne9.

What Causes Adult Acne # 4: Diet

While it is a myth that oily or greasy foods cause acne, some reports say that high-glycemic foods exacerbate acne. Carbohydrate-rich foods like chips and bread may worsen acne5.

What Causes Adult Acne # 5: Hormones

Hormonal acne is associated with the excess production of sebum, an oily substance that skin glands secrete. This can contribute to the clogging of pores, which may result in pimples. It often occurs in women between 20 to 50 years old. Women undergoing pregnancy or menopause are most likely to experience hormonal acne. 

External factors that contribute to hormonal acne include stress, inadequate sleep, and using products that are not oil-free or non-comedogenic10.

Talk to Your Dermatologist

Looking into what causes acne in adults is the key to how to stop pimples coming on face. Your dermatologist will be able to help you pinpoint the cause of your breakout. If the trigger is stress, take time to rest and rejuvenate your mental and physical body. If what causes your acne is the skincare products that you use, replace it with a non-comedogenic brand. Practicing stress management and getting better quality sleep and rest may also help in managing your acne.

It is also important to talk to your dermatologist for the best treatment plan to manage your acne. As in the case of adolescent acne, it is best to treat adult acne immediately and aggressively in order to prevent it from becoming more severe and possibly causing permanent acne scars.

If symptoms persist, consult your doctor.

Suffering from acne? Try our acne severity screener and our acne scarring risk screener, and get connected to a dermatologist.

Please click here to send your questions or concerns. Foods, Drugs, Devices and Cosmetics Act prohibits dispensing of ethical or prescription medicines without prescription. For suspected adverse drug reaction, report to the FDA at

Learn more about Acne here.


Hello Health Group does not provide medical advice, diagnosis or treatment.

Written by

Martha Juco, MD


Updated Jun 14, 2023

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