Acne is one of the toughest trials of being a teenager, but the truth is that anyone can experience breakouts, at almost any age after puberty. The hormonal changes of puberty bring on oilier skin and hair, which can make it easier for acne to develop.
So what’s the difference between getting acne when you’re in your teens and getting it when you’re an adult? What causes a zit is pretty much the same regardless of how old you are: When sebum (the oily, waxy substance that keeps skin moisturized) and dead skin cells plug up a pore and bacteria is added to the mix, a pimple appears. Some are small, near the surface, and go away pretty quickly, like whiteheads and blackheads. Others are deeper in the skin, more painful, and tend to take a while to disappear, such as cysts and nodules.
Beyond this, there are two big factors that affect your odds of getting acne, whether teenage acne or adult acne: First is your family history; if your mom and/or dad had acne (and all that tends to go with it, like oily skin and larger pores), you are very likely to develop it as well in your teens. That said, some people develop acne as adults for the first time.
The second important factor is hormones: When androgens, male hormones that both men and women have, surge—which happens during adolescence and, for women, during pregnancy and when a woman stops and starts birth control pills (which contain hormones)—breakouts become a lot more likely. This is a primary reason why, for many people, acne improves after their teenage years: hormonal changes have leveled off and are no longer fueling bad breakouts.
The best acne treatment for teens and adults alike starts with a regimen that combines regular cleansing of your face and any parts of your body that tend to get breakouts; that means washing twice daily and as soon as possible after you’ve sweat a lot. Also, be sure to avoid touching your face (hands and nails carry a lot of bacteria that can lead to pimples); use makeup that’s labeled oil-free, comedogenic and/or acnegenic (the last two terms mean the makeup won’t clog pores or cause breakouts); and shampoo your hair regularly, especially if you have oily hair. Avoid the temptation to pick at a pimple, too, which can introduce more bacteria and make the zit worse and even leave a scar or mark.
When breakouts do happen, you have a variety of acne treatments to choose from, and many people find that a combination approach works best. For example, products with salicylic acid help get rid of the dead skin cells that can fuel a pimple, and those with benzoyl peroxide are effective at killing pimple-causing bacteria. Glycolic acid (which can be effective in a topical product or a peel) helps remove oil and dirt on the skin, and retinols, which are derived from vitamin A, can work especially well for preventing new acne. And while it’s tempting to take a “more is better” approach by using a lot of products, doing so is likely to over-dry your skin, which may make acne worse.
Teens in particular may want to skip skim milk to help get clear skin; research has found a link between drinking skim milk and acne, perhaps because of hormones in the milk. Other studies have found that eating a lot of refined sugar, as well as some dairy products, may contribute to breakouts in both teens and adults.
Adult acne treatments are much the same as those for teens—regular cleansing and finding a treatment regimen that works for your skin are still key—but adults may have a few more options. Since the production of sebum and the production of dead skin cells are both controlled by hormones, hormonal therapy may be particularly effective for women, who are disproportionately affected by acne as adults. (That’s due to greater hormone fluctuations around menstrual periods, pregnancy, and menopause.) If you also have a lot of facial or body hair or irregular periods ask your doctor about hormonal testing to see if your androgen levels are normal (most women’s are); teenage girls may be able to use hormonal therapy too, if your doctor deems it right for you.
If your doctor decides you’d benefit from hormonal therapy as part of a regimen to get rid of acne and you’re not trying to get pregnant, she may prescribe you an oral contraceptive (birth control pills) that contains estrogen and progestin, either on its own or with another prescription for an anti-androgen medication; both will lower the amount of hormones circulating in your body. Keep in mind that it will take time to see results with any medication, so don’t expect your acne to clear up quickly.
If you’re an adult dealing with acne, you’re also more likely to have dry skin since our skin loses the ability to retain moisture as we age. That means that some acne medications and treatments may be too strong and over-drying, so you might need to use a gentler formulation (such as a product with less benzoyl peroxide) to avoid irritation. (On the plus side, acne treatments like retinols and salicylic acid are also good anti-aging products, so they can help you beat not only breakouts but also wrinkles.) Lastly, rosacea, a condition in which the skin becomes red and often ruddy, is more common in people with acne and can make your skin to sensitive to acne treatments. A good anti-acne regimen for adults includes a gentle cleanser, a non-comedogenic moisturizer (to combat dryness), and a thin layer of acne-fighting products used as needed to keep breakouts at bay.