Struggling with adult acne? Experts share tips to tackle it

Acne is often associated with the greasy skin of hormonal teenagers going through puberty – but it can actually affect anybody at any age. 

The NHS estimates that around 95% of people aged 11 to 30 are affected by acne. 

For most people, acne will disappear as they reach their mid-20s, but that’s not always the case. 

The NHS estimates that around 12% of women over 25 and and 3% of men experience adult acne (it is more common in women), yet studies show that rates have been rising over the past decade.

These rates may not be reflective of real life, explains Elizabeth Rimmer: Founder of London Professional Aesthetics, a London Skin Health Clinic.

Elizabeth tells ‘In reality, I suspect the figures are quite high. 

‘There are more options to get help now but there is no question that some people still suffer in silence with it.’

What is adult acne?

Adult acne is any acne that starts after the age of 25. It is not simply a matter of having a few spots, though, Elizabeth explains. 

She adds: ‘The symptoms of acne include: whiteheads, blackheads, oily inflamed skin, large painful pus-filled spots (cystic lesions). 

‘You can have all or some of these symptoms to be diagnosed with acne.’

Dr Ross Perry, Medical Director of Cosmedics skin clinics, adds that there are six types of spots caused by acne. 

These also include papules – small red bumps that may feel tender or sore. Pustules – similar to papules, but have a white tip in the centre, caused by a build-up of pus. Nodules – large hard lumps that build up beneath the surface of the skin and can be painful. 

‘Cysts are the most severe type of spot caused by acne…that look similar to boils and carry the greatest risk of causing permanent scarring,’ he adds. 

In terms of where you’re going to find it, Savaş ALTAN Medical Aesthetic at Vera Clinic, says adult acne is more common around the chin, and along the jawline, while teenage acne usually appears in T-zone (forehead, nose, and chin). 

Who is affected by adult acne? 

Anyone can struggle with acne, at different points in their life, yet gender and ethnicity can play a role.

While all skin types are at risk of scarring and pigmentation, Elizabeth explains, darker and mixed ethnicity skin types may be more at risk of dark spots once acne lesions have healed.

Women are much more likely to suffer from acne than men – this is due to hormone fluctuation. 

Elizabeth explains that women with excessive levels of androgen (this includes testosterone) are more likely to experience acne. 

This raised level of hormone can be due to polycystic ovaries.

Although there isn’t much research into this, women report that hormonal acne can be triggered, or helped, by changes to contraception. 

Comedian Siânny Thomas, 36, had her first acne breakout after she had the copper coil put in around spring 2014. 

‘Before this I had very low maintenance skin,’ she tells us. ‘I’d barely take my makeup off before bed (I’m neurodivergent so routines are difficult for me). 

‘It cleared up with Yasmin, the contraceptive pill but I came off it after six months due to leg pain and swollen breasts as well as being too irritable for comfort.’

It cleared up in the sun and when Sian came ‘out of a stressful situation’ but it came back after she stopped taking Yasmin. 

She’s not ‘overjoyed’ at her acne being visible, yet she has let it breathe this summer as, alongside having MS and an overactive thyroid it’s too ‘uncomfortable to wear makeup in this weather’.

‘I figured I never look at other women with visible acne and think negative things so just go for it,’ she concludes. 

What causes adult acne?

There’s no one single cause for acne. It can be influenced by our genetics, hormones, pollution and humidity (yes, living in cities like London can make it worse!), and lifestyle. 

‘As with acne in general, adult acne is hereditary to a degree and is majorly influenced by your hormones, excessive oil production in the skin and stress,’ Elizabeth explains.

Occasionally, skin and hair care products can be triggers. 

Myth busting with Elizabeth Rimmer

Myth 1: People who get acne obviously eat a lot of junk food.

In my experience most acne sufferers eat a ‘normal’ diet, if not slightly ‘healthier’ than average. Improving diet seems to be one of the first things people try.

It’s so important to do this but can also leave you feeling disappointed as curing acne just isn’t that simple.

Myth 2: People who get acne are unhygienic.

Again – quite the opposite is true here. Acne sufferers tend to over-care for their skin in an attempt to improve it.

Myth 3: Any ads for miracle cures.

Like all complex skin problems, there isn’t a miracle cure. In fact there isn’t a cure at all.

The more severe the problem, the more likely it will take a number of different interventions working together at different levels to get on top of it and maintain it.

At some point in time the acne will resolve itself but when that happens is a complete unknown.

Medically speaking, Savaş says that adult acne is caused by the same things that cause teenage acne: excess skin oil and bacteria.

They add: ‘This can also be due to fluctuating hormones, including during pregnancy and menstruation, and the environment of the skin which can trigger excess oil causing acne. 

‘Emotional and physical stress can also affect adult acne.’

How can you treat adult acne? 

Acne can come and go on its own, but that doesn’t make it easier to deal with flare-ups. 

Everyone is different, and what works for your friend may not work for you, so we asked our three experts for their advice to get a range of tips. 

Savaş explained that a structured skincare routine is crucial, but it’s vital not to overdo it as ‘using several different products on your skin can cause more breakouts and irritation’. 

Before you go trying loads of new products, learn what your skin type is. Then, they suggest cleaning twice daily with cold water or a gel-based, surfactant-free cleanser. 

They add: ‘Make sure the product you are using is fragrance and oil-free, especially if you have sensitive skin as fragranced products can result in stinging sensation and allergies while oil in the product can clog pores and cause acne over time.’

Top tips with Elizabeth Rimmer

  • Wash your face morning and evening with a gentle perfume-free cleanser and tepid water for one full minute, then pat dry with clean kitchen paper.
  • Keep water temperature down generally for showering, bathing and avoid steaming – heat stimulates oil, which is a factor in acne.
  • Avoid using any oil-based product on your skin, including opting for mineral makeup.
  • Try to reduce the amount of carbohydrates you eat. Carbs are really important so don’t cut them out completely but don’t overload on them as they will trigger insulin release and antagonise acne tendencies.
  • Mild acne will respond well to good quality medical skincare. Over the counter skin care does not contain the same level of active ingredients and does not come with the advice and support of an expert.
  • Moderate to severe acne will need skincare but you may also need to consider adding other layers – in-clinic treatments such as LED and peels. In some cases, medications may also be recommended.

Dr Ross Perry also believes in the importance of ‘cleansing your skin thoroughly morning and night to get rid of any dirt and debris’.

The sheer amount of cleansing lotions, gels, and foams, leave-on products and specific acne skin kits are overwhelming. 

Some work by killing the bacteria that cause acne inflammation whilst others remove excess oil from the skin or speed up the growth of new skin cells and the removal of dead skin cells. 

It’s important to buy the right one for your skin, but Ross recommends looking out for ones with salicylic acid, glycolic acid or benzoyl peroxide, ‘which all help to break down the bonds between dead skin cells, eliminating them from the surface of your skin’, followed by a gentle oil-free moisturize (if your skin is oily).

Be patient, Ross adds, as products might not work overnight. 

There’s a bunch of (pricey) private treatments out there, like laser. 

If your acne is moderate to severe and over-the-counter products haven’t worked then your GP may be able to prescribe medications such as topical retinoids, topical antibiotics, azelaic acid, antibiotic tablets or isotretinoin tablets – but these may not work, and come with certain side effects. 

Meanwhile, we know it’s tempting but try not to keep touching your face. ‘Especially your chin, which naturally produces more oil and sebum, and definitely don’t squeeze,’ he adds. 

‘If the skin is red and angry you might want to try dabbing on some tea tree oil or witch hazel to soothe it.’

Finally, be sure to load up on an oil-free daily SPF30 which is non-greasy as the sun can also cause breakouts, Dr Ross adds. 

Soothing acne doesn’t stop with the skin. Diet and lifestyle can have a huge impact too. 

‘Eating a good well-balanced diet consisting of leafy greens, fish and probiotics will also help,’ Dr Ross continues. 

‘Getting plenty of sleep, drinking at least 8 glasses of water and ditching alcohol and cigarettes is all common lifestyle advice for clearer better skin.’

Finally, if acne is making you depressed or anxious don’t hesitate in visiting your GP.  

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