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8 Causes of Adult Acne—and How to Actually Treat It

When it comes to finding an effective adult acne treatment, you’ve likely tried every lotion, potion, and serum out there. But it also helps to get to the root of the problem. In other words, to really treat your adult acne, you may need to understand what causes it in the first place.

Because, honestly, there’s nothing more disappointing than waiting until your 20s to finally have clear skin and then learning the hard way that bad breakouts don’t necessarily end when your teenage years do. Coming to terms with adult acne is difficult—but rest assured, you’re not the only adult dealing with zits.

Knowing what’s causing your pimples can help you clear up your skin and keep breakouts at bay. Keep reading to learn some of the most common adult acne causes—and the best ways to treat these stubborn breakouts.

Remind me, what causes breakouts?

At the root of all acne is a clogged pore. Your pores, which are the opening that surrounds each hair follicle, are an important part of your skin because they also house your sebaceous glands.

These glands secrete sebum (oil) through the pore opening, which helps keep your skin soft and protected. But if the pore gets clogged by dirt, dead skin cells, excess oil, and possibly bacteria, you’ve got a recipe for a pimple.

Sometimes, just taking better care of your skin by cleansing or exfoliating regularly can be enough to prevent acne. For many others, though, the situation is more complicated. And, especially when you’re an adult, trying to figure out what’s causing your acne can get pretty frustrating.

Common adult acne causes:

1. Hormonal fluctuations

“Fluctuation in hormones, such as before one’s menstrual cycle, is the main cause,” dermatologist Julia Tzu, M.D., of Wall Street Dermatology, tells SELF.

For instance, we know tha

t an increase in the production of progesterone (which happens after ovulation) can be related to acne because it ramps up your skin’s production of sebum. Androgens (male hormones) like testosterone can also increase sebum production and, therefore, play a role in hormonal acne in people of all genders.

This issue usually rears its ugly head in the form of deep (painful) cystic acne around the chin, neck, and back, dermatologist Rebecca Kazin, M.D., of the Washington Institute of Dermatologic Laser Surgery and the Johns Hopkins Department of Dermatology, tells SELF.

Cysts are pockets of pus that form deep in the skin, SELF explained previously. They’re notoriously stubborn to treat because topical treatments don’t usually have much of an effect. And because they’re so deep, they are more likely to cause scarring if popped.

Because your hormones naturally fluctuate at certain points in your life, the American Academy of Dermatology (AAD) explains, hormone-related acne is most likely to pop up:

Around the time of your period.During or after pregnancy.During perimenopause and menopause.When you start or stop using hormonal birth control.

2. Stress

We know that chronic stress can play a huge role in skin issues like acne, and it’s strongly suspected that the hormone cortisol may be responsible for the link.

When you’re stressed, your adrenal gland releases cortisol, Neal Schultz, M.D. a New York City–based dermatologist, tells SELF, and recent research also suggests that it’s produced locally in hair follicles and different types of skin cells. Although it’s commonly referred to as the “stress hormone,” cortisol is actually an important compound that helps regulate a ton of different bodily processes, including the immune system, digestive system, and neurological systems affecting your mood. Its levels naturally fluctuate over time (even within a single day).