Adult acne - Why do people over 30 still get blemishes?

Having acne as a teenager was one thing, but you thought you’d grown out of it. And now those pimples are back again.
It may seem unfair, but adult acne is more common than you think. This article looks at what causes and triggers it to help you get to the root of the problem. You can find out how to care for your skin Which skincare products and routine are best for acne-prone skin?

You may find it reassuring to know you’re not alone.

Acne isn’t just for teenagers. Experts estimate that up to 40% of adults over the age of 25 have blemished, acne-prone skin1 and that 75 - 85% of them are female2.

Adult acne (also known as Acne Tarda) is particularly common amongst women who have taken the pill since the onset of puberty and come off it to try another method or start a family. Soon after they stop taking the pill, blemishes appear.

The symptoms of adult acne are usually only mild to moderate, but those who experience blemishes when they’re over 30 suffer just as much − if not more − than younger patients. The reasons are clear: teenage pimples are annoying, but are considered completely normal. Society expects you to have grown out of acne by the time you’re an adult, and can judge you if you still have spots.

Adult acne develops in the same way as teenage acne, and it starts with micro-comedones. Micro-comedones is the name given to the microscopically small precursors of comedones (a comedone being a blackhead or a whitehead). Everyone has micro-comedones but, in skin that isn’t blemish-prone, they dissolve. If your skin is prone to acne small inflammatory reactions occur − one of the underlying causes in the development of acne3,4

At the same time, acne-prone skin produces excess sebum. This sebum is unable to drain away because the pores are clogged and the excretory ducts are blocked. Comedones (blackheads and/or whiteheads) develop as a result and are most commonly found on the face, neck, chest and back. Acne bacteria gets to work in the blocked sebum, leading to red and inflamed pimples.

There is no definitive research on the causes of adult acne but it is thought to be associated with hormones and fluctuations in hormone levels. Teenage acne is linked to the hormonal fluctuations of puberty. The causes of adult hormone fluctuations are, clearly, different and you can find out more about the relationship between acne and hormones here.

Other important influencing factors include a genetic predisposition, smoking, inappropriate skincare and make-up and stress5,6. You can read more about these, and other potential causes and triggers, in the causes and triggers of acne.

As with acne at most life stages, adult acne tends to effect people in two ways: physically and psychologically.

Physical impact 
Acne alters someone’s appearance and can be difficult to live with. Even after the blemishes have healed pimple marks (caused by post-inflammatory hyperpigmentation) and acne scars can remain. Our advice is to consult your doctor as soon as your acne becomes a problem. Early medical intervention can reduce the severity of your blemishes as well as the chances of marks and scars.

Psychological impact
Living with acne can be very stressful. Research shows that people with acne are more likely to suffer from depression, anxiety and social phobias than those without acne11. People with acne don’t like what they see in the mirror and may suffer from low self-esteem and an inferiority complex. Behaviour can change and they may hide behind too much make-up, appear shy and even stop socialising.