What causes acne in adults?

The causes of adult acne are not entirely clear. It may be linked to the behavior of certain sex hormones, particularly those called androgens, which control excretion from the oil-producing sebaceous glands. Other possible triggers include smoking, cosmetic use, stress or taking certain medications such as those used to treat epilepsy or depression. Some women may also have a genetic predisposition to the condition.

Researchers have been able to dispel some myths about the causes of adult acne, such as lack of face washing or certain foods making one break out. Acne is not caused by poor hygiene; in fact, washing your face too often or aggressively can irritate acne lesions. Additionally, no evidence exists to connect certain foods, such as fried foods and chocolate, to acne. Although a healthy diet is conducive to overall well-being, no foods are thought to specifically cause or exacerbate adult acne.
Patricia Farris, MD

All acne is caused by hormones. Male hormones called androgens stimulate sebaceous glands triggering a series of events that cause acne. Many adult women complain their acne flares before menstruation. This is because there are hormonal fluctuations that occur during the luteal phase of the cycle that trigger acne.

In some adults acne is the sign of real hormonal disorders most commonly polycystic ovarian syndrome (PCOS). In PCOS androgen hormones are produced by the ovaries causing acne, infertility, and metabolic problems including insulin resistance. Early diagnosis is important since PCOS can be treated with oral contraceptives and insulin sensitizing medications.

Other factors that contribute to adult acne include medications and stress. As you can see, acne in adults is a complicated problem that usually requires a comprehensive evaluation by your dermatologist.

Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
Hormone changes throughout life can irritate the skin and cause adult acne. Learn more about adult acne in this video with Dr. Oz.

Acne isn’t just for hormonally crazed teenagers anymore. Many adults can’t seem to outgrow it because of stress hormones. Yet most people don’t make the connection. They come into my office asking whether it’s their chocolate habit (no), or if their skin has somehow gotten oilier (not likely), or whether their soap, makeup, or moisturizer could be to blame (possibly, but not probably).

If there’s simply too much going on in their lives, odds are it’s stress acne and corticotropin-releasing hormone (CRH) is the culprit. Acne is an inflammatory condition and CRH has already been linked to other inflammatory disorders. Also, the skin’s own production of CRH may fuel inflammation that leads to acne. What can make things worse is that tense people often can’t leave pimples alone. Squeezing, poking, and picking at them becomes an almost obsessive way to release tension, but it also makes breakouts worse, exacerbating the inflammatory response, and you’re left feeling a tad more stressed. It’s one of those vicious cycles.

From The Mind-Beauty Connection: 9 Days to Less Stress, Gorgeous Skin, and a Whole New You by Amy Wechsler.

While multiple factors might contribute to the onset of adult acne, sebum overproduction is the most common cause. Sebum - a type of oil created by the sebaceous glands in your skin - is used to lubricate skin and hair. Excess sebum can mix with lingering dead cells to clog pores. Pimples occur when clogged pores trap bacteria and become infected.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.