Medically reviewed by Mary Lucas, RN
Written by Our Editorial Team
Last updated 8/23/2020
Living with acne is hard, and it’s even more challenging when you’re an adult and still dealing with what’s commonly seen as a teenage condition.
Acne isn’t just the pimple you get before your period every month; it’s living with a complexion that never quite completely clears up.
Maybe as one pimple heals, the next rears its ugly head. Or maybe you have a patch of them, growing like you planted them together.
Acne is a skin condition, but it affects your quality of life. For some women, it makes #nomakeup days the stuff of dreams and filters on your selfies your best friends.
But it doesn’t have to be that bad. Adult female acne isn’t uncommon, and there are solutions that can help you reclaim your healthy skin.
Though acne is one of the most common skin conditions in the U.S., we generally think of it only affecting teenagers in the throes of puberty. The truth is, acne vulgaris affects an increasing number of adult women.
In general, acne is caused when dead skin cells block the release of sebum, or oil, from your pores. Sebum itself isn’t bad — it’s simply oil produced in your sebaceous glands that works to keep your skin moisturized.
But an overabundance of it, particularly when trapped beneath the surface of your skin, can cause big trouble.
Mild acne is typically characterized by occupying less than half of your face, and includes few comedones, papules and pustules.
Moderate acne is generally acne that affects more than half of your face according to the Adult Female Acne Scoring (AFAST) scale .
Moderate acne is characterized by a few pimple types, including papules and pustules. Papules are small pink bumps, whereas pustules are pus-filled pimples, typically red around the base.
Deeper, scar-causing acne lesions like cysts and nodules generally signify severe acne.
The immediate cause of acne is trapped oil beneath the skin’s surface, but several factors can contribute to acne breakouts, particularly in women.
Hormone fluctuations around your menstrual cycle, pregnancy, menopause and when starting or stopping birth control pills can all lead to breakouts.
One study suggests acne worsens in 60 percent to 70 percent of women when they are in the premenstrual period.
Stress is another cause of acne flare-ups, according to the American Academy of Dermatology. When you’re under stress, your body produces more androgens — a type of hormone found more abundantly in males — which can stimulate oil production.
Sleep deprivation related to stress can further worsen acne.
Genetics may also play a role in adult acne. If one of your parents or siblings suffers or suffered from adult acne, you could be at a greater risk. Genetics can even impact the type and severity of your acne lesions, according to researchers.
Cosmetics, skin care products and hair products can clog your pores and make you more prone to acne. This is why you see many labelled as non-comedogenic, meaning that they won’t clog your pores.
Finally, certain medications and medical conditions can lead to acne in adult women.
Drugs such as corticosteroids, benzodiazepines, lithium and progestin contraceptives (among others) can trigger acne.
Diseases of the endocrine system, such as insulin resistance, polycystic ovary syndrome (PCOS) and endocrine tumors (on the ovaries, adrenal and pituitary glands, for example) are associated with adult female acne.
There are many potentially effective treatments available for moderate acne. Some of these can be found on drugstore shelves, while others require a dermatologist’s or physician’s prescription.
Benzoyl peroxide. Benzoyl peroxide is available over-the-counter as an acne spot treatment, in face washes, and other skincare products. It’s generally used in mild-to-moderate acne, and works to kill the bacteria that causes acne. Benzoyl peroxide can irritate and dry your skin, and can also bleach your clothing and pillowcases.
Topical retinoids. Topical retinoids, including tretinoin and adapalene, are prescription medications. They work to relieve acne by reducing dead skin cells and clogged pores. These medications are considered a first-line therapy, and generally have significant success in reducing acne lesions.
Antibiotics. Oral antibiotics may be prescribed for the treatment of moderate to severe acne. Medications like tetracycline and doxycycline work to kill the bacteria that causes inflammatory acne lesions. They’re often prescribed in conjunction with a topical product like a retinoid, but are rarely recommended for long-term use.
Oral contraceptives. If your acne is largely hormonal, birth control pills can regulate your hormones and control breakouts. They can be used long-term and primarily work by reducing oil production caused by fluctuating hormones.
Azelaic acid. This one may not be on your radar, but studies show that azelaic acid (in cream or gel form), is an effective first-line treatment for both inflammatory and non-inflammatory acne.
In addition to these medications, some lifestyle changes may help with breakouts. Specifically, working to regulate your stress levels and getting enough sleep may be helpful not only for your mental health, but your skin.
And as always, if you’re experiencing adult female acne and want to start doing something about it, you should consult with your healthcare provider to discuss your options — they’ll be able to help you come up with a game plan and treatment schedule, or refer you to a specialist who can.