By Vanessa Lapiner, Dermatologist
Still battling breakouts in your 30s, 40s, or even 50s? Yep, it’s a thing, and you’re definitely not alone. As a dermatologist, I can’t tell you how many times I’ve heard, “Wait, I’m dealing with wrinkles and pimples?!” Adult acne is a cruel joke from the skin gods: frustrating, unexpected, and downright unfair. The good news is you don’t have to suffer through it. Let’s dive into why this is happening (hint: it’s not because you stole your teenager’s skincare) and more importantly, how to fix it.
WHAT DOES ADULT ACNE LOOK LIKE?
Painful, red bumps, pus-filled pimples or throbbing Godzilla-like nodules or cysts under the skin which take forever to settle down. Adult-onset acne has a favourite hang-out spot over the lower third of the face in particular over the chin, jawline and neck.
WHY ME?
Blame it on a perfect storm of hormones, stress, and even your skincare routine. Adult acne happens because your hormones have decided to throw a party, and oil production is the guest of honour. Add in life’s stressors (hello deadlines, life-work juggle and small humans), and your skin can start to act like a moody teenager.
WHAT TO DO?
When your skin is throwing a bigger tantrum than your toddler, you need a strategy.
SIMPLIFY TO AMPLIFY
Streamline your skincare, and stick to it. Overloading your skin with too many products – especially ones with high concentrations of functional actives or even certain ‘gold-standard’ ingredients such as L-ascorbic acid, botanical oils or occlusive ingredients – will make things worse. Piling on make-up and concealer – even the ones that are supposedly non-comedogenic (meaning they shouldn’t cause blackheads or breakouts) or product-hopping in desperation to find an acne-busting solution will also add fuel to the acne fire.
HORMONAL HAVOC
In my practice, one of my go-to questions for women is: what contraception are you using? Hormonal IUDs, like the Mirena or Kyleena, release progestogen – a known acne trigger. You’ll be swimming frantically against the current if you’re not addressing hormonal acne at its source. If you’re experiencing sudden acne, it’s crucial to check your hormones, particularly free testosterone levels and the ratio of your luteinising hormone to follicle stimulating hormone, to rule out conditions like polycystic ovarian syndrome (PCOS) or menopause-related imbalances. Another key factor is your metabolic health. Testing fasting insulin and glucose levels can reveal hidden issues like insulin resistance, which could be fuelling your breakouts.
CHANNEL SHERLOCK HOLMES
Consider whether there could be any other sneaky skin saboteurs. Have you recently started taking any new meds such as antidepressants, mood stabilisers or anti-epileptics? What about whey powder, protein powders or creatine as part of a new gym programme? Is your new shampoo triggering breakouts over your forehead? Has laundry taken a back seat and you haven’t got round to changing your pillowcases often enough? If your skin is acting up, it’s time to play detective to eliminate as many undercover culprits as possible.
FOOD VS FACE
I see this all the time: chronic acne often mirrors imbalances in your gut. An overgrowth of ‘bad’ bacteria, compounded by inflammatory foods is a common cause. The trick isn’t to only use probiotics but also to repair the gut lining, boost fibre levels, and address digestive enzyme deficiencies. Tweak your diet. It’s sad but true that milk is not only pro-inflammatory but also contains breakout triggers such as testosterone and Insulin-like Growth Factors. Skimmed milk interestingly is the worst culprit as it contains less skin-clearing oestrogen than whole milk. Plus the lactose in milk is a sugar which stimulates insulin, the catalyst for a whole hormonal cascade resulting in more inflammation and oil production. High glycemic foods such as sugary sweets and processed carbs worsen breakouts in the same way.
STRESS LESS, BREAK OUT LESS
Stress wreaks havoc on your skin by triggering cortisol spikes that make your oil glands go haywire. You know that ‘tired yet wired’ feeling? That’s a warning sign that your cortisol levels are too high and it’s time to focus on stress management techniques like meditation, exercise or a simple nightly bath to sooth your mind and skin.
ENLIST THE HELP OF A PRO
Sometimes DIY just won’t cut it and that’s when it’s time to call in the pros. Your aesthetician can tailor in-clinic treatments like chemical peels, microneedling with acne-targeted serums, or advanced light therapies like ForeverClear BBL and Dermalux LED blue light to tackle stubborn acne. These treatments go deeper than anything you can do at home, giving your skin the reset it needs minus the guesswork.
DIAL-A-DERM
When your trusty over-the-counter soldiers like salicylic acid, benzoyl peroxide, sulfur, azelaic acid, zinc and niacinamide fall short, it’s time to hightail it to your dermatologist for some prescription power. Whether you need powerhouse retinoid creams, topical antibiotics, or oral meds like targeted nutraceuticals, testosterone regulators or even pulse Roaccutane (yes, that’s a thing!) your derm has an arsenal ready to deploy.
The bottom line? Adult acne is frustrating, but if you’re caught in a cycle of flare-ups, take charge with a targeted, dermatologist-approved plan because who has the time or patience for bad skin days?
