Research suggests that acne affects up to 15% of adult women and around 5% of adult men in the UK. For many, breakouts persist from adolescence, while others develop acne for the first time in their twenties, thirties, or even forties.
What Causes Adult Acne?
Hormonal Fluctuations
Hormones are the primary driver of adult acne, particularly in women. Fluctuations in androgens — especially around menstruation, pregnancy, polycystic ovary syndrome (PCOS), and perimenopause — stimulate excess sebum production and trigger breakouts.
Stress
Chronic stress raises cortisol levels, which in turn increases oil production and inflammation. Adults juggling demanding careers, families, and financial pressures are particularly susceptible.
Skincare and Cosmetic Products
Heavy or comedogenic products can clog pores. Switching to non-comedogenic, fragrance-free formulations often helps. Over-cleansing or using harsh scrubs can also worsen acne by damaging the skin barrier.
Diet
Emerging evidence links high-glycaemic diets and dairy consumption to acne. While diet alone rarely causes acne, reducing sugar and processed foods may support other treatments.
Treatment Options for Adults
The good news is that adult acne responds well to treatment. Options include:
- Topical retinoids: Adapalene or tretinoin remain first-line treatments and also offer anti-ageing benefits — a bonus for adult patients.
- Azelaic acid: Available as Skinoren (20%) on prescription or in lower-strength OTC formulations. It is safe in pregnancy and effective for post-inflammatory hyperpigmentation.
- Oral antibiotics: A 12-week course of lymecycline or doxycycline for moderate inflammatory acne.
- Hormonal therapies: Combined oral contraceptives (e.g., co-cyprindiol/Dianette) are licensed for acne. Spironolactone is sometimes used off-label (see note below) and can be effective for hormonally driven acne in women under medical supervision.
- Isotretinoin: Reserved for severe or treatment-resistant cases, available through dermatology referral.
Seeking Help
Many adults feel embarrassed about acne, but it is a legitimate medical condition that deserves professional attention. Your GP is the first port of call, and online prescription services now make consultations more accessible than ever. Do not suffer in silence — effective treatments are available.