The Expert's Guide To Fighting Adult Acne

Illustrated by Joel Burden.
When we said goodbye to puberty, we thought we said goodbye to a number of things: awkward interactions with our 13-year-old crushes, arguments with our parents about sleepover privileges, and the frequent, unexpected appearance of pimples. In reality, our adolescent problems have just evolved. Dating continues to be awkward, and our parents still just don't get it. But when we take a look at the acne we’re still dealing with, there’s something particularly archaic about the whole situation. After all, acne is supposed to be a right of passage: We dealt with the huge pimple on our nose (preserved forever on school picture day), and in return, we should be rewarded with blemish-free adult skin, right? Yet, here we are — well past our pre-teen years and still breaking out.
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We asked dermatologists Sejal Shah, MD and Joshua Zeichner, MD why we just can’t seem to get away from these pesky blemishes, and they gave us seven reasons you're still breaking out. They range from biological to habitual. The good news is, knowledge is power. From simple over-the-counter solutions — like the once-prescription-only Differin Gel Acne Treatment — to making healthier food choices, we’re breaking down everything you need to know about treating your adult acne. Read through to finally say goodbye for good.
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Illustrated by Joel Burden.
Getting Dirty

Dr. Shah says one of the most common yet unexpected causes of adult acne is the little things that come into contact with your face every day. Items like your yoga mat, pillowcase, cell phone, and more are riddled with dirt and sweat that can clog pores and cause breakouts. So take extra care to clean and sanitize these items often. Wash your sheets regularly, clean your yoga mat after every use, and use a disinfectant wipe to clean your phone at least once a week.
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Illustrated by Joel Burden.
Beauty Buildup

Adults tend to use more hair and skin-care products than they did when they were teenagers. (After all, we're not limited to an allowance anymore.) And common ingredients such as oil, shea butter, lanolin, and sodium laureth sulfate can dry out your skin and lead to excess oil production. But how do you know if your breakout is due to your beauty products and not any other number of factors? These blemishes typically occur where you apply these products, such as along your hairline, jawline, or on your upper back where your hair hangs down. Dr. Shah suggests paying close attention to your product labels. "Choose products that are oil-free, noncomedogenic, or nonacnegenic," she says. If you find that a product is causing the acne, she suggests that you stop using it immediately and treat the blemishes how you normally would.
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Illustrated by Joel Burden.
Family Ties

Unfortunately, even if you work to keep your skin in tip-top shape, some people have a genetic predisposition to acne that can make you more likely to develop it as an adult. (Thanks, mom and dad.) If this is the case, you can treat yours by severity. More severe cases where it goes past just a clogged pore (those deep inflamed bumps known as cystic acne), may require professional help. Dr. Zeichner suggests going to see a dermatologist for prescription antibiotics or other treatments. For regular flare-ups, use a topical product that has known acne-fighting ingredients such as adapelene, the retinoid found in Differin Gel Acne Treatment.

If Differin sounds familiar, you may have previously been prescribed it by a derm, but it's now available at the drugstore. In fact, the active ingredient is the first topical retinoid for acne treatment available over the counter. It works on both big and mild breakouts alike by increasing cell turnover and preventing pores from clogging. Just make sure to use a gentle cleanser and moisturizer before layering on the SPF, because your skin will be more sensitive to the sun — as with any retinoid.
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Illustrated by Joel Burden.
Stressing Out

Stress and acne go hand in hand — and unfortunately, you probably experience just as much stress (if not more) as you did as a teen. It's because stress hormones increase oil production. According to Dr. Shah, acne caused by any type of hormone appears in the lower half of the face, like on your cheeks and chin. She suggests altering your lifestyle to reduce stress. Of course, that can be easier said than done. Try keeping your phone out of the bedroom to prevent late-night work emails (or social-media stalking), and seek out exercises that clear and soothe the mind, like yoga and meditation. Getting a good night's sleep (typically seven to eight hours) is also crucial to make sure you’re well rested for a hectic day. Luckily, stress breakouts typically start small, so add a topical treatment to your daily regimen; it should be sufficient enough to calm blemishes.
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Illustrated by Joel Burden.
Your Diet

Both Dr. Shah and Dr. Zeichner agree that poor nutrition makes you more susceptible to breakouts. And when you're working late or eating on the go, it can be difficult to make healthy choices. Sugar, simple carbs, and dairy can be the biggest acne culprits. So if you're consuming more of these than usual, your acne will flare up in places that you typically break out. We know it’s hard to go cold turkey, so try limiting your intake or look for healthier alternatives. Swap white breads and rice for brown, and choose fresh fruit over processed treats. You can also incorporate more antioxidant-rich foods that reduce inflammation, like fish and green tea.
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Illustrated by Joel Burden.
Pill & Supplement Overload

Birth control, supplements, vitamins — what you put into your body can cause your hormones to fluctuate. While there are three FDA-approved birth control pills that help treat acne, Dr. Shah explains that some options contain more androgen components (masculine hormones), which overstimulate oil glands and cause acne to flare up. If you're on a high-androgenic pill and experiencing breakouts well past the six-week adjustment period, you might consider speaking to your doctor about switching. Supplements, such as whey protein and biotin, can also pose problems for your skin (although there isn't confirmed research on this yet). Instead of using acne treatments while on the supplements, she suggests looking for alternative sources altogether. "It's just going to be an uphill battle to try to fight it," she says.
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Illustrated by Joel Burden.
Roller-Coaster Hormones

Adult acne occurs more in women than in men (insert unamused emoji here), and we can thank fluctuating hormone levels for that. Our hormones are particularly in flux during menopause or during our period — showing up as breakouts a week before Mother Nature visits. Dr. Shah suggests using a cleanser that controls excess oil the week leading up to your period. To treat existing acne, she preaches looking at the severity of it and going from there. One note of caution: Your skin tends to get drier as you age. Since OTC treatments can further exacerbate the issue, she suggests adding a moisturizer on top of any topical treatment to lock in hydration.
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