Why You're Still Breaking Out & What To Do About It

Illustrated by Anna Sudit.
Breakouts are one of the top skin-care concerns of my clients, and age isn't always a big factor. While acne is usually thought of as a teenage concern, breakouts can plague adults well into their 30s, 40s, and beyond. It's the cause of breakouts that generally changes — that and the fact that they typically don’t occur as frequently as they did in adolescence.

Fortunately, no matter what stage of life you're in, there are ways to help prevent and treat breakouts. Here are some tips to help you combat acne throughout the decades.

In the early to mid 20s (ages 22 to 25, in particular), hormones from the teenage years should start to level out, and breakouts should diminish. However, fluctuations in hormone levels right before and during your period can stimulate sebaceous glands to produce excess oil, resulting in monthly breakouts.

During this time, many young women may start to use birth control pills, which can have an impact on breakouts since these pills affect the natural hormonal balance. Their effect on skin can be either positive or negative, and you should work with your doctor to figure out which one will benefit your skin.

Tips to prevent breakouts during this period:
Use a gentle antibacterial cleanser to prevent monthly hormonal breakouts. Since the chemistry of skin may change during the menstrual cycle, switching up your cleanser — not your entire routine — can help avert a breakout. Look for a formula with salicylic acid, and start using it approximately three days before your period starts.

Illustrated by Anna Sudit.
Go easy on the anti-ageing products. There is so much awareness about preventing skin ageing that many young women are conscious about putting in the effort earlier rather than later. While I certainly applaud and encourage this effort, it’s important not to overdo the anti-ageing regimen. This is because many products for ageing skin have potent active ingredients that can increase the metabolism of the cells (such as certain vitamin combinations and peptides), and these may be too active for a younger complexion, where the metabolism and cell growth are already functioning efficiently on their own. The stimulation of anti-ageing products could potentially increase breakouts — the opposite of what you want.

If you are prone to cystic breakouts, use a treatment formulated for cysts to prevent these monthly flare-ups. Get ahead of cyst formation by experimenting with your dairy intake. Many of my clients have noticed a direct correlation between their dairy intake and breakouts.
Stress is a big culprit for breakouts during this period. Many women who never broke out in their teens may experience breakouts because of elevated stress levels. Along with clogged pores and breakouts, women in their 30s begin to detect signs of ageing.

Tips to prevent breakouts
during this period:
Manage stress to reduce breakouts. We know that the 30s are a stressful period in a woman’s life, when she may be juggling family, an active household, and a busy career. Stress not only affects acne flare-ups; it also worsens the overall skin condition, which is why it's essential to keep it at bay.
Illustrated by Anna Sudit.
Stress causes breakouts because it induces the adrenal glands into overproducing the steroid cortisol. That makes the sebaceous glands produce more oil, thus making skin more oily and prone to bumps. These breakouts often look like inflamed, puss-filled papules rather than simple whiteheads or blackheads.

Make sure you are getting enough sleep and exercise to keep stress levels low. You may also consider practicing meditation to help alleviate stress.

Practice a balanced skin-care routine that focuses on anti-ageing, yet won’t add excess oil, especially if you’re still experiencing a good amount of oil production and breakouts. Look for moisturisers and specialty serums that are lightweight and possibly even oil-free.

If you experience hormonal cystic acne, try drinking hot lemon water first thing in the morning (before you eat or drink anything else) to help flush out and purify the body internally, potentially reducing breakouts.


By this time, regular, consistent acne shouldn’t be much of an issue; however, you may still experience monthly breakouts due to hormonal fluctuations from perimenopause. Oestrogen helps regulate the sebaceous glands (which are responsible for producing skin oils), and during perimenopause oestrogen levels slowly start to decline, which can still lead to the occasional breakout for some women.

Tips to prevent breakouts during this period:
Use acne spot treatments as needed for blemishes. A good cyst treatment can help prevent and treat monthly cystic flare-ups. If you typically experience a cystic breakout each month, apply the spot treatment to the cyst-prone area three days before your period begins, and continue using it throughout the week. A spot treatment is effective because it treats just the area with the flare-up instead of treating the entire face where no breakouts are present, which would only increase dryness all over.
Illustrated by Anna Sudit.
You can also get a cortisone shot from a dermatologist or apply ice or a hydrocortisone cream to reduce inflammation. Just don't pick at your breakouts — it will delay the healing process happening within the skin and could lead to lingering scars. This is especially true of ageing skin, which takes longer to heal.

Women in this age group may also want to consider trying a retinol treatment. Retinol is beneficial for preventing the appearance of ageing (smoothing and reducing the look of wrinkles, brown spots, and large pores) and is best for those whose acne years are behind them.
As for red, inflamed, pustular-type acne, these blemishes require both exfoliation and reducing bacteria in the pore lining without causing inflammation, and so retinol is not the best choice. Again, a well-formulated, alcohol-free salicylic serum will be more effective. A non-prescription retinol is not an effective strategy if the goal is to prevent inflamed blemishes.

Regardless of what age group you fall into, it’s important not to switch up your entire routine to one focused exclusively on combating acne issues if you experience only the occasional breakout. You can also tweak your skin-care routine to be a bit more acne-focused if your breakouts appear the same time every month — just don't make the whole month about fighting acne if there are periods when you have none.


More from Skin Care