Adult acne can be devastating — and truly mystifying, too. Just when you think you've bypassed the blackheads, under-the-skin bumps, and angry red spots of your teenage years, they come back with a vengeance, reminding you of their reign of terror at a time when you're finally supposed to have everything together.

"It is definitely a misconception that you only get spots in your teens," says London-based dermatologist Dr. Justine Kluk. "Around 10 to 15% of women develop acne for the first time, or continue to suffer from it, well beyond their teenage years, and adult acne appears to be on the rise." While it's possible to get the same type of breakouts as an adult as when you're a teenager, women in their 20s, 30s, and 40s tend to experience more zits on the lower third of their faces. "The sides of our cheeks and places like our neck and chin often bear the brunt," Dr. Kluk says.

From stress to hormones to your diet, there are numerous factors that can contribute to acne flare-ups in adulthood. "Genes play an important role. We know that a strong family history of acne and onset of acne at an early age can predict a more severe or persistent course. Hormones can also cause acne to flare up, which is why many women have increased breakouts around the time of their period," Dr. Kluk says. "Underlying medical conditions such as polycystic ovary syndrome (PCOS, which affects approximately 8% of women of reproductive age) also increase the risk of acne." The wrong makeup and skin-care products can also contribute.

From a proper skin-care routine to prescription medication, here's everything Dr. Kluk prescribed one Refinery29 staffer for her acne, a case she describes as comedonal (small, flesh-colored bumps, inflammatory (red and irritated), and nodular (often large and painful) with most breakouts occurring on her chin and lower face. Of course, what works for one person might not work for you, and everyone's skin concerns are different. When in doubt, see a derm — and don't forget to stay consistent with your routine for best results.

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