…there appears to be an increase in post-adolescent acne, and that the disease is lasting longer and is requiring treatment well into the mid forties."2

International Journal of Cosmetic Science, 2004

Adult acne affects 25% of adult men and 50% of adult women at some time in their adult lives. 1/3 of adults affected with facial acne also have acne on their back and body. These are the official statistics, but most adults have had a zit or two in their adult lives. For still unknown reasons, people seem to be struggling with acne into their 20s, 30s, 40s and beyond.1-3 Dermatologists find themselves seeing more adult acne patients than in previous decades. Adult acne can cause depression and social anxiety in an adult the same way it can in a teen.2,4

Primarily men


If a man experiences acne as an adult, most likely he simply has adult acne. This means a case of acne which is stubborn and has held on since adolescence without reprieve. Few men experience adult onset acne--acne which suddenly develops well into a man’s 20s or later. If a man does experience adult onset acne, it is likely due to some sort of prolonged irritation of the skin or comedogenic product he is using.

Almost always women


Just like men, women can experience adult acne--acne symptoms which stubbornly stick around past adolescence. However, unlike men, many women experience adult onset acne as well—a sudden upsurgence of acne well into her 20s or beyond.

Men

Since acne in a man is normally the same stubborn case of acne he had as a teen, treatment usually remains the same. Benzoyl peroxide, when used correctly, can achieve or approximate total clearing in most adolescent and adult males. Accutane, while it is often reserved for males with moderate to severe acne and can come with serious side effects, tends to cure about 2/3 of men who take it as well. Dermatologists also have other treatments that they can prescribe.

Women

Female hormones tend to fluctuate more than male hormones, and unlike men, hormonal treatment is an option for women.5-11 If you are experiencing waves of premenstrual breakouts or are simply dealing with the same stubborn case of acne you had as an adolescent, a quick check of hormone levels (you can ask your family doctor for this test) is prudent. However, if you and your doctor decide not to pursue hormonal treatment, benzoyl peroxide, when administered correctly, should prove strong enough to achieve and maintain consistently clear skin. Doctors can also prescribe Accutane, a powerful systemic oral medication, to women with more severe acne. Accutane provides a cure to about 2/3 of women, but comes with severe side effects including severe birth defects. Doctors can also prescribe other medical treatments.

A special case: Poly-Cystic Ovary Syndrome: If you experience a stubborn outbreak of adult onset acne, especially if it comes with hirsuitism (hair overgrowth) and/or menstrual irregularities, it may be a good idea to speak to your doctor to rule out the possibility of poly-cystic ovary syndrome, an easily diagnosed reversible disorder that can affect hormone levels and result in acne.12


  1. Cunliffe WJ, Goulden V and Stables GI. "Prevalence of Facial Acne in Adults." Journal of the American Academy of Dermatology. 1999; 41(4): 577-80.
  2. Knaggs HE, et al. "Post-adolescent acne." International Journal of Cosmetic Science. 2004; 26(3): 129-38.
  3. Collier CN, et al. "The prevalence of acne in adults 20 years and older." Journal of the American Academy of Dermatology. 2008; 58(1): 56-59.
  4. Gollnick HPM, Finlay AY and Shear N. "Can we define acne as a chronic disease? If so, how and when?" American Journal of Clinical Dermatology. 2008; 9(5): 279-284.
  5. George R, Clarke S and Thiboutot D. "Hormonal therapy for acne." Seminars in Cutaneous Medicine and Surgery. 2008; 27(3): 188-96.
  6. Seirafi H, et al. "Assessment of androgens in women with adult-onset acne." International Journal of Dermatology. 2007; 46(11): 1188-91.
  7. Williams C and Layton AM. "Persistent acne in women: implications for the patient and for therapy." American Journal of Clinical Dermatology. 2006; 7(5): 281-90.
  8. Bataille V, et al. "The influence of genetics and environmental factors in the pathogenesis of acne: a twin study of acne in women." The Journal of Investigative Dermatology. 2002; 119(6): 1317-22.
  9. Cunliffe WJ, Goulden V and McGeown CH. "The Familial Risk of Adult Acne: A Comparison Between First-Degree Relatives of Affected and Unaffected Individuals." The British Journal of Dermatology. 1999; 141(2): 297-300.
  10. Ascenso A and Marques HC. "Acne in the adult." Mini-Reviews in Medicinal Chemistry. 2009; 9(1): 1-10.
  11. Choi CW, et al. "The clinical features of late onsent acne compared with early onset acne in women." Journal of the European Academy of Dermatology and Venereology. 2010; 25(4): 454-461.
  12. Kamangar F and Shinkai K. "Acne in the adult female patient: a practical approach." International Journal of Dermatology. 2012: 51(10): 1162-74.