How Is Teen Acne Different from Adult Acne?
Males Are More Affected as Teens, Whereas Females Are More Affected as Adults, and All Adults Tend to See Breakouts More Around the Chin and Jawline

The Essential Information
Age: Adolescent acne, often referred to as "teen acne," affects people up to 25 years old, while adult acne affects people over 25 years old.
Prevalence: Teen acne is more common than adult acne.
Gender: Teen acne is more common in males, while adult acne is more common in females.
Location of Breakouts: Teen acne often includes breakouts on the entire face, whereas in adult acne, breakouts are more common on the lower half of the face (cheeks, chin, and jawline).
What They Have in Common: Teen and adult acne are both hormonal conditions, are passed down in a family through genetics, and may be affected by diet.
The Science
Acne in teens and adults is the same disease: acne vulgaris. However, depending on the age of the person with acne, it is classified as either:
- Adolescent or teen acne, which occurs in people under 25 years of age.
-
Adult acne, which occurs in people over 25 years of age, and can be either persistent or late-onset.
Persistent acne: If teen acne never goes away and continues past the age of 25, it becomes adult acne and is called persistent acne.
Late-onset acne: If acne shows up spontaneously after the age of 25, it's called late-onset acne.1,2
Although teen and adult acne are the same disease, teen acne is much more common than adult acne.

A comprehensive study of over 17,000 Chinese acne sufferers published in 2012 in the journal Acta Dermato-Venereologica found that only 25% of all acne cases were adult acne, most of which were persistent.3
Differences in Symptoms
Teen and adult acne differ in type of breakouts, location of breakouts, and presence or absence of scarring.
Teen acne:
- Type of breakouts: A combination of inflammatory lesions (papules, pustules, nodules, and cysts)4 and non-inflammatory lesions (whiteheads and blackheads).
- Location of breakouts: Usually on the forehead, nose, and chin.4
- Scarring: Less common in teen acne than in adult acne.5
Adult acne:
- Type of breakouts: Mainly inflammatory lesions (papules and pustules).5
- Location of breakouts: Usually on the cheeks and lower part of the face, including the chin and jawline.5 Also, there are more breakouts around the mouth, on the neck, chest, and on the back in adult acne than in teen acne.6
- Scarring: More common in adult acne, perhaps because breakouts are mainly inflammatory, and because adult acne is more resistant to treatment and takes longer to heal.5
Expand to read details of studies
Differences Between Sexes
- Teen acne: More common in males.
- Adult acne: Normally equally common in both sexes, but more common in females if it is late-onset acne.
Expand to read details of studies
Differences in Causes
Since teen and adult acne are different manifestations of the same disease, they both arise from hormonal imbalances. Teen and adult acne are also both more likely to arise if the sufferer has a family history of acne, and both teen and adult acne may be made worse by poor diet.
Smoking and alcohol consumption show a much weaker potential connection.3,8,9
Let's take a closer look at each potential cause, starting with hormonal imbalance.
Hormonal imbalance
In both teens and adults, an increase in the level of androgens (male hormones present in both males and females) in the body must occur for acne to form. This increase in androgens may be caused by:
-
Teen acne:
Males and females: Puberty and/or poor diet.
Females only: Poly-cystic ovary syndrome or pregnancy. -
Adult acne:
Males and females: Ongoing hormonal imbalance and/or poor diet.
Females only: Pregnancy or poly-cystic ovary syndrome.
Here's how androgens lead to acne: Increased androgen levels stimulate the growth of skin oil glands under the skin, resulting in increased production of skin oil (sebum), which can lead to a cascade involving acne bacteria (C. acnes), inflammation, and ultimately acne.10
Family history
- Teen acne: If your mother and/or father had acne, you're more likely to suffer with it, and to develop it earlier.
- Adult acne: If your mother and/or father had acne, you're more likely to suffer with adult acne.
The following British Journal of Dermatology article sums it up:

Both teens and adults are much more likely to develop more severe acne, and teens are likely to develop acne earlier, if they have at least one first-degree family relative (a parent, sibling, or child) with acne. According to an overview article published in 2012 in the British Journal of Dermatology, "Acne occurs earlier and is more severe in those with a positive family history."11
Similarly, a study that looked at 454 people with adult acne found that a family history of acne was a key risk factor for suffering from acne after age 25.

The study was published in the Journal of Clinical and Aesthetic Dermatology in 2018. The researchers found that among 454 patients with adult acne, 70.9% had a family history of acne. They wrote, "Our results agree with the literature data on adult acne....[that] family history represents one of the main risk factors."12
Several research groups have investigated the role of genetic (hereditary) factors in both teen and adult acne by studying pairs of twins at different ages. Identical twins are exactly the same genetically, whereas non-identical twins are genetically similar as a pair of siblings who are not twins.
Expand to read details of studies
Diet
In both teens and adults, diet is the third most frequently implicated factor by scientists in acne development and severity.9 However, research is still trickling in, and no firm conclusions can yet be made.
Diet suspect #1: Food with a high glycemic load
- Teen acne: Sugary foods may increase skin oil (sebum) production and teen acne.
- Adult acne: Sugary foods may increase skin oil (sebum) production and adult acne as well.
For both teens and adults, eating a diet that contains a large amount high glycemic load food may contribute to acne development. Examples of such foods include white bread, white rice, pasta, soda, or candy.
Eating high-glycemic load food increases the production of a hormone called insulin in the body. Because insulin is a "master hormone," which controls other hormones, an increase in insulin can lead to an increase in male hormones (androgens) in the blood. As discussed above, an increase in androgens leads to increased skin oil (sebum) production and acne.16
Diet suspect #2: Milk
- Teen acne: There might be a weak connection between dairy (particularly milk) and teen acne.
- Adult acne: There might be a weak connection between dairy (particularly milk) and adult acne as well.
The studies performed thus far on dairy and acne are based on questionnaires, which are prone to error, but most do show a correlation between milk and acne. No correlation has yet to be shown between cheese or yogurt and acne.16,17
Expand to read details of studies
In addition to the above potential causes of teen and adult acne, smoking and alcohol may also factor in.
Smoking
- Teen acne: Smoking may be linked to teen acne, but the evidence is contradictory.
- Adult acne: Smoking may also be linked to adult acne, but the evidence is contradictory.12,18,19,21,22
Expand to read details of studies showing a link between smoking and acne
Expand to read details of studies showing no link between smoking and acne
Alcohol
- Teen acne: Drinking alcohol might be linked with teen acne, but the evidence is limited.
- Adult acne: Drinking alcohol probably does not cause adult acne.
Expand to read details of studies
References:
- Williams, C. & Layton, A. M. Persistent acne in women: implications for the patient and for therapy. Am J Clin Dermatol 7, 281 - 290 (2006). https://www.ncbi.nlm.nih.gov/pubmed/17007539
- Tangetti, E. A. The role of inflammation in the pathology of acne. J Clin Aesthet Dermatol 6, 27 - 35 (2013). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3780801/
- Shen, Y. et al. Prevalence of acne vulgaris in Chinese adolescents and adults: a community-based study of 17,345 subjects in six cities. Acta Derm Venereol 92, 40 - 44 (2012). https://pdfs.semanticscholar.org/c638/70a8e25bd12b097dac2791015f013b5cbcca.pdf
- Tom, W. L. & Barrio, R. New insight into adolescent acne. Curr Opin Pediatr 20, 436 - 40 (2008). https://www.ncbi.nlm.nih.gov/pubmed/18622200
- Khunger, N. & Kumar, C. A clinico-epidemiological study of adult acne: Is it different from adolescent acne? Indian J Dermatol Venereol Leprol 78, 335 - 341 (2012). http://www.ijdvl.com/article.asp?issn=0378-6323;year=2012;volume=78;issue=3;spage=335;epage=341;aulast=Khunger
- Suh, D. H. et al. A multicenter epidemiological study of acne vulgaris in Korea. Int J Dermatol 50, 673 - 681 (2011). https://www.ncbi.nlm.nih.gov/pubmed/21595660
- Swathi, G. & Mamatha, S. K. A clinico-epidemiological study of acne in adults. Int J Science Res 11, 822 - 825 (2013). https://www.ncbi.nlm.nih.gov/pubmed/22565434
- Williams, C. & Layton, A. M. Persistent acne in women: implications for the patient and for therapy. Am J Clin Dermatol 7, 281 - 290 (2006). https://www.ncbi.nlm.nih.gov/pubmed/17007539
- Youssef, E. M. & Youssef, E. K. Diet and acne in Upper Egypt. Am J Dermatol Venereol 3, 13 - 22 (2014). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2836431/
- Dawson, A. L. & Dellavalle, R. P. Acne vulgaris. Br Med J 346, f2634 (2013). https://www.ncbi.nlm.nih.gov/pubmed/23657180
- Bhate, K. & Williams, H. C. Epidemiology of acne vulgaris. Br J Dermatol 168, 474 - 485 (2012). https://www.ncbi.nlm.nih.gov/pubmed/23210645
- Skroza, N., Tolino, E., Mambrin, A., et al. Adult acne versus adolescent acne: A retrospective study of 1,167 patients. J Clin Aesthet Dermatol 11, 21-25 (2018). https://pubmed.ncbi.nlm.nih.gov/29410726/
- Walton, S. et al. Genetic control of sebum excretion and acne - a twin study. Br J Dermatol 118, 393 - 396 (1988). https://www.ncbi.nlm.nih.gov/pubmed/2965597
- Evans, D. M. et al. Teenage acne is influenced by genetic factors. Br J Dermatol 152, 579 - 581 (2005). https://www.ncbi.nlm.nih.gov/pubmed/15787839
- Bataille, V. et al. The influence of fenetics and environmental factors in the pathogenesis of acne: A twin study of acne in women. J Investig Dermatol 119, 1317 - 1322 (2002). https://www.ncbi.nlm.nih.gov/pubmed/12485434
- Tsoy, N. O. Effect of milk and dairy products upon severity of acne for young people. World Appl Sci J 24, 403 - 407 (2013). https://pdfs.semanticscholar.org/fbbc/8bbfecee0b2efbfb2d7579550e8db6a068ab.pdf
- Ismail, N. H., Manaf, Z. A. & Azizan, N. Z. High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study. BMC Dermatol 12, 13 (2012). https://pubmed.ncbi.nlm.nih.gov/22898209/
- Adebamowo, C. A., Spiegelman, D., Berkey, C. S. et al. Milk consumption and acne in teenaged boys. J Am Acad Dermatol 58, 787-793 (2008). https://pubmed.ncbi.nlm.nih.gov/18194824/
- Capitanio, B., Sinagra, J. L., Ottaviani, M., Bordignon, V., Amantea, A. & Picardo, M. Acne and smoking. Dermatoendocrinol 1, 129-135 (2009). https://pubmed.ncbi.nlm.nih.gov/20436880/
- Yang, Y. S., Lim, H. K., Hong, K. K. et al. Cigarette smoke-induced interleukin-1 alpha may be involved in the pathogenesis of adult acne. Ann Dermatol 26, 11-16 (2014). https://pubmed.ncbi.nlm.nih.gov/24648681/
- Wolkenstein, P., Misery, L., Amici, J. M. et al. Smoking and dietary factors associated with moderate-to-severe acne in French adolescents and young adults: results of a survey using a representative sample. Dermatology 230, 34-39 (2015). https://pubmed.ncbi.nlm.nih.gov/25413494/
- Dréno, B, Bettoli, V., Araviiskaia, E., Sanchez Viera, M. & Bouloc, A. The influence of exposome on acne. J Eur Acad Dermatol Venereol 32, 812-819 (2018). https://pubmed.ncbi.nlm.nih.gov/29377341/