As a skin care expert and esthetician for 30 years, I’ve been asked every skincare question imaginable, but the one I hear most often is, “My teenage years are long gone. Why do I still get blemishes and acne cysts as an adult?” Due to hormonal fluctuations carried over from your teenage years, it’s not uncommon to get breakouts well into your 20s, 30s and even beyond. In fact, adult acne is on the rise.
Adult breakouts tend to be more infrequent than teenage breakouts. Thus, it’s normal to question why you have perfectly clear skin for weeks, then one day a blemish appears out of nowhere. Is it from stress? Is it from not washing your face? Is it diet related? Is it from your dirty cell phone? PMS? The answer isn’t always easy to find. However, if you still get occasional blemishes, ask yourself these 11 questions and you just might find the solution—once and for all.
11 Reasons You Might be Breaking Out
#1 Do you touch your face often?
This may come as a surprise, but subconsciously touching your face all day makes it quickly become the dirtiest part of your body. While it’s important to wash your skin every night, it’s much more effective to not touch your face unnecessarily in the first place. This adds bacteria to the skin which causes breakouts.
Pro Tip: Keep your hands occupied. Get a toy or gadget that you can play with when you’re most likely to touch your skin.
#2 Have you been eating more dairy than usual?
When you develop cystic breakouts (those hard, painful, underground bumps that linger for weeks) on the chin, jawline and neck area, it might be a sign that you’re consuming more dairy than your body can tolerate. Your skin acts as an excretory system to get rid of things with which your body doesn’t agree. When you get too much dairy, it is by nature going to be harder to digest. This can cause cystic blemishes to appear on the lower area of the face. Read more about why eating dairy can cause cystic acne.
Pro Tip: The best way to determine if your acne cysts are directly related to your intake of dairy is to completely cut dairy out of your diet for at least three weeks. Keep a food diary and log every single thing you eat. This will hold you accountable. If you don’t develop any new cysts, then this might solve your problem. It doesn’t mean that you cannot eat any dairy at all. Slowly introduce dairy back into your diet. The point at which you start breaking out again shows your body’s tolerance level.
#3 Have you been under tremendous stress?
I’ve certainly had personal experiences that have confirmed this is true. In addition, though, the Stanford University School of Medicine conducted a study about this in 2002 involving students suffering from acne. Their college professors conclusively proved that exam stress worsened the students’ acne. According to researchers, their findings indicated that “subjects who had the greatest increases in stress during examination periods also had the greatest exacerbation of acne severity.”
Stress doesn’t just affect acne flare-ups. In general, it worsens the overall skin condition. It induces the adrenal glands into overproduction of cortisol. This is a steroid that makes sebaceous glands produce more oil, making skin extra oily. Thus, in stressful periods, people experiencing an increase in acne get more inflamed, pus-filled papules than simple whiteheads or blackheads.
Pro Tip: The easiest solution for reducing stress is to get 7-8 hours of sleep every night. The research supporting this is crystal clear. Sleep (or lack thereof) affects every aspect of your health, well-being, physiology and both physical and mental performance. It’s essential, not just for tissue repair and regeneration, but also to maintain a strong immune function (this is needed to fight off acne). When our bodies are under tremendous stress and fatigue, sleep can make a huge difference.
#4 Do you NOT wash your skin each and every night?
You probably know that sleeping with your makeup on is bad. But also think about the oil, dirt, and debris that builds on the skin during the day. The combination of these can absolutely trigger new blemishes. This is one habit that you must practice faithfully if you want a clear and healthy-looking complexion.
Pro Tip: The #1 reason people don’t wash their face at night is exhaustion. If this describes you, try performing your nighttime skin routine earlier in the evening when you’re less tired. In fact, your skin actually benefits greatly from doing this. Did you know that your skin starts to repair itself once the day turns from light to dark? Removing makeup gives your skin a clean palette for applying your night time performance products. I talk more about this in this video.
#5 Have you started using new skin care products?
When you introduce new products into your routine, you might experience some initial blemish purging. This is especially true if the products are exfoliating your skin more than it’s used to. (This is actually a good thing; exfoliants restructure the skin’s natural cell turnover process) However, if the purging continues for more than 4-6 weeks, this means the products may not be a good fit for your skin.
Pro Tip: When introducing any new product to your skin, I always recommend using one new one for 3-4 days before adding a second new product. If your skin reacts negatively, it’ll be easier to determine which product is causing it. However, some breakouts can start weeks before they actually appear, so this isn’t always a completely sufficient test. For any allergic or rash reaction, though, it’s at least a good place to start. Read how to avoid a negative reaction to new skincare products.
#6 Are you about to start your menstrual cycle?
Many women experience a surge of blemishes at the start of their monthly cycle. This process is completely normal and common, but can still be very frustrating. Just before the start of a woman’s cycle, there is more progesterone in the skin. This causes water retention, resulting in a puffier appearance. (If you find yourself bloated and your pants get a little tight, then this surely will sound familiar.)
When this occurs, it puts pressure on the pores and creates a narrower pore lining. Additionally, oil can get thicker during this time because of an imbalance of hormones and an increase of testosterone during the pre-period hormonal shift. When thicker oil tries to get through a narrower opening, this creates an ideal environment within the skin for breakouts.
Pro Tip: Taking Vitamin B-6 every day for one week prior to your cycle may help regulate hormonal imbalances. Calcium-magnesium supplements may also help when taken during this time. I also advice switching up your skincare routine slightly to minimize bacteria.
#7 Do you suspect your hormones might be off?
Hormones are chemical messengers, created by our bodies to regulate everything from metabolism to cell growth to reproductive cycles and mood. When they fluctuate, they can trigger weight gain, depression, sleeplessness, and fatigue in addition to adult acne and breakouts. A common sign of hormonal imbalances is an inconsistent, sporadic, or even nonexistent monthly cycle.
Pro Tip: I would advise you to check with your physician or gynecologist to see if they can run tests to check your hormone levels. From there, they may have recommendations to treat the imbalance internally. Read how birth control pills may affect your skin.
#8 Have you flown on a plane in the last few days or week?
I can attest to this one. Flying on an airplane absolutely throws my oil-producing skin out of whack. This usually leads to post-flight breakouts. The cabin of an airplane has extremely low humidity, which causes the skin to get extremely dehydrated (it lacks water). When an oily-prone skin type gets dehydrated, the skin tries to repair itself by producing even more oil. Since oil breeds bacteria and bacteria leads to breakouts, flying on a plane can definitely cause problems.
Pro Tip: Whenever you travel by plane, you should have two main objectives to re-set your skin once you have arrived at your destination. The first is to exfoliate surface dry cells, and the second is to hydrate the newly exposed cells and reduce oil and bacteria from within the pores. Doing so can really help minimize breakout activity. Post-flight, I always exfoliate first then hydrate and reduce oil and bacteria.
#9 Have the weather temperatures been fluctuating from day to day?
When the season is changing and the weather is warm one day and cold the next, it can really leave your skin confused. You guessed it–unbalanced skin can lead to blemishes, especially with sweat.
Pro Tip: If this happens, you should adjust your skin care routine ever-so-slightly. You don’t want to go for a major overhaul and switch your entire routine to acne-focused products. Over-compensating like that could leave your skin dry and irritated. A great way to address the sudden breakouts is to temporarily switch to an exfoliating acid serum that uses salicylic acid.
#10 Are you using an IUD?
IUD’s, while a very popular form of birth control, can cause acne. This is listed as a side effect of IUD’s containing progesterone, specifically Mirena, Skyla and possibly Liletta. The IUD releases progestin into the body, and this is converted into progesterone. This, then, turns into various types of testosterone. These hormones can overstimulate oil glands. When oil mixes with dead cells in the pore lining, this can trigger acne. This is particularly a cause of cystic acne—the hard, painful bumps that develop deep within the skin and can linger for weeks. Read how this client got rid of hormonal breakouts caused by an IUD.
Pro Tip: Since the underlying cause of IUD-induced breakouts is a hormonal imbalance, it’s best to consult with your physician. He or she can help you explore the possibility of starting some hormone-regulating medications to counteract the testosterone. Some people see an improvement from a medication known as Spirolactone. It was originally developed as a diuretic to treat high blood pressure, but it’s now being prescribed off-label for improving adult acne in women. It works by blocking androgen hormones from stimulating oil glands. Another option is to prescribe a patch that releases a small amount of estrogen. If need be, some people simply have the IUD removed.
#11 Have you recently started using a Clarisonic brush or facial scrub?
When rubbed too hard on the skin, sonic brushes and/or abrasive facial scrubs can increase breakout activity. I think this may have to do with what type of product applied immediately after. Physical exfoliators like these can potentially create pathways in the pores into which pore-clogging moisturizers can enter further. This can create blockages in the pores which leads to bumps and breakouts. For many, the benefits of exfoliation that these provide can actually help lessen breakouts. However, I know that personally, I need to be careful with scrubs. As for the Clarisonic, I never use one and here’s why.
Pro tip: When using a Clarisonic or a facial scrub, be sure to avoid using too much pressure when massaging these over the face. Go lightly. In addition, pay close attention to what you’re applying to the skin afterward. Choose an oil-free serum and moisturizer. These are better choices for breakout-prone skin.
So there you have it. These are some of the most common causes of breakouts that I tend to see. It’s very, very challenging to ever truly know why one gets breakouts in their adult years but hopefully, this provides some fresh insight and gives you some new things to try.
Celebrity Esthetician & Skincare Expert
As an esthetician trained in cosmetic chemistry, Renée Rouleau has spent 30 years researching skin, educating her audience, and building an award-winning line of products. Trusted by celebrities, editors, bloggers, and skincare obsessives around the globe, her vast real-world knowledge and constant research are why Marie Claire calls her “the most passionate skin practitioner we know.”