Once thought to be the province of teens, acne is sprouting up—literally—in more and more adults, even rising to what The New York Times calls “epidemic proportions.” The data is there to prove it, too: A 2018 report published in the journal Clinical, Cosmetic and Investigational Dermatology demonstrated a substantial upsurge in adult acne, which overwhelmingly affects women.
“Acne occurs frequently after the teenage years and at significantly higher rates in women compared with men,” clinical associate professor of dermatology at NYU’s Langone Medical Center (and author of 100 Questions & Answers About Acne) Doris Day says. Indeed, “as many as fifty percent of women will suffer from acne at some point in their adult lives.”
While experts aren’t entirely sure why they’re seeing an uptick in adult acne cases, several possible causes have asserted themselves.
Chief among them? Hormonal fluctuations. As estrogen takes a nosedive before your period, your testosterone levels rise, thus turning up oil production. In turn, this may lead to clogged pores and the pimples that arrive with them. Doctors also speculate that the escalation in adult acne is due to contraceptives. Women are taking birth control pills at an earlier age and many stay on them for decades. When they do go off of them, their hormones go through a similar shift to a teenager’s, as hormones that have been suppressed for years are, essentially, switched back on.
Stress also seems to play a leading role in adult acne—for men and women. As Dr. Alexa Kimball, a professor of dermatology at Beth Israel Deaconess Medical Center, found through her research, “stress could indeed trigger an acne episode. And the greater the stress, the more pronounced the breakout.” This is due in part to the stress hormone CRH (corticotrophin-releasing hormone), which fixes to the skin’s sebaceous glands and cranks up oil production, thus resulting in those pimples we thought we’d left behind in high school. What’s more, stress leads to heightened cortisol levels, which can result in oiliness and inflammation. (Stress also tends to cause people to sleep less, eat poorly, ditch their usual skincare routines, and forgo relaxation strategies—all of which impact skin’s health and appearance.)
Another possible culprit? Environmental skin stressors, such as pollution, exposure to oil and grease (hello, all you cars on the road), and sun exposure.
Before you despair, do know that there’s a number of ways you can treat—and even prevent—adult acne. Here are 6 smart ways to thwart it:
1. Keep your phone clean
Sound strange? Think again. It’s estimated that we touch our phones roughly 2,000 times per day. Bacteria, dirt, and other matter can build up on your phone and lead to breakouts on the lower half of your face (where, by the way, dermatologists see the most acne flare-ups in adult women). You likely can’t imagine living without your phone but you can wipe it down daily with an antibacterial wipe—and use headphones while speaking.
2. …and your hands off your face
Touching your face—when stressed, when tired, and sometimes when you’re just plain happy—is as natural as smiling. But the same bacteria and dirt that gathers on your phone also collects on your fingers, and repeatedly touching your face with them can spawn pimples. Self-soothe yourself—or get an instant pick-me-up—by crossing your arms and alternatively gently tapping your shoulders (a technique somatic therapists recommend to quiet the nervous system) or go for a brisk walk.
3. Watch your insulin intake
Studies show that excess insulin—which is created by eating foods with a high-glycemic index such as pasta and bread—may have an impact on androgens (like oil-generating testosterone). Watch your complexion—and your waistline—by nixing these eats from your diet.
4. …and your dairy consumption
Even organic half-and-half, milk, cheese, and other dairy products are high in hormones that can affect your skin’s clarity and oil production. Replace that creamer in your coffee with nut milk, and trade that cheese in your sandwich for magnesium-rich avocado. Pile the rest of your plate with antioxidant-rich, skin-boosting foods, such as kale, almonds, blueberries, spinach and beets.
5. Change your pillowcase
Save your skin by swapping your pillowcase? Yes. Much like your phone, your pillowcase collects bacteria that can prove deleterious to your skin’s health. (After all, consider what it comes into contact with—residual hair products, sweat, oil and makeup, to name just a few.) While it’s not realistic to sleep on a fresh pillowcase every night, be sure to change it at least once a week.
6. Simplify your skincare routine
Exfoliators hold a lot of allure—who doesn’t want that fresh-scrubbed, radiant look?—but exfoliating too often can cause more harm than good. Over-exfoliating sensitive, acne-prone skin damages your natural barrier and signals the skin to produce more oil to try to balance itself out. The result? Even more breakouts. Meanwhile, experts hypothesize that adult acne is on the rise because of the sheer number of products we pile on our hair and face. (What’s more, “combining multiple products may inactivate the hero ingredients in each, and using the wrong things can certainly cause an acne flare,” the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital Joshua Zeichner told The New York Times).
Rather, streamline your skincare routine: Exfoliate no more than once a week and on the daily use a gentle cleanser followed by a light moisturizer and sunscreen. At night, use a retinol treatment, which can prevent dead skin cells from clogging pores (while also helping erase fine lines and wrinkles). Lastly, look for products that are free of irritants. Because while your acne may have followed you into adulthood, that petulance—in products and otherwise—doesn’t have to.