Most common questions dermatologists hear in clinics is, “Why am I still getting acne at this age?”
Many adults assume acne is something that should disappear after teenage years. When it doesn’t, it often leads to frustration, self-doubt, and constant experimenting with skincare products.

The truth is, persistent acne in adults is far more common than people think. And in most cases, it has very little to do with poor hygiene or not taking care of your skin.

Why Adult Acne Is Different From Teenage Acne?

Acne that continues into adulthood behaves differently. It tends to be deeper, slower to heal, and more likely to leave marks behind. Instead of small whiteheads on the forehead, adult acne usually shows up along the jawline, chin, lower cheeks, or neck.

These breakouts are often painful. They don’t come and go quickly. Some stay under the skin for weeks, even when everything else in your routine seems right.

This is usually the first sign that the cause isn’t just on the surface.

Why Acne Doesn’t Go Away in Adulthood

From a dermatologist’s point of view, persistent acne is rarely caused by one single factor. It’s usually a combination of internal triggers and external habits that slowly push the skin into a constant state of inflammation.

Hormones

Hormonal influence is one of the biggest reasons adult acne refuses to settle. Even when hormone levels appear normal on reports, small fluctuations can stimulate oil glands. This is why many adults notice breakouts around their menstrual cycle, during stressful periods, or alongside conditions like PCOS.

Hormonal acne tends to sit deep in the skin and feels tender. These are not the kind of pimples that respond well to random spot treatments.

Excessive Oil Production

There is a common belief that oil production decreases as we grow older. For many people, this simply isn’t true. Some adults continue to produce excess sebum well into their thirties and forties. When oil mixes with dead skin cells, pores clog easily, leading to repeated breakouts in the same areas.

This is especially common in people with naturally oily or combination skin.

Stress

Stress affects the skin more than most people expect. Long-term stress increases cortisol, a hormone that directly increases oil production and inflammation. Dermatologists often see acne worsen during emotionally demanding phases of life, even when diet and skincare haven’t changed at all.

This is why adult acne often flares during work pressure, poor sleep, or major life changes.

Worst Skincare

Many adults with acne are actually over-treating their skin. Frequent exfoliation, mixing multiple active ingredients, or using strong “anti-acne” products can weaken the skin barrier. When the barrier is damaged, the skin becomes more irritated and starts producing even more oil to protect itself.

Instead of improving acne, this cycle keeps it going.

Diet and Lifestyle

Diet alone doesn’t cause acne, but it can make it harder to control. High sugar intake, refined foods, excess dairy, irregular sleep, dehydration, and smoking all increase inflammation in the body. When inflammation rises, the skin often reacts through breakouts.

In adults, acne is usually a reflection of how the body is coping overall.

Genetics and Medical Conditions

If acne runs in the family, the chances of persistent acne are higher. Certain medical conditions, especially those linked to hormones or metabolism, can also show up on the skin first. In some cases, acne is one of the earliest visible signs that something internally needs attention.

Why Adult Acne Needs Careful Treatment

Adult skin is more delicate than teenage skin. Harsh treatments may reduce acne temporarily but often leave behind dryness, irritation, and dark spots. This is why self-treatment rarely works long-term.

Dermatologists approach adult acne with balance. The goal isn’t just to clear pimples quickly, but to calm inflammation, protect the skin barrier, and prevent marks and scarring.

Treatment of Persistent Adult Acne

Treatment is never the same for everyone. Depending on the underlying cause, a dermatologist may focus on topical medications, internal treatments, or a combination of both. In-clinic procedures may be advised to speed up healing and reduce pigmentation.

Equally important are realistic skincare routines and lifestyle guidance that support long-term control rather than quick fixes.

Topical Treatments for Persistent Adult Acne

• Retinoids
  Help unclog pores, reduce blackheads and whiteheads, and improve skin texture over time. They are introduced gradually to avoid irritation, especially in adult skin.
• Benzoyl Peroxide
  Targets acne-causing bacteria and reduces active inflammation. Lower strengths are often preferred for adults to minimize dryness.
• Azelaic Acid
  A well-tolerated option that helps control acne while also improving post-acne pigmentation. Commonly used in patients prone to dark spots.
• Topical Antibiotics
  Used for a limited period to reduce bacterial activity and calm inflamed acne. They are almost always combined with other treatments to prevent resistance.
• Salicylic Acid
  Gently exfoliates inside the pores and helps reduce congestion. Useful for blackheads and mild inflammatory acne.
• Niacinamide-Based Formulations
  Support the skin barrier, reduce redness, and help regulate oil production. Often recommended alongside active acne treatments.

Procedural treatments for Persistent Adult Acne

Chemical Peels
Chemical peels help exfoliate the upper layers of the skin, unclog pores, and reduce excess oil. Superficial and medium-depth peels are commonly used for adult acne, as they improve active breakouts while also addressing post-acne marks.

Acne and Comedone Extraction
For patients with persistent blackheads and whiteheads, professional extraction can provide relief that topical products cannot achieve on their own. Dermatologist-performed extraction is done under sterile conditions to reduce inflammation and prevent scarring.

Laser and Light-Based Treatments
Laser and light therapies target acne-causing bacteria, reduce oil gland activity, and calm inflammation. These treatments are particularly useful for adults who experience frequent flare-ups despite ongoing medical treatment.

Microneedling
Microneedling is often recommended once active acne is under control. It stimulates collagen production, helping improve acne scars, enlarged pores, and uneven skin texture. In adults, this procedure is performed with caution to avoid triggering new breakouts.

Intralesional Injections
Painful, deep cystic acne nodules can be treated with intralesional injections. These injections rapidly reduce swelling, pain, and inflammation, often within a few days. This approach helps prevent long-term scarring and speeds up healing.

Can Adult Acne Be Controlled Long-Term?

While adult acne may not always disappear overnight, it can be effectively managed. With the right diagnosis, consistent treatment, and realistic expectations, most patients experience significant improvement and fewer flare-ups over time.

Persistent acne in adults is not a failure of skincare or self-care. It’s a signal from the skin that something deeper needs attention. With the right diagnosis and a thoughtful treatment plan, clear and healthy skin is absolutely achievable.

By combining medical expertise, customised care, and consistent follow-up, The Skin Firm Clinic focuses on achieving clear skin that is healthy, stable, and sustainable over time.