Acne can affect anyone, and we’re willing to bet that if you’re reading this, you’ve probably woken up to a zit at least once or twice. But while some people got to bid acne farewell after those tumultuous teen years (lucky ducks), many of us still deal with pesky pimples well into our 20s and 30s — and beyond.
Despite what you may have heard, chocolate likely isn’t to blame. Here’s the real explanation for why you may still be facing acne and how to get clear answers (and skin).
Types of acne
A tough skin day means different things to different people. As you probably already know, acne can show up as whiteheads, blackheads, painful cystic acne, and more. Dermatologists group acne into a few variants that require different treatments:
- Acne vulgaris. This common skin condition affects about half of women in their 20s, a third of women in their 30s, and a quarter of women in their 40s. It occurs because of oil-clogged follicles.
- Acne tarda. Developing acne later (after age 25) can be a sign of endocrine issues like PCOS.
- Cystic acne. These are the deep, painful inflammations that look more like boils than the more squeezable-looking surface acne. (You shouldn’t pop pimples of any kind, but especially not cystic acne.)
- Acne conglobata. This rare, more severe form of acne comes with painful cysts and acne that clusters in twos and threes. If your acne develops deep, tender cysts, you should see a dermatologist to talk about medications that can help manage it.
- Acne mechanica. Some sweaty athletic clothes or equipment can lead to skin issues when they rub against your skin.
- Occasional acne. This is also known as airplane acne, “maskne,” stress acne, and other times when factors align to produce pimples.
Common causes of acne
Your skin is a complex organ. Your body is continually shedding old cells, growing new ones, and producing an oil called sebum to keep skin moisture in balance. Acne happens when excess sebum and dead skin cells clog follicles under your skin, attracting bacteria and causing inflammation that leads to a pimple.
So what makes your skin tip off balance? Acne has a few causes:
- Hormone fluctuations. An increase of certain hormones can make your oil glands get a little overexcited and produce more sebum than your skin needs — this results in hormonal acne. Seed cycling might help get your hormones in balance.
- Family history. Check your parents’ yearbook photos. If they were acne-prone, some researchers say you might be more likely to develop zits, too.
- Pregnancy. Growing a new human inside your body can cause a variety of strange symptoms, including acne.
- Medications. Some meds may disrupt or change your usual oil balance, leading to pimples.
There are also other factors than can affect acne. You won’t necessarily start getting acne purely for these reasons, but if you’re already predisposed or have acne, they can make your skin worse:
- Stress. Stress isn’t just a mood; it shows up in your body and can stimulate certain hormone production, which can exacerbate acne.
- Environmental gunk. Acne comes from clogged follicles. Sometimes, skin can respond badly to humidity or pollution. (If you’ve spotted some “maskne” pimples around your chin from mask-wearing, you might know what we mean.)
- Diet. Does pizza give you acne? It depends. Starchy or sugary foods can worsen existing acne for some; for others, diet won’t make a difference.
- Skin products. Some oily makeup or skincare products can react negatively with your skin.
How to treat acne
Dealing with acne is common, so don’t feel bad if your skin isn’t perfectly clear. You have several options that can help you treat your skin.
First, see if there are changes you can make to help prevent acne in the first place. Swapping products to try a sensitive skin moisturizer or body wash instead can make a difference. If you get acne breakouts from a sweaty sports bra, try switching to one with sweat-wicking fabric, and make sure to wash your workout gear with a gentle detergent after every gym visit.
When it comes to treating existing acne, you can start by trying some over-the-counter (OTC) treatments, like a cream or ointment with benzoyl peroxide. Salicylic acid and some retinoids can also help treat acne.
If your skin is stubborn, not responding well to OTC treatment, or you want to rule out another potential condition like PCOS, see your doctor or dermatologist — they can diagnose conditions that may lead to more persistent or severe acne. Doctors can also prescribe stronger medicated creams or oral medication that can get to the root cause of acne to clear your skin.
Whatever acne-treating method you use, give your skin some time to rebalance and show results. Benzoyl peroxide treatments can take four weeks of consistent use to start working and months to show the full effects. Retinoid creams can also take two to six weeks to work.
We can all agree that acne is annoying, but it’s generally treatable. Luckily, you have several options to find your way to healthier skin. As always, speak to your dermatologist before making any major changes to your skincare routine.