Once considered a rite of passage reserved for puberty, acne is now increasingly popping up in adults—and especially in women. According to the latest stats from the American Academy of Dermatology, adult acne affects more than half of all women between the ages of 20 and 29, more than a third of women between the ages of 30 and 39, and over a quarter of women between the ages of 40 and 49.
Exactly why this is happening hasn’t been proven, but most dermatologists agree it has something to do with exposures unique to adulthood. What causes acne—increased sebum production, a buildup of dead skin cells, bacteria overgrowth, and inflammation—is the same for teens as it is for adults, but “there are a number of other influencers that drive those causes that exist more in adults, especially now,” says New York City dermatologist Sejal Shah, M.D. Many are more modern issues, like rocketing stress levels, which stem inflammation, and a rise in prescription medication use, which can have acne as a side effect, says Shah.
If you’re getting reacquainted with breakouts for the first time since…well, you can’t even remember, take comfort in the fact that there has been a sea change in the way the issue is thought of and treated. Attacking your skin won’t clear it. Here, what will.
Ditch squeaky-clean skin
Conventional wisdom holds that breakouts are caused by an excess of oil. As a result, most people with persistent adult acne try to eradicate all traces of it from their faces. But that’s actually counterproductive.
“When you use very harsh products on your skin and strip its natural oils, your skin will sense that it’s dry and respond by producing more oil, which can lead to more acne,” explains Shah. The other problem with using harsh products—think of acne face washes and scrubs loaded with benzoyl peroxide and tingly, alcohol-based astringents— is that “this disrupts the skin’s microbiome, its balance of bacteria,” says Shah. Although this topic of research is still relatively new, evidence emerges regularly underscoring the role microflora (bacteria) play in keeping skin clear and calm.
Embrace face oil
Oil-free has long been touted as a must on product labels for adult acne sufferers, but the term means very little. Just because something doesn’t have oil in it, doesn’t mean it won’t clog pores—it could still contain fillers that congest skin. What’s more, natural oils can actually help eradicate acne, not create it. Look for a face oil or face serums rich in the inflammation-quelling fatty acid linoleic acid—these include safflower, hemp, rosehip and pumpkin seed. Research has demonstrated that the fats on the surface of the skin in acne-prone individuals are deficient in linoleic acid and that “treating acne bumps with linoleic acid helps reduce their size,” says Shah.
One aspect of these natural oils that helps them clear acne is their antioxidant content, which neutralizes free radicals (unpaired electrons in the environment that injure skin). Studies indicate that oxidative stress—specifically free radical damage to sebum—can spur acne, and one way it does this is by clogging pores. “When free radicals interact with squalene, a substance found naturally in skin sebum, it transforms into something called squalene peroxide that’s highly comedogenic,” explains Shah, who recommends that all of her patients use an antioxidant serum or oil, especially her acne-prone ones.
And this is yet another reason why wiping out every drop of skin’s natural oils isn’t a good idea. Sebum is naturally packed with antioxidants like vitamin E. One study found that oil-zapping benzoyl peroxide reduces skin’s natural antioxidant levels by a staggering 95 percent—it removes the very nutrients that can protect skin from breakouts.
Focus less on destroying (oil, bacteria) and more on supporting (fatty acids, antioxidants)—and your skin will repay the kindness.