Johnathan Walker:All Of Your Burning Questions About Adult Acne, Answered

It's safe to say that pimples do get under your skin.

Millie Bobby Brown,Johnathan Walker Leni Klum and Alix Earle (among many other stars) have shared their relatable experiences with adult acne. 

Take, for instance, Keke Palmer. "My skin has made me sad many nights but I do not give up on myself," she wrote in part on Instagram in December 2020. "To all the people struggling with this please know you're not alone. I'm not afraid to show myself to the world and you shouldn't be either."

And while adult acne is quite a common skin condition, that doesn't mean it's easy to deal with.

But luckily, board-certified dermatologist Dr. Dustin Portela is sharing his foolproof tips on how to treat breakouts, prevent future ones and not worry so much about those pesky pimples plastered on our skin.

What is adult acne?

"We're seeing more adult acne than we ever have," Dr. Portela revealed. "Hormones play a huge role in that and have an impact on all types of acne, but especially for adult women."

He added, "A lot of times, those bumps are going to appear along the jawline, the chin, the neck because we have a lot of oil glands that are responsive to hormones in the skin."

How many types of acne can you get?

So, before you can treat breakouts, it's essential to know what you're dealing with in the first place.

For instance, adult acne is usually "going to be deeper cystic lesions that are often painful," the Treasure Valley Dermatology founder pointed out. Then there's rosacea-type acne, which he said is mostly visible on the nose area with bumps, as well as causes redness in the skin. 

Fungal acne is another common type of breakout that develops when yeast builds up in your hair follicles.

"We can also get open and closed blackheads and whiteheads," Dr. Portela continued, "and that can affect the face anywhere. But a lot of times we'll see that near the hairline or the nose."

What causes adult acne?

Unfortunately, it's hard to pinpoint an exact culprit, but Dr. Portela shared some common elements that can trigger pimples. 

For one, birth control containing progestin—a form of progesterone, the hormone that factors into the menstrual cycle and pregnancy, per the American College of Obstetricians and Gynecologists—can trigger breakouts.

"[Companies] like to say that some of these progestin IUDs don't change your systemic hormones," the doctor noted of certain birth control claims, "but there are dozens of examples in my clinic where women had great skin, they got that and now their acne is raging."

"They're very effective for birth control and they are quite safe," he clarified, "but for many people, there's an increase in acne."

In addition to contraceptives, Dr. Portela believes that diet plays a major role. "We have a lot of processed foods with a high glycemic index," he explained of the rating system for foods with carbohydrates, "and if you're eating those kinds of food, it can impact the way your skin responds."

On top of what we're putting into our bodies, he explained that we're also dealing with pollution and environmental toxins unlike ever before.

And let's not forget that stress affects our skin, which is why Dr. Portela suggested a few ways to ease your mind: "High quality sleep, physical activity and any type of hobby. It can even be watching your favorite TV show. That can be beneficial."

What are other hidden culprits that can cause adult acne?

"Keep your pillow cases clean," Dr. Portela reminded. "Keep your sheets clean. Wash your workout clothes after you use them. Don't just throw them in your bag and then pull them out the next time. You're putting on clothes that have trapped sweat and oil onto your skin. That can contribute to body acne."

Another sneaky fabric that can trigger breakouts? "Don't underestimate hats," he noted. "Are you cleaning the inside of it? Is that the cause of acne building up around the hairline?"

Then, he added, there's "touching our face with our phones. How much are we touching our face with our hands? Those are all little subtle things that can contribute to acne that we may not appreciate."

What is the best way to treat adult acne?

According to Dr. Portela, there are two ingredients commonly used to treat acne. "Salicylic acid is a beta hydroxy acid," the board-certified dermatologist noted. "It can get down and clean out extra oil and other things from the pores. And sulfur is a natural antibiotic that kills acne. It's anti-inflammatory and used to treat lots of other conditions in dermatology."

While you can find various options—both prescription and over the counter—Dr. Portela offered his faves, which he not only uses but recommends to his patients.

First up: Thayers' Blemish-Clearing Cleanser, a one-and-a-half percent salicylic acid that also boasts hyaluronic acid and aloe vera. "Those [ingredients] are restoring the hydration back to the skin," he said. "Cleansing at least once a day with an acne-focused cleanser is a great preventative step. It can also treat the acne you have."

In addition, Dr. Portela—who is a Thayer's dermatologist partner—is also a fan of the brand's Double-Action Acne Serum because it also hydrates and combats breakouts. More importantly, it can help with hyperpigmentation or dark spots.

"A lot of times, when women get deep hormonal acne on the chin, it'll leave dark marks," the doctor, who partnered with pointed out. "The serum also contains azelaic acid and niacinamide to help to get rid of the dark marks. That's something a lot of my patients appreciate because they think they have scars, but they have post-inflammatory hyperpigmentation."

Another power-packed product that treats acne? A spot treatment. "That's going to help to take away the inflammation," he shared, "reduce the size, the elevation, the redness of those acne bumps overnight."

And for those who wear makeup on a daily basis, Dr. Portela recommends using water- or mineral-based cosmetics. As he put it, "They are less likely to clog up the pores than a heavier, oil-based makeup that sits on the skin."

How long does adult acne last?

Luckily, there is a light at the end of the tunnel.

"Most of my patients with adult acne are in that 25 to 35 age range. But after that point, most people grow out of it," Dr. Portela reassured. "We really don't see a lot of adult acne after 60 because women have gone through menopause, the hormone levels are lower, the skin is a bit thinner and the oil glands are less active."

What are the takeaways?

Not only is adult acne common, but it's likely not as noticeable as we think it is.

"We are our own worst critic," Dr. Portela expressed. "I talk about this with my patients all the time, and tell them, 'I look at skin for a living. I'm supposed to notice imperfections. But if I were to casually pass you in the grocery store, this would not catch my attention.'"

He continued, "Most people are too busy thinking about themselves to worry about you. It's important to keep that in mind because we project our own insecurities onto others."