The Nuance

I’m a Grown-Up. Why Am I Still Getting Acne?

For many people, acne is chronic, and prevention is critical

Markham Heid
Elemental
Published in
4 min readFeb 21, 2019

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Credit: Oppenheim Bernhard/DigitalVision/Getty

Every week, the Nuance will go beyond the basics, offering a deep and researched look at the latest science and expert insights on a buzzed-about health topic.

TThere’s a reason acne is synonymous with awkward teenage years. Roughly 95 percent of pubescent teens and tweens deal with breakouts, according to a 2018 study in the Journal of Clinical and Aesthetic Dermatology.

But the idea that pimples vanish after puberty is a myth. “It’s amazing to me that patients still come in and tell me they’re surprised to hear that acne persists into adulthood,” says Adam Friedman, MD, professor and interim chair of dermatology at the George Washington University School of Medicine and Health Sciences. “For a lot of people, especially women, acne is a chronic disease.”

While it’s true that acne is less common among adults than it is among teens, more than half of twentysomething women (and 42 percent of men) suffer from acne, according to a study from the University of Alabama at Birmingham. Even well into their forties, roughly one in four women and one in 10 men deal with acne pimples, that study found.

“Acne is an inflammatory disease in which the immune system gets turned on inappropriately.”

“Young men tend to get [acne] more severely than young women, because they’re more oily and producing more testosterone,” says Diane Berson, MD, an associate clinical professor of dermatology at Weill Cornell Medical College. “But once men are clear, they tend to stay clear.” Women, on the other hand, can experience flare-ups throughout adulthood, she says. Why? “Any kind of hormonal change or fluctuation can trigger a breakout in someone who is predisposed to the condition,” Berson says. And that’s a lot of people.

Forget the stuff you learned as a kid about “dirt” clogging pores and causing pimples. While that can happen, Friedman says persistent acne has little to do with filthy skin. “First and foremost, acne is an inflammatory disease in which the immune system gets turned on inappropriately,” he says.

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Markham Heid
Elemental

I’m a long-time contributor at TIME and other media orgs. I write mostly about health. I grew up in Michigan, but these days I live in southwest Germany.