Adult Acne: Why It Happens and What to Do About It

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Written By Linh Huynh

Breakouts in your 20s, 30s, and 40s aren’t random and they’re absolutely treatable.

Adult Acne Isn’t Just Hormonal; It’s Multifactorial

For many, breakouts didn’t end with high school. They show up in your late 20s, spike in your 30s, and for some, persist into your 40s. The causes are different. The patterns are different. The treatment needs to be different too.

Adult acne is rarely due to “dirty skin” or bad habits. It’s typically the result of a combination of:

  • Hormonal shifts (often tied to cycles, stress, perimenopause, or medication)

  • Inflammation and insulin resistance

  • Gut-skin axis disruption

  • Topical products that overload or clog the skin barrier

  • Chronic stress, which increases oil production and cortisol-driven inflammation

Acne scars form when inflammation breaks down the skin’s collagen structure and the body heals unevenly. The deeper the inflammation, the deeper the scar. That’s why surface treatments aren’t enough. You have to treat the layers under the damage.

What Adult Acne Looks Like

Adult acne usually shows up in more subtle but persistent patterns than teenage breakouts. Common signs include:

  • Deep, painful cysts that sit under the skin (often along the jawline)

  • Inflammatory red papules that cluster around the chin, mouth, or cheeks

  • Blackheads and enlarged pores that seem resistant to exfoliation

  • Post-inflammatory pigment that lingers even after the breakout fades

  • Skin that feels congested, reactive, or “off” despite good skincare

It can be mild but chronic, or flare monthly in a cycle you can’t seem to break.

Where It Happens (And What That Tells Us)

Understanding where acne appears helps us decode the cause:

Jawline, chin, neck

Often linked to hormonal shifts especially androgens like testosterone. Worsens with stress, menstruation, PCOS, or birth control changes.

Cheeks and side face

Can indicate gut imbalances or reactions to pillowcases, masks, or skincare. Also common in inflammatory diets or those with histamine sensitivity.

Forehead and temples

Usually connected to stress, poor sleep, or digestion. Can also be triggered by hair products or heavy SPF.

Back and shoulders

Linked to sweat, friction, workout gear, and systemic inflammation. Also responds well to internal gut support and topical barrier treatments.

Why Adult Acne Is So Frustrating

  • It’s resistant to most over-the-counter products

  • It often flares at the worst possible times (right before an event or travel)

  • It can coexist with dry skin or early aging—so harsh products make it worse

  • It leaves pigmentation and scarring behind even after the breakout clears

  • It affects self-image in subtle but persistent ways

This isn’t just cosmetic, it’s chronic skin dysregulation.

Dairy can spike insulin-like growth factor (IGF-1), which stimulates oil production and inflammation especially in hormonally sensitive skin. Even “healthy” forms like Greek yogurt can be a trigger for stubborn breakouts around the jawline and chin.

What We Recommend at Core

There is no one-size-fits-all acne plan. But here’s what we evaluate during consultation:

Inflammation + Gut Health

We ask:

  • Are there food triggers (dairy, sugar, gluten, alcohol)?

  • Any bloating, fatigue, or mood swings?

  • Is stress unprocessed or unmanaged?

Addressing internal inflammation helps calm persistent, deep breakouts. For some, this includes IV therapy, medical-grade probiotics, or targeted supplementation.

Hormonal Influence

We assess:

  • Cycle regularity

  • Birth control history

  • Symptoms of PCOS or perimenopause

  • Chronic stress and cortisol dysfunction

Mild hormonal acne can often be treated topically. Moderate to severe types may benefit from GLP-1 weight loss, metabolic coaching, or collaboration with your provider for labs and hormone panels.

Skin Barrier Health + Products

We eliminate:

  • Harsh exfoliants

  • Drying agents (benzoyl peroxide overuse, excessive acids)

  • Poor-quality sunscreens or occlusive moisturizers

Then we rebuild the barrier with:

  • iS Clinical Active Serum

  • Skinbetter AlphaRet or retinoids

  • Medical-grade SPF (Pavise, Eclipse, Tone Smart)

  • Topical anti-inflammatory serums

Morpheus8 doesn’t just smooth skin, it targets the depth where acne scars form. By combining microneedling and radiofrequency, it remodels collagen and rebuilds dermal support from the inside out. Less surface damage, more long-term correction.

Procedures That Actually Help

The most effective in-clinic treatments for adult acne and scarring:

CoolPeel CO2 Laser

  • Resurfaces texture, minimizes pore visibility

  • Fades acne scars and post-inflammatory pigment

  • Minimal downtime with real collagen stimulation

Morpheus8 RF Microneedling

  • Targets cystic scars and under-the-skin congestion

  • Rebuilds dermal density to prevent new breakouts

  • Tightens laxity while calming inflamed skin

What to Avoid

  • Chasing viral skincare

  • Over-cleansing or “starting over” with your routine every time you break out

  • DIY extractions or picking

  • Assuming that acne = oily skin (many adult clients have dry + breakout-prone skin)

  • Dismissing your breakouts as “normal” when they’ve lasted for months or years

Adult Acne Is Treatable But Only If It’s Understood

Clear skin isn’t about finding the right product—it’s about understanding what your skin is trying to tell you.

At Core, we don’t sell acne protocols. We help you rebuild skin health from the inside out, across the gut, hormones, barrier, and nervous system.

This is personalized, clinical support: not a new cleanser and a motivational quote.




Linh Huynh
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