Adult Acne Causes – What Really Causes Adult Acne?

Is adult acne really any different from teenage acne?

Is adult acne really any different from teenage acne?

Did anyone ever tell you that acne is a teenage skin problem?

Did anyone tell you that you would grow out of your acne, but you didn’t?

You’re not alone!

In fact, 60 million adult Americans have acne, according to the American Academy of Dermatology. That’s about 1 in 4 adults! It’s a multi-billion-dollar industry. Adults are throwing their money at treatments that don’t work, because most doctors and dermatologists don’t actually understand the true causes of adult acne.

I know something that the American Academy of Dermatology doesn’t – adult acne has the same causes as teenage acne, and it’s curable! Permanently! (Though not by the methods that your dermatologist recommends.)

So the good news is, you won’t have to deal with acne for the rest of your adult life if you don’t want to!

Let’s get down to the causes of adult acne.

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How is adult acne different from teenage acne?

In short: it’s not much different at all. Adult acne and teenage acne are both caused by fluctuating and out-of-balance hormones. Now if we trace that back upstream, using something called “root cause analysis,”[1] we find that the causes of imbalanced hormones are actually slightly different for adults and for teenagers.

The main reason why acne is commonly believed to be a teenager skin problem is because teens’ hormones are fluctuating wildly, making it more likely that they’ll get acne. In teenagers, growth hormone, IGF-1 and testosterone are all kicked into high gear (even in girls), causing height spurts, muscle growth, and sexual development.

Turns out that these hormones can all directly cause acne when they’re too high in the body. Add to that the high-stress environment of most schools, and you can see why teenagers are a little more prone to getting acne.

The main difference between adult acne and teenage acne

Adult acne is becoming increasingly common, and it’s easy to see why when you bring diet and stress into the picture.

For adults who are genetically predisposed to getting acne (that includes me and you!), eating foods that cause increases in IGF-1 and testosterone, such as milk and dairy, cause our hormones to fluctuate, causing acne in a similar way to teenagers.

It’s true, we’re not going through puberty and massive bodily change as adults, but diet alone is enough to throw off your hormones enough to cause breakouts. Add the stress of most folks’ workplaces, commuting, traffic, money worries, and more, and you get a surefire recipe for acne!

Adult acne multiplier: negative beliefs and thoughts

You won’t hear this next bit from your dermatologist. You won’t hear it from your doctor. And you won’t see it on the news. But my own experience (and that of many others) demonstrates that negative thoughts and beliefs can have a powerful multiplying effect on adult acne.

Do these thoughts resonate at all with you?

  • “I hate having acne.”
  • “It’s not fair! I’m an adult, so I should have grown out of my acne years ago!”
  • “Acne is really embarrassing as an adult.”
  • “I hope I’m not stuck with acne for the rest of my life.”
  • “I’m worried that I’ll never be able to get rid of my acne.”
  • “I feel helpless about my acne.”
  • “I’ve tried all the treatments out there, but nothing worked! What should I do? Help!”

These kinds of thoughts are perfectly normal! That said, if you find yourself thinking these thoughts often, it’s a good sign that your mind could be sabotaging your skin, hampering your efforts to clear up your skin.

How can these thoughts possibly cause acne? Well, the clinical experience of Dr. John Sarno, pioneer of mind-body treatment for back pain, has shown that skin diseases such as psoriasis, eczema, and acne can be affected by the mind.

That’s right, the mind!

Dr. Sarno is mostly known for treating back pain, and his explanation for how the mind can create back pain is that your brain reduces oxygen and blood flow to certain parts of your body (e.g. your back) to try to protect you from repressed emotions bubbling up to the surface.

How does this relate to adult acne?

Well, Dr. Sarno has found that mind-created back pain has “equivalents,” meaning other diseases which tend to show up at the same time. Acne is high on that list!

So how can your mind make acne worse? Well, Sarno doesn’t go into great detail in his books about skin disorders, but my interpretation is that your brain can actually fluctuate your hormones in response to negative thoughts. It’s a protection mechanism, it seems, to guard your ego (your “self”) from these intensely negative emotions — fear, anger and insecurity — bubbling up to the surface.

Of course, this is all speculation! But I’ve found that turning around the thoughts I think has actually led to a major improvement in my skin, and I think it can do the same for you.

Here are some improved thoughts:

  • “I have had acne in the past.”
  • “I’m an adult, and adults can get acne just like teenagers can.”
  • “I’m looking forward to having clear skin.”
  • “I’m meant to have clear skin.”
  • “I know I’ll find a way to get rid of my acne.”
  • “I have total control over my skin health through the foods I eat and the thoughts I think.”

As I mentioned, clinical evidence of Dr. John Sarno and another doctor, Howard Schubiner, with thousands of patients suggests that improved thoughts such as these can actually have a biochemical effect in the body.

My own line of reasoning suggests that your mind can exert control over your hormones, and that changing your thoughts about acne and skin health from negative ones to positive ones can actually change your body’s hormones by regulating gene expression (via epigenetics), and thereby affect your actual skin health.

If nothing else, these improved thoughts will lower your stress levels about acne, which science has well documented to reduce cortisol and inflammation. [2] [3]

In summary

  • Adult acne is similar to teenage acne, in that it’s caused by fluctuating hormones.
  • Adult acne is different in that adults’ hormones are out of balance primarily because of poor diet + stress (puberty’s not a factor anymore).
  • Most dermatologists don’t know what causes adult acne. (Good thing you found this blog! :).
  • Adult acne can be cured by diet modifications, stress reduction, and improved thoughts. (See our book for in-depth advice — Sonia and I walk you through the whole process from acne to clear skin. It’s the last acne treatment you’ll ever need.)

About Devin Mooers

Devin MooersHey! Over the past 10 years, I've developed a powerful system for clearing acne with a little-known diet- and lifestyle-based method, and I want to spread the love. That's why I started Clear Skin Forever back in 2011. I studied engineering and product design at Stanford University, and graduated in the top 5% of my class, but afterward, I decided to focus on writing about health, since I found it so fulfilling to help people clear their acne for good. Thanks for reading, and sign up for email updates to stay in the loop with clear skin tips! Also, be sure to check out our book if you haven't yet, all about how to fix acne permanently with diet and lifestyle changes. We've helped thousands of people get clear skin this way!

Sources (click to expand)

  1. Root cause analysis is an extremely powerful tool for finding the root cause of some problem or disease. I wish the medical world practiced this more often! Read more on Wikipedia about root cause analysis. ^
  2. Lorenz TH, Graham DT, Wolf S. The relation of life stress and emotions to human sebum secretion and to the mechanism of acne vulgaris. J Lab Clin Med. 1953 Jan;41(1):11-28. ^
  3. Chiu A, Chon SY, Kimball AB. The response of skin disease to stress: changes in the severity of acne vulgaris as affected by examination stress. Arch Dermatol. 2003 Jul;139(7):897-900. ^

{ 36 Comments }

  1. Idara says

    Awesome post! I love adding coconut oil to my steamed vegetables and my smoothies. I tried it on my face and found out the hard way that it breaks me out. But I haven’t had that issue with hemp and grapeseed oil.

  2. Idara Hampton says

    Thank you for explaining epigenetics so clearly. It’s very easy to follow. Congrats on clearing your skin. Your story is inspiring.

  3. Idara says

    This is such a well researched and well written article. B5 is great for the skin. I also love B6 and B12 for boosting energy, promoting a healthy luteal phase, and stopping PMS.

  4. Idara says

    Great post! Understanding hormonal imbalances isn’t always easy, so thank you for writing an informative and easy to follow article with helpful tips.

  5. wendy says

    There is no official link between iron and acne in science research but antidotally I believe there is. My daughter used prescription acne creams for a couple of years with only modest improvements to her skin. She recently was prescribed an iron supplement, her iron levels were on the low side of normal, because of her low energy state and, voila, Not only does she feel more energetic, her face is very noticeably improved and much smoother in, just days. She is a big meat eater. Who knew iron can be hard to absorb?

  6. Srey says

    I love this post! I recommend this book “inheritance” by Sharon D Moalem. It talks a lot about genetics, and could be helpful to understand more about epi genetics, and our human genome.

  7. Mike says

    Why do you say that coffee negatively affects muscle since there is like a bunch of evidence that shows the caffeine from the coffee actually helps build muscle and burn fat. Of course this is when you take black coffee without any sweeteners. I have read so many articles that talk about consuming coffee in a fasted state leading to positive muscle gains you can find them easily too

    • Devin Mooers says

      Hey Mike! Interesting point here. I found this study:

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2257922/

      …Which says that you habituate to the caffeine in a few days’ time, meaning your morning coffee no longer stimulates over-production of cortisol once you adapt to drinking coffee daily. However, the study still found that a 1:00 PM cup of coffee boosted cortisol levels higher than normal (though the study only ran for 5 days of caffeine habituation). My personal experience is that coffee just makes me more stressed out in response to stressful events, which includes cortisol release. But I haven’t read the articles you have about fasted-state coffee drinking leading to muscle gains – I wonder if this is just due to metabolic rate increase from the caffeine? In any case, if coffee floats your boat and treats you well, go for it!

    • Devin Mooers says

      Hey Julie! I’m not totally sure on this. That still sounds like a good range. I was going based on a Dr. Mercola article, which I can no longer find (the link is broken). I am far from an expert on what ideal ferritin levels should be!

    • Rhonda says

      I will interject with a personal anecdote about Ferritin levels. I have a genetic disorder called Hemachromatosis. It causes iron from the food I eat to get into my organs and my body can only release it through phlebotomy (donating blood). My Dr noticed a high ferritin level and high liver enzymes on a blood panel and on a hunch she ordered a DNA test for this. If you are suspicious that your ferritin levels are out of whack, ask for this test. This condition is very common especially if you are of Irish or Scottish descent. It’s a lifelong condition but the remedy is easy because you just have to have your levels checked regularly and donate a pint of blood to balance your levels. I am so grateful my doc was smart enough to call for this test. Having this disorder and not taking care of it can lead to liver damage and heart attack. It’s hereditary and if you do have it, all of your nearest relatives should test for it too. Hoping it’s not the case for you, and wishing you all the best!

      • Devin Mooers says

        Kudos to your doc for finding this!! I’m so glad you know now. I had a genetic test done a few years ago, and ruled out hemachromatosis (at least current knowledge of it). So I guess it was just from my diet. And I do have a fair amount of Irish + Scottish in me. Go figure! Great thing to check for, though, as you just found out!

  8. Katy says

    I’m 25 and I have very irregular periods (which have never been regular) and acne since puberty. I got literally all my hormones checked and everything came out normal. Does anyone have an explanation for this?

    • Devin Mooers says

      Hey Katy! I don’t put much stock in hormonal tests, blood tests, saliva tests, or related “snapshot” health tests. I don’t think they’re a very accurate reflection of long-term reality, and don’t often give very useful information for clearing acne (in my experience). The fact that you have irregular periods right away shows that something’s up with your hormone levels, and/or some basic nutrient levels like vitamin A, utilizable iron (don’t go taking iron pills though!), and/or maybe some toxin overload issues. There are lots of things that feed into having a normal cycle, and a hormone test isn’t going to tell you what needs to be fixed.

      Are you drinking fluoridated water, do you know?

      Also, do you want to give an overview of what your current diet is – the more detail the better! – and any pills/supplements you’re taking? I can see if anything jumps out!

  9. Johnny Cox says

    Hi. Im going to say that Im afraid to eat coconut because of acne. Chocolate of any kind gives me acne too. Even fish oil. All these oils do it to me. I used to suspect leaky gut causing me breakouts. All these oils ruin my skin. Whey concentrate and isolate too! Someone said “keep eating the Extra Virgin Coconut oil, It’s just die-off!! It will stop soon” But it does not stop. I get brutal acne from it. Tempted to try again after reading this, but it scares me. My acne is so painful..

    • Devin Mooers says

      Hey Johnny! Really sorry to hear about your experience with so many oils/fats giving you acne. Huge bummer! Frustrating not to know whether it’s from die-off or detox, or just an adverse reaction. (I will say that whey isolate/concentrate both give me acne as well!)

      Couple questions… are you using organic coconut oil, or non-organic?

      Also, do you want to post a mini diet overview right here? I can see if any major red flags come up.

      Finally, are you drinking fluoridated tap water? (And/or using fluoride toothpaste?) Wondering if these fats/oils might be causing a detoxification of fluoride, causing transient acne.

    • Devin Mooers says

      Hey Ashley! I think it’s okay in really small amounts as a garnish or flavoring, but it’s very high in PUFA so I wouldn’t make it a main cooking or salad oil. Toasted sesame seed oil is even a bit more risky because of the toasting process damaging more of the PUFA (and the protective vitamin E found in raw sesame oil).

      What are you wanting to use sesame oil for? Maybe I can suggest a skin-friendly alternative!

  10. Kris says

    Hi Devin,
    Great research, thank you for linking the sources. I’ve suffered with back acne for years. I eat a mostly plant based diet, so I’d call myself a flexitarian (95% plants, 5% grass fed-organic animal). Before that I did mostly Paleo, therefore lots of fresh plants, but still a lot of organic meat/poultry.
    From recent testing, I have low iron stores (ferritin), normal iron (since I suppliment), and low iodine (I now supplement—-boyfriend has shellfish allergy…). I take vitamine A and Magnesium as well.
    I’m game to try anything thats humane and organic even if its not a plant based suppliment, but I would be interested in the Frankin-rice you mentioned since I try to avoid dairy due to an intolerance (causes me inflammation and IgG testing shows markers). If the colostrum is derived from cows or colostrum is from humans, wouldn’t in theory the human one be closer to what we need? Albeit odd to consider!!
    I’ve also looked for a non-bovine ferritin supplement, but it seems I may need to take the bovine one as the plant ones are just more iron (leading to excess). I just want to be humane in my choices, with no added hormones from the cows, etc. With all that said—I’m open to anything—as my skin and other health issues are the number one priority! Any product tips would be greatly appreciated. I use Pure Encapsulations too. 😊 Thank you!

    • Devin Mooers says

      Hey Kris! Sorry for the epic delay on this, I haven’t checked blog comments in a long time. My fault!

      How low is your ferritin? Did you get liver enzymes checked? It’s quite possible to have low ferritin, but also have an overload of unusable iron stored up in your liver. Taking additional iron supplements on top of that, if that’s the case, isn’t a very good idea. Liver enzymes (and/or GGT) can help point to iron overload in the liver. (See my iron article for more info on tests.)

      What kind of iron are you supplementing with?

      Doubt you’ll find human-sourced colostrum, though it’s an interesting idea! 🙂

      Are you interested in lactoferrin for reducing your iron levels, or for boosting your ferritin? There are definitely other, more effective ways of modulating ferritin, I think (see the iron article linked above for way more info on all the iron stuff, including why I think many people may have an iron overload problem even if ferritin levels don’t show it). I’d target the iron-utilization-boosting nutrients listed in the iron article, personally.

      Also, how much iodine are you taking? What form?

      Finally, have you thought about A2 milk as a skin-safe dairy option, that would give you some lactoferrin in a whole food form?

  11. Donna says

    I actually test low for iron. My Tibc, Total Iron, Iron Saturation, and Ferritin are all low.
    It was recommended for me to take Lactoferrin with an iron supplement to properly increase my iron.
    I’m confused about your article because it makes me second guess my situation. You don’t believe ANYONE is actually low in iron?

    • Devin Mooers says

      Hey Donna! How low are we talking on these numbers?

      I definitely think there are a small number of people who are actually low in iron, but I think it’s probably a lot fewer people than most doctors think. Often, if you have iron dysregulation, excess iron gets stored up in your liver, which doesn’t show up one these blood tests. If you’re lacking in one of the co-factors necessary to use iron properly (vitamin A, molybdenum, vitamin C, copper, ceruloplasmin, vitamin B12, etc.), you can get excess iron deposits in the liver combined with low circulating iron. When you add a plain iron supplement on top of that, without addressing the deficient co-factors, you can worsen the problem. Did you happen to get your liver enzymes and/or GGT tested? That can sometimes indicate excess iron storage in the liver. But keep in mind I have zero clinical experience in all this and just going based on the all the research I’ve read (and my own iron overload problem).

  12. jay,s says

    hi, suffering from acne for 20 years and a rediculolus amount of money spent on “solutions”i tried a newer supplement that’s called acne block that contains lactoferrin,found it on amazon.. it actually was/is one of the only supplements I have tried that actually helped..

    • Devin Mooers says

      Great to hear you got good results from lactoferrin! The science is sound behind why it works, helping to reduce iron overload. Good stuff.

  13. Sara says

    Would eating liver or taking a dessicated liver supplement cause iron overload? I would like to get more vitamin A, but am concerned about the extra iron I would be getting.

    • Devin Mooers says

      Hey Sara! Wise to be cautious about this. Do you have reason to suspect you have existing iron overload? Curious about that, I’ve suspected that in myself for a while now, and have been avoiding liver for that reason. I’m taking Pure Encapsulations vitamin A instead.

    • Sarah says

      Suggesting vegans/Vegetarians have a greater risk of iron deficiency is incorrect. There are at least as many meat-eaters as vege people deficient in Iron. Meat is not an efficient source of iron for human beings. Cutting out animal products goes along way in clearing up acne.

      • Devin Mooers says

        Hey Sarah! I actually agree with your first point now, but differ in the second. I think many people, vegeterians and meat-eaters, have an iron overload problem. This is pretty new to me, but the research seems sound. Turns out you can have anemia AND iron overload, due to iron getting deposited in your liver, but a lack of nutrients that are required to put iron into hemoglobin, like vitamin C, vitamin A, molybdenum, and copper. I also think the research strongly points to heme iron from meat being an excellent source of iron – much more absorbable than plant iron – but I now think eating too much meat leads to iron overload, because your body can’t shut off absorption from heme iron like it can from plant iron. If you’re curious to learn more, I just posted a huge article on iron and acne two days ago:

        Iron and Acne

        I think this is really an unusual perspective, and the opposite of what most people will tell you! Curious to hear your thoughts! 🙂 (I’m actually eating mostly vegetarian these days, due to trying to reverse my iron overload problem, and, yes, the environmental impact.)

  14. Taylor says

    So if I maintain a Paleo/Whole 30 diet that includes high quality meats and seafoods and I do not eat any of the iron-fortified foods or foods that inhibit lactoferrin – my body should be creating lactoferrin on it’s own in a healthy manner and I likely do not need to supplement it, correct?

    • Devin Mooers says

      Yep, exactly! Historical iron overload can be an issue, less so for menstruating women due to the continual iron dumping outlet. Bloodletting was effective back in the day for many diseases due to iron removal! Men don’t have such a built-in iron removal system (perhaps explaining why men tend to live shorter lives than women – iron buildup!). I’m not 100% sure how effective lactoferrin supplementation is for addressing built-up iron overload. Morley Robbins (gotmag.org) is the guy to read about on all the iron issues.

  15. Christina says

    I’m confused. I was just about to purchase some FCLO for my teen daughter to help her with her acne and now I stumbled across your reply where you state you no longer recommend FCLO! Why the change?

    • Devin Mooers says

      Hey Christina! Sorry about the confusion here – I wish we could keep the same recommendations forever, but our knowledge (and the science, and reader experience, etc.) forces us to change our recommendations now and then, and it’s hard to change everywhere all at once! We changed this recommendation because FCLO is basically pure PUFA (polyunsaturated fat), which is more susceptible to lipid peroxidation than other fats, and this is a major contributor to acne, we now believe (lipid peroxidation). The vitamin A in FCLO tends to be very beneficial, but you can get that vitamin A from eating liver, taking desiccated liver capsules, or taking a vitamin A supplement such as this one by Pure Encapsulations. We now think it’s best to reduce the total body load of PUFA as much as possible, rather than trying to boost omega-3s, for instance. Does this make sense?

    • Devin Mooers says

      Hey Sam! That’s actually a really good idea. We currently do not recommend taking FCLO or cod liver oil – we’ve updated our book but haven’t found the time yet to update our cod liver oil blog post – we’ll do that soon! We recommend taking desiccated liver capsules or eating grass-fed liver regularly, or taking a vitamin A supplement like this one:

      Pure Encapsulations Vitamin A 10,000 IU

      Taking vitamin E is a great PUFA defense strategy when you’re eating out at restaurants or for some reason consume a large amount of PUFA. We’re working on a “PUFA Shield” supplement that incorporates full-spectrum E along with some other lipid peroxidation blockers to make it easier for travelers, folks who eat out a lot, etc. to avoid the worst PUFA effects on acne.

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