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.)
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. ^


  1. Annalena says

    I have been using dermalmd blemish serum for years. I am 50 years old and have had adult acne for most of my life. I find this serum not only helps prevent and heal acne, it also evens out my skin tone. I am fair skinned, but despite it’s darker appearance blends very well. I think it would work for any skin tone.

    • Devin Mooers says

      Thanks for sharing, Annalena! Have you tried working on more internal causes of acne at all? That’s great that you found something that works, but also wondering if there are still internal triggers going on, requiring you to keep using the topical serum.

    • Dave Dye says

      Summer heat and no air conditioner I was dealing with some very unsightly acne and bring 30 years old dealing with this ….um no…tried a few different things before buying dermalmd serum as your recommendation and they did not work at all…one was from dial and the other ST Ives…still dealt with breakouts on my forehead and chin…decided on these after reading the reviews and wow it cleaned my skin in 2 days! I will be reordering definitely.

  2. Maria Najeeb says

    Hi. Hope you are doing fine. I was surfing through internet to find ways how to get rid of acne scars and I came over your page. I am 30 years old. My face was very clean, but from few months I am facing acne and acne leaving scars after gone. I am unmarried and this thing is making trouble in my proposals. can u suggest me something good for acne scars. I tried many things but all in vain. Please help. I will be thankful to u.

    • John Glory says

      Hello I love your articles. Could you pls help me to get rid of my acne. I am a Nigerian, living also in Nigeria. Am suffering and my children were also suffering. Tanks for your love.

  3. Taylor says

    Y’alls treatment plan has improved my skin dramatically! I’m so happy for the results and for feeling better in my overall health. I wanted to see if y’all had anything to say about the age-old impossible-to-treat blackhead situation. In time and sticking with this plan, have you seen a decrease or disappearance in blackheads? I’ve read about all the clay and honey masks in the world but am really interested in what y’all might have to say about it since usually products are not the real answer!

    • Devin Mooers says

      Hey Taylor! This is great news, I’m glad the plan has been working well for you! 🙂 On blackheads, definitely. We find that then tend to reduce gradually over time as people follow our diet and lifestyle recommendations. Some folks have had success with steam towels, honey masks, etc., but we don’t really push or recommend those things because they’re a lot of hassle to do, and don’t really solve the root problem!

  4. Shany says

    Hi both! I’m a 22 year old female , during college and up until 22 I had pretty clear skin with the odd blemish but recently out of nowhere I’ve gotten bad acne on my face and back, its really worrying me , I don’t know whether I should go to my doctor or try to cure myself ? Making me upset as it’s just come out of nowhere 🙁

    • Sonia Carlson says

      Hey Shany! Hmm. That must be frustrating, and alarming, too! When your skin changes suddenly like that, it’s useful to think about whether anything else has changed for you recently – your diet, your stress levels, where you live, your job, a relationship, etc. (Graduating from college, considering life in the “real world”?) That might provide a clue to what triggered this. If that doesn’t naturally lead to some corrective action, then I would recommend doing a program like ours, which helps you address the acne naturally with diet and lifestyle changes. Our program is described in our ebook, and when you buy the book, you get access to the members-only CSF Forum, so you can get as much personalized help and guidance as you need from us and other readers – you won’t have to do it alone!

  5. Amy says


    I am 22 and have been dealing with chronic acne since highschool. I have tried just about every OTC topical, home remedy and prescription antibiotics and creams. The only thing that has worked for me was the antibiotics but my acne quickly returned after using them. I was just about ready to break down and try accutane until I came across your website. After reading alot of your posts, I think I may have found my saving grace. Starting today I am cutting out dairy and limiting gluten and sugars. I hope I can finally get the results I’ve been desperately searching for. The hardest thing for me I think will be cutting out coffee and stress management but I am going to try my best!

    I appreciate that you include research studies into your posts, it gives your explainations more value and credit, so thank you! Its easy to find recommendations for acne on the web but it makes me question how much evidence and truth backs it.

    Question for you: what are your thoughts on essential oils? I am currently using them topically but I know they can be taken in pill form.

    • Sonia Carlson says

      Hey Amy! I’m so glad you found our site before going on Accutane 🙂 :). That’s GREAT – cutting out / down on dairy, gluten, and sugars is a major dietary improvement! Since you’ve been on antibiotics, I highly suggest taking steps to improve your gut microbiome – check out our article on probiotics, gut health, and acne for ideas.

      Essential oils – I know many of our readers, like you, use them topically instead of the usual chemical face washes / treatments to good effect (in addition to diet and lifestyle changes). Unfortunately, I just don’t know a lot about using them internally. If you learn more and decide to try this, reply back and let us know what you tried and how it worked!

  6. Lucy says

    Hi Sonja and Devin,

    Just want to say thank you so much for this website! Ive been struggling with adult acne for nearly 4 years now, Ive tried every over the counter / natural topical remedy you can imagine, but of course it always comes back somehow. Its refreshing to finally see something that talks about treating acne internally, as I think the root cause of my acne has always been hormonal ( I have perfect skin before I went on the pill and now its been a 4 year battle!) Ive tried to implement some changes in my diet before, but have never had enough accurate / informative information to do so, to know which triggers what!
    I have been vegatarian for overa year now but I never really thought about dairy.. I have in the past week decided to cut out both dairy and also other animal products (Eggs etc) and I can see my skin healing in front of my eyes, and the redness and inflammation has gone down too. I will definitely be following note of all your dietary tips . Also I would like to know your opinion about sun exposure. I live in the uk, so obviously not much sun lol, but would you say that sun was a significant help with acne, and Ive read in some places that sun exposure can actually make acne worse?


    • Sonia Carlson says

      Hey Lucy! I’m so glad you found our site, and resonated with its message :). I hope you see some great results after making those changes to your diet! Eggs are an acne trigger for a few people, but for the rest of us are a really great source of critical nutrients (particularly the yolks) – so you might experiment with reintroducing those later to see how it affects you.

      For most people, a healthy amount of sun exposure (i.e. no burning) improves the clarity of their skin. Aside from the vitamin D, getting sun means you’re out in the fresh air, and it’s psychologically healthy too, a great mood elevator! Of course, pay attention to your body’s own signals, but generally you don’t need to be afraid of getting a healthy tan 🙂

  7. Nadia Marinova says

    Dear Sonia and Devin, thanks a lot for your website! I am almost going to cry, because finally I find such a comprehensive review of all the adult acne triggers. Some I have experienced and suspected, some I didn’t even know about! For example the mycotoxins in the coffee, especially the Starbucks coffee. Well, guess what, a year ago we moved to Germany, where the only “american” coffee we can find is the Starbucks blend. My adult acne went ballistic! And that’s the best explanation, since I have quit dairy years ago. I am also a Stanford graduate and have taken a course with Dr. Sapolsky, have even read his book you are citing. I am very impressed by you, guys, and wish you all the best! I am totally buying your book! Nadia Marinova

    • Sonia Carlson says

      Hi Nadia! I’m so happy to hear that you resonated with the message of our site and have found some of the info here to be so useful for you! It can be maddening to discover that a particular, previously unsuspected food (or drink) is the acne trigger you’ve been searching for… but also really exciting. Have you quit drinking your local S’bucks, then, and seen positive changes in your skin? Thanks for your comments and well wishes – best to you, too!

  8. Mary says

    I have a question as a adult/teen female, we use makeup on a daily basis and I read through most of these articles and what would be a good item (soaps/cleansers) to clean your face of makeup. Because you say that cleansers only mask the problem and sometimes can make it more severe.

    • Sonia Carlson says

      Hi Mary, since neither of us wears makeup, we literally just wash our faces with water and that’s that. However, if you wear makeup, one cleanser we recommend is DeVita Aloe Vera Moisture Cleanser because it has truly all-natural ingredients that are non-comedogenic (as far as we know). Another thing you might do is just google “natural makeup remover,” and you can find loads of “recipes” for natural, make-your-own remover at home.

    • Laurie says

      Years ago my dermatologist recommended using Dove soap to clean my face and using Almay cosmetics if I had to wear makeup. I switched and noticed a difference right off the bat! Good Luck!

  9. Rachel says

    I’m surfing thru your articles as an adult with cystic acne that comes and goes. I totally agree diet, water and a positive mindset can help clear skin! I read some reviews on Apple cider vinegar that you can dilute and drink it ( haven’t done that) but I’ve been using it as a topical and have seen great results! It tends to dry my skin so I really only use it when I feel a flare up coming or have woken up with the I can’t leave the house today zit. What are your thoughts on apple cider vinegar? I use witch hazel as a daily cleaner which helps also; any suggestions/ideas on these or other organic based topical’s? Tea tree oil makes me flare so I don’t use that. Thanks for all the great advice & insight! So happy to know I’m not alone!!

    • Sonia Carlson says

      Hey Rachel! It sounds like you’re really paying attention to how your skin is reacting to different things as you experiment with natural acne treatments, which is great. Everyone is different, and we are often our own best doctors! The Clear Skin Forever approach is very much about healing the root causes of acne, which involves targeting one’s diet and lifestyle – but what’s a girl (or guy) to do right now, today, about that “I can’t leave the house today” zit, as you say? If you’ve found a natural topical solution (like apple cider vinegar) that works, go for it! But realize that you’re still just treating symptoms, not addressing the actual problem, so consider making those lowest-hanging-fruit changes like removing dairy, gluten, and sugar from your diet.
      Another suggestion we received from a reader was to apply fresh-squeezed lemon juice to a break out, let it dry completely, and then apply 100% aloe vera (like from Aubrey Organics) to the area. Do this maybe 2x per day for as long as desired. Devin was doing some dietary experimenting recently and tried this on a few resulting pimples, with good success!

  10. Rachel says

    Hey Devin! Thanks for the highly interesting read.
    As a scientist at UCLA, I had been doing a bit of digging through journal articles on my own before stumbling upon your site. I found one of the same articles you cite describing the dairy/IGF-1 effect.
    I already follow a basically Paleo diet- would say I’m about 90/10. I don’t drink milk, but being originally from Wisconsin, I definitely would struggle to give up cheese. (Seriously, cheese is one of my favorite foods!) I am willing to try it for 1-2 months though if there is a chance it will clear my mild-moderate adult acne.
    My question is- in my case, while on hormonal birth control, I noticed an almost entire clearing of my acne. This held for the 3 yrs I was on a combined bcp (administers estrogen and progesterone), but my acne returned when I discontinued use. So I have always known my acne was of hormonal origin. However, I still consumed dairy whilst taking bcps and my face was entirely clear. Now, off bcps and eating less diary (but still cheese) I am breaking out mildly but consistently. I am struggling to make the connection here. Is it plausible the root is really the IGF-1/testosterone/dairy issue? It seems it might more likely be estrogen/progesterone balance, since being on the pill cleared things right up. Of course, I know all hormones are connected so I think there may be something here. Could you possibly elaborate a bit on this hormonal network or point me to a resource?
    I plan to cut out cheese (the only dairy I really eat anymore, but I do eat a LOT of it!) for the next 2-3 months and see what happens. I will report my progress!
    Hope to hear back from you.

    • Sonia Carlson says

      Hi Rachel! I’m from Illinois originally and lived in Wisconsin for a few years, so I understand the lure of the cheese :). I’m cheering for as you cut it out for awhile though; it’ll be good to know if you’re reacting to that. (In my experience, not eating dairy gets easier after the first week. If you can stop eating cheese for one week, you can do it for three months!) In response to your experience with birth control – yes, many women find an improvement in acne when they go on the pill, and many even use the pill for that reason primarily! Very briefly, some formulations of the pill reduce acne symptoms because they dose you with synthetic female sex hormones, including estrogen. Estrogens suppress androgens, which cause increased sebum production. So I think it is the testosterone(androgen)-to-estrogen balance that is the likely culprit here, not so much the balance of estrogen and progesterone.
      That said, how birth control affects acne is a big issue for women, one that’s definitely of interest to me, so I’m planning on writing an article on this topic as my first post to this blog. (I’m Devin’s partner and have been kind of behind-the-scenes from the beginning, but am now coming on to CSF in a more official capacity!) If you haven’t already, you might be interested in signing up for the CSF email list so you get notified when the new article is posted!

      • Taylor says

        Hey Sonia,

        Just reading through the comments to get some more information. I don’t know if you ever did a blog post on birth control (I couldn’t find it), but I would be extremely interested in reading it!

        • Sonia Carlson says

          You know, I still haven’t done that blog post – what are you most interested in knowing about birth control as it relates to acne?

          • Taylor says

            I did a lot of searching before I found out that acne was your body’s way of telling you something was going on internally. I went through years of harsh, expensive acne products a well as years of natural acne lines and at-home treatments – and during that time, I had a lot of people encouraging me to just take birth control because it clears up your skin. I’ve never been a take a pill to get a fix type of person, but it’s a end-all solution for so many people because it “regulates” your hormones. But if acne is your body’s way of telling you something wrong and you’re taking birth control to fix it – there are likely still lots of internal issues going on!

            My acne turned cystic a few months ago and I found your website while doing the Whole30 – I had a horrible reaction to taking Fish Oil. I had to fine-tune the diet with vitamins and supplements based on your articles and am finally finding great results (also AAAAALL the probiotics). I probably could’ve gotten on birth control a few years ago and saved myself a lot of time, money, effort, and self-esteem – but ultimately, my body still would’ve been in trouble! While having adult acne has been miserable, I am thankful for it and I’m glad I never got on birth control to fix it. Ya’ll talk so much on the importance of the ROOT cause of acne and I appreciate that so much!

          • Devin Mooers says

            I’m glad you didn’t take the easy way out, Taylor! Definitely difficult but long-term rewarding to figure out the root causes of your acne, so you can really be free of it for good. Thanks for the kind words, glad you’ve enjoyed some of our writing!

  11. kristina says

    Hi there i stumbled on your website. I have such oily hair and skin. I wobder if its hormones. I have endometriosis and even though im not diabetic i get sugar highs and loes. Im 29 have acne flares and also have gastritis. So basically i will give ur plan ago

    • Devin Mooers says

      Hey Kristina! It’s most likely hormones, especially if you’re dealing with endometriosis and oily hair as well. I’d really recommend doing a Paleo-type diet for re-normalizing your hormones. That would involve removing dairy, gluten, vegetable oil, and sugar, which could eventually get the blood sugar swings under control as well (not to mention acne and gastritis). It’s the type of diet I recommend and walk through in my book, and I also go into some other environmental / lifestyle changes that can help to get crazy hormones under control. Anyway, if you’re interested, here’s a link to that:
      Clear Skin Forever e-book
      Hope this helps, Kristina! I think you’re on the right track.

  12. bexjor says

    This is really interesting, I can’t say I eat any of this excessively and my diet is pretty spot on but my skin has flared up a lot since starting IPL treatment on my face. I have had to stop because it was becoming cystic and I go through ups and downs with it at the moment. I have a perfect skin routine, I will try the fish oil as I do probably need that. And my hormones are also completely shot haha. Thanks it was a really interesting read!

    • Devin Mooers says

      Hey Bexjor, I’m glad you enjoyed the article! Interesting about the IPL treatment – so were you doing that originally for acne, but you think it’s making it worse?

      Also, would you mind sharing your skin routine? And your current diet? Curious if anything will jump out at me as an acne trigger, since you mentioned your hormones where shot.


  13. Nora says

    Hi Devin,

    I have been following the 5 rules religiously (almost): no gluten, no dairy, less sugar, control oil intake, and try not to stress (though this is hard to control).
    At the same time I also changed my skincare regime.
    My skin is much better thank you for your advices:) Oily skin is now I’d classify as semi dry-normal which I love.
    Though can’t help but have another massive pimple sitting on my cheek. This one has been sitting under the skin as red spot since months ago and sometimes disappear. But just recently it started to come out!
    Any tips on how to heal it quickly without leaving a mark?
    During my teen years I used to put bit of garlic on the pimple and it will dry it out and would vanish within days and no scar. But I guess I must have aged now that my skin is not that flexible anymore often it will leave mark on my skin for months to clear up…:(
    Thanks Devin
    ps. have you signed up instagram? :p

    • Devin Mooers says

      Hey Nora,

      Sounds like you’re doing great with the diet! That’s fantastic! About the large pimple, I’m not aware of any quick and easy fixes that won’t leave a mark. I really, really advise against picking and squeezing – definitely increases the risk of scarring. Can you get out in the sun where you live now? If you laid out with your face in direct sun for 10 minutes a day for a few days, it would clear up a lot faster, I bet. (Make sure you don’t get sunburned, of course!) The UV rays kill P. acnes bacteria and reduce inflammation, and tend to make pimples dry out and clear faster. Not to mention increasing nitric oxide production, which increases blood flow to the skin for removing wastes.

      I just created an Instagram last week – search clearskinforever. Haven’t put anything on it yet, though! I’m a total Instagram newbie. Any tips for things to share on it? 😛

      • Nora says

        Thanks for the tips on UV to kill p.acnes. I’ll give it a go. Wonder if laser will kill it too.
        Instagram is amazing, you should put up ideas for recipes, paleo related stuff etc. I just followed you 😀

        • Devin Mooers says

          Yep, I believe lasers work, too. Expensive, from what I’ve heard, though, and won’t give you the nitric oxide benefit, or the mood-boosting effects of direct sunlight! 🙂

          I’ll give it a go with Instagram, thanks!

  14. Amy says

    Very interesting information on how our own thoughts can affect our skin. I have tried cutting out dairy, gluten and sugar only to go back to them to some degree. How long before you can see significant results when overhauling your diet?

    • Devin Mooers says

      Hey Amy! It really depends on the extent to which you overhaul it, how closely you adhere to it, and a range of other factors, like your sleep, sun exposure, your overall stress levels (even small amounts of perpetual stress can trigger acne), the personal care products you use, all mixed in with your unique genetic makeup. The crazy thing about clogged pores is that they can literally take up to 90 days to show up as visible acne after they get clogged, so there can be quite delayed echo effects. Some folks report seeing an overnight difference, but for others (myself included) it takes more on the scale of several weeks to several months. It becomes addictive, though, eating clear-skin-promoting food, once you solidify the link for yourself between certain foods and how they affect your skin. After enough cycles of going on and off a clear skin diet, it becomes easier to maintain because you see the direct link between, “Oh, if I eat this, I’ll get acne! No thanks, I like my clear skin too much!” Anyway, hope this helps. Let me know if you have any other Q’s and I’d be happy to answer them!

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