Does hormonal acne go away with age?

Is there an age when it stops?

There is no fixed age when hormonal acne ends. Adult acne can be a continuation of teenage acne or begin for the first time after 25. Breakouts can persist for decades, because a birthday is not a cancellation notice. Women experience adult acne more often than men, although hormonal acne affects both.234

Why do breakouts continue in adulthood?

Hormonal changes can increase sebum, the oil your skin produces. Excess oil and dead skin cells block hair follicles, where bacteria can contribute to inflammation. Hormonal acne can include blackheads, whiteheads and painful cysts, not just one particular kind of spot.45

Hormones fluctuate around periods, during pregnancy, during the transition to menopause and after starting or stopping birth control pills. Menopause can bring new acne rather than end it, so it is not the retirement package acne was expected to accept. Stress, family history, medicines and pore clogging products can also contribute to adult breakouts.2

Flares before a period and inflamed spots along the jawline or neck are common in adult acne. Those patterns are useful to discuss with a doctor, but diagnosis also involves reviewing your products, medicines and health changes. Hormone tests are unnecessary in most acne cases; a clinician can consider them when the presentation is unusual.134

Should you wait or treat it?

Treat ongoing acne rather than waiting for an age milestone. Untreated acne can leave permanent scars. Mild adult acne often responds to treatments applied to the skin, but these usually control breakouts rather than cure the tendency to get them. Continued treatment can maintain the benefit, which makes clear skin less of a graduation and more of an ongoing subscription.34

• Wash with a gentle cleanser twice daily and remove makeup at the end of the day.
• Choose skincare and makeup labelled noncomedogenic, meaning designed not to clog pores.
• Ask a pharmacist about benzoyl peroxide or salicylic acid for mild acne.
• Avoid scrubbing and picking spots: scrubbing can worsen irritation, and picking can cause scars.

For persistent acne, prescription options include creams or gels such as adapalene and tretinoin. Some women benefit from a combined birth control pill or spironolactone, particularly for stubborn lower face and jawline acne. These hormonal treatments require a prescription and a review of your health and medicines; the pill is unsuitable for some people.67

How long does treatment take?

Initial improvement can take four to six weeks. Women taking the pill for acne typically notice improvement after two to three months; spironolactone can reduce breakouts and oiliness within a few weeks. Take prescribed hormonal treatments daily as directed and keep follow up appointments. Some people continue hormonal treatment long term to prevent new breakouts.47

When should you see a doctor?

See a doctor if acne is not improving with self treatment, is deep or painful, is causing scars, or is affecting your mental health. Hot, swollen or red skin also needs assessment for possible infection. If a prescribed medicine seems to trigger acne, keep taking it and contact the prescriber rather than stopping it yourself.26

If you are pregnant or planning pregnancy, discuss acne treatment before starting or continuing medicines. Isotretinoin must not be taken during pregnancy, and topical retinoids should be avoided. Spironolactone requires birth control because exposure during pregnancy can cause serious birth defects.347