How common is adult acne?

How many adults have acne?

Estimates for acne after age 25 include about 5% of women and 1% of men, while other clinical estimates put the figure for women at up to 15%. Broader counts are higher: among 749 surveyed adults aged 25 and older, 54% of women and 40% of men reported some form of acne. In that same group, 12% of women and 3% of men had acne reaching a specified clinical severity score. Percentages need an age group and a definition, even if a single tidy number would look better in a headline.123

Acne generally becomes less common with age, but it does not disappear on a fixed birthday. In a photographic assessment of women, the proportions with clinical acne were:2

Women also seek more specialist care for adult acne. Across US dermatology visits from 2002 to 2016, acne accounted for 10.1% of visits among women after age 20, compared with 4.1% among men. Those figures count appointments, not the proportion of all adults who have acne.4

Can acne start for the first time in adulthood?

Yes. Adult acne can persist from the teenage years, begin after age 25, or return after a clear period. Persistent acne is the most common pattern in adult women, accounting for 75% to 85% of cases in published estimates. These percentages describe women who have adult acne, not all women.1

Adult acne often has mild to moderate severity. Inflamed spots commonly affect the jawline and neck, but acne can also appear elsewhere on the face, chest or back. Large whiteheads are another common feature. Deep inflamed spots and large whiteheads can leave scars.3

Why does acne continue after the teenage years?

Acne develops when excess oil and dead skin cells block hair follicles, the openings where hairs grow. Bacteria in blocked follicles can cause inflammation and pus. Hormonal changes around periods, pregnancy and menopause can contribute, as can certain medicines and greasy skin or hair products. Flares before a period are common in adult women.35

What should you do about adult acne?

Wash affected skin twice daily with a gentle cleanser, remove makeup before bed, and avoid scrubbing or squeezing spots. Choose noncomedogenic skincare and makeup. Noncomedogenic means less likely to block pores, which is a more useful label claim than a bottle's ambitions. For mild acne, a pharmacist can help you choose a treatment such as benzoyl peroxide.25

Benzoyl peroxide usually starts working within four weeks. Start with the lowest strength and follow the packet directions; it is usually used once or twice daily. Dryness, peeling and irritation can occur. Ask a pharmacist or doctor about troublesome side effects, combining acne treatments, or use during pregnancy. Seek emergency help for throat or tongue swelling or difficulty breathing.6

See a doctor for deep, painful spots, scarring, acne affecting your mental health, or acne that is not improving with treatment. With benzoyl peroxide, seek advice if acne worsens or has not improved after 12 weeks. Prescription options include creams, antibiotic tablets, hormonal treatments and isotretinoin. Isotretinoin must not be taken during pregnancy.3567