Face Value

Why Do I Have So Many Pimples As An Adult?

Even if you had great skin as a teen, you may not be out of the blemish woods.

Originally Published: 
A man with a pimple picking at his face in the bathroom mirror.

Like teenage acne, adult acne is annoying and humiliating. And, like teenage acne, your adult pizza face is mainly due to poorly balanced sex hormones. But hormonal imbalances can have many causes, which is why stressed out parents who never had pimples as adolescents suddenly find themselves breaking out. And that’s especially trying for men, who don’t have a wealth of skincare resources geared toward them.

“In men, the sebaceous glands can become hypersensitive to testosterone, leading to an excess production of sebum,” says plastic surgeon Joseph Cruise, M.D. Sebum is an oily substance produced by the glands, and it’s needed to protect your skin. But too much of it can lead to pimples that weren’t previously there. “The androgens present in the male body can encourage oily skin and acne breakouts.”

Everyone produces three vital sex hormones that can conspire to produce adult acne — testosterone, estrogen, and progesterone. Although adult acne is more common in women than men, both sexes largely break out due to testosterone. Men’s testosterone is what drives the production of sebum and acne, but the catch is their hormonal fluctuations are less predictable than women’s monthly menstrual cycles (which totally cause breakouts).

The upshot is that, when a man’s testosterone spikes and his sebaceous glands cannot keep up, excess sebum combines with dirt and dead skin cells, creating a perfect environment for bacteria to grow. This causes inflammation in the form of pimples, cysts, blackheads, and whiteheads, or acne, which can be more severe and chronic among men, despite being less common.

The testosterone decline that comes with the early days of fatherhood could presumably protect men from some of this hormonal acne, but only temporarily. As kids get older and more self-sufficient, scientists suspect that testosterone levels rebound to some extent, before dipping again in old age. When testosterone starts to make a comeback and combines with stress, dads can experience breakouts.

Of course, it’s not just about testosterone. Other hormones play a role. “Elevated levels of progesterone also increase oil production, but it also causes our pores to swell shut,” says registered nurse Rebecca Lee. Other factors, such as eating too much dairy and sugar, as well as excessive sweating, can add to hormonal acne. Irritation from certain cleansers and products can cause dryness, swelling, and inflammation.

A gentle cleanser and products with benzoyl peroxide can help, Cruise and Lee say. Benzoyl peroxide destroys cells and bacteria blocking the pores and stopping acne already on the surface and below the skin.

But although not washing your face exacerbates the problem, so does washing it too much, experts warn. Much like your hormones, the key is finding a balance and not stressing out about it.

Still, hormones are almost always thrown off as a result of stress. So even more important than cleansers is exercising, meditating, sleeping, and maintaining a healthy diet — the sort of stuff that de-stresses. “Excessive stress may cause your body to produce an excess of hormones, which can cause you to break out,” Cruise says.

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