Why Am I Still Breaking Out? A Clinical Look at Adult Acne
Acne isn’t just something teenagers experience. In fact, adult acne is increasingly common, particularly among women aged 25 to 45. If you’re still breaking out well beyond high school, you’re not alone, and more importantly, it’s not your fault.
At The Dermal Clinic, we meet with women every week who are doing all the “right” things—eating well, cleansing morning and night, avoiding harsh products—and still experiencing frustrating, painful, and often unpredictable breakouts. The good news is that adult acne is manageable with the right clinical support, targeted treatments, and education.
Let’s break it down: what causes acne in adulthood, what it looks like, and what you can do to treat it safely and effectively.
What’s Really Causing Breakouts in Adulthood?
Adult acne isn’t the result of poor hygiene or greasy food. It’s a complex, medical skin condition driven by a combination of internal and external factors. The most common cause? Hormonal fluctuations.
Androgens—like testosterone—can stimulate oil (sebum) production in the skin. When these levels shift (before your period, during peri-menopause, or after stopping hormonal contraceptives), your oil glands may overproduce. Combine that with dead skin cells, inflammation, and an imbalance in your skin’s microbiome, and you’ve got the perfect recipe for a breakout.
For some people, the skin’s barrier is also part of the problem. Adults often unknowingly damage their skin by using aggressive exfoliants, stripping cleansers, or incorrect products. This compromises the skin’s natural defences and creates a reactive, inflamed environment that’s slow to heal.
Other contributing factors include:
Stress, which increases cortisol and can disrupt oil balance
Poor sleep, which slows cellular repair
Occlusive or comedogenic products, including some cosmetics and sunscreens
Digestive health, as growing evidence links gut imbalance with systemic inflammation and skin conditions
What Does Adult Acne Look Like?
Adult acne often presents differently than the breakouts you may have experienced as a teenager. Rather than scattered blackheads or oily congestion across the T-zone, adult acne tends to appear in more defined patterns and can feel deeper and more persistent.
One of the most common signs is inflammation concentrated around the lower face—especially the jawline, chin, and neck. These breakouts are often hormonal in nature and may worsen cyclically, such as before your menstrual period or during times of increased stress.
The lesions themselves are frequently tender to the touch and may appear as red, swollen papules, pustules, or even cysts that sit deeper beneath the skin. Unlike superficial pimples that resolve quickly, these inflammatory breakouts can last for days or even weeks and often leave behind marks—even if you haven’t touched them.
Another hallmark of adult acne is its coexistence with dry or sensitive skin. Many women experiencing breakouts in adulthood also describe their skin as dehydrated, reactive, or flaky. This is because adult skin tends to have a slower cell turnover rate and a more vulnerable barrier function, making it prone to irritation and delayed healing.
After the active acne subsides, the skin may develop flat red marks (post-inflammatory erythema) or darker pigmentation (post-inflammatory hyperpigmentation), which can linger long after the breakout has cleared. These marks aren’t scars in the traditional sense, but they can be just as distressing—especially if they accumulate over time.
So, if you’re seeing persistent breakouts in the same lower face areas, experiencing slow healing, or noticing that your skin feels both dry and inflamed, you may be dealing with adult acne. And it’s not just cosmetic—it’s clinical. And it can be treated with the right approach.
How We Treat Adult Acne at The Dermal Clinic
At The Dermal Clinic, we don’t believe in one-size-fits-all solutions. Adult acne is a complex skin condition, and our treatment approach reflects that. Each plan is tailored to your individual skin needs, guided by medical insight and evidence-based practice.
Once we’ve completed your skin consultation and digital analysis using the MoreMe skin imaging system, we begin designing your treatment journey. Our focus is on reducing inflammation, preventing new breakouts, supporting skin healing, and correcting the pigmentation or textural changes left behind.
One of our most effective tools for treating adult acne is Laser Genesis. This advanced 1064nm Nd:YAG laser works beneath the surface of the skin to calm redness, regulate oil production, and stimulate healthy collagen formation. It’s gentle enough for sensitive skin and requires no downtime, making it ideal for busy clients who want results without disruption.
For clients dealing with active breakouts, we may introduce LED light therapy using a combination of blue and red wavelengths. Blue light helps reduce acne-causing bacteria, while red light accelerates healing and soothes inflammation. This treatment is particularly useful for clients who cannot tolerate aggressive therapies or have compromised skin barriers.
In cases where congestion is a key issue, we may recommend a HydraFacial using an acne-safe protocol. This medical-grade resurfacing treatment gently clears blocked pores while simultaneously hydrating the skin—helping to reset skin function without causing further irritation.
Some clients experience residual redness or pigmentation after their acne has healed. In these instances, Intense Pulsed Light (IPL) therapy may be used to target post-inflammatory erythema or discolouration. When acne scarring is present, we can also incorporate microneedling using the SkinPen, but only when the skin is no longer inflamed and has been adequately prepared.
Every step of your treatment is selected with precision—there are no “cookie-cutter” packages here. We adjust your plan as your skin changes and ensure you feel informed, comfortable, and empowered throughout your journey.
Looking Beyond the Surface
Because acne is often influenced by what’s happening internally, we take a holistic view. During your consultation, we’ll discuss your hormonal history, stress levels, gut health, and lifestyle patterns that could be impacting your skin.
Where appropriate, we may refer you for hormonal screening or nutritional support. We work alongside you to ensure your skin treatment aligns with your overall wellbeing, not just what’s visible on the surface.
You might feel frustrated, defeated, or even embarrassed by recurring acne as an adult—but please know: this is a medical condition, not a reflection of your hygiene or effort. Acne is common. And, when approached with clinical care and personalised support, it’s treatable.
At The Dermal Clinic, we don’t offer “quick fixes”—we deliver structured plans, real education, and professional-grade treatments that rebuild skin function from the inside out.
If your skin is breaking out and nothing seems to work, it’s time for a different approach. We’re here to help.