My Weird, Life-Changing Experience With Adult Acne

“You used to have such beautiful skin.”

My mother, bless her, meant well. She had cut her vacation short to help me move my life from New York back to Canada, an act so generous I couldn’t justify my sudden desire to chuck her out of our U-Haul. She was lamenting the state of my 31-year-old face, the face she herself had created and nourished and raised, the face that had betrayed her good works by erupting in acne at the altogether inappropriate age of 30.

And the thing is, I did once have beautiful skin, fresh as a dew-dropped daisy, despite my storm of teenage insecurities: too pale, too mottled, my entire body mapped by freckles. With all the energy I spent wishing I were someone else, I couldn’t find time to feel grateful for clear skin. I didn’t wash my face until I was in my 20s, never ran through the litany of nuclear prescriptions or the creams and lotions that bleach out the bedsheets. The odd zit was quickly popped and dismissed, thanks very much for coming, see you next month.

My adult acne emerged from the hormonal swamp that was the result of switching from oral contraceptives to an IUD and starting medication for anxiety. The first zits were a curiosity; after a few months of pawing helplessly at my face, I asked my dermatologist during my twice-yearly skin screening what she recommended. She wrote me a prescription for topical Tretinoin, which made my skin blotchy and dry and my acne worse. “Yeah, that’ll happen,” she shrugged when I reported it on my next visit, her attention focused on a particularly funky mole on the bottom of my right foot, as if to say: Lady, I’m ensuring you don’t have cancer. Your lowly concerns are beneath me.

Adult-onset acne is not uncommon, especially among women. Fluctuating hormones, like those produced by pregnancy, menopause or a change in contraception, are a common cause — although stress, diet and heavier skin treatments (shout out to your anti-agers) also play a role. A 2015 study found a 200 percent increase in the number of adults seeking treatment for acne, which has some dermatologists convinced that adult-onset acne is becoming more endemic. It’s one of the sadistic circus games played by the human body: You’re lulled into a stupor by the clear skin of your 20s, only to wake up in what’s meant to be your prime with a face that looks like it’s been lovingly caressed with a meat tenderizer.

Along with the Tretinoin, which I stopped using after a few months, I tried the usual suspects: cult fave spot treatments like Murad salicylic acid and Mario Badescu’s drying lotion, oil cleansers, clay masks. My acne caroused over my jawline and temples; it experimented with vicious cystic bumps and the friendlier whiteheads. I vacillated between detached and deranged. I learned how to use concealer. I found new angles for photographs. I skipped work one day when I just couldn’t with a honker on my chin. My doctor suggested cutting out cheese, chocolate and wine, which was very cute and funny.

Above all, I found my prevailing reaction to my new face to be a benign shrug, a curious indifference, a general bemusement. A few years before I developed acne, at the still-blooming age of 27, my partner of eight years ghosted on me. Since then, I had moved alone to New York City, ripped live cockroaches out of the jaws of my cat, learned how to juggle Tinder dates. I once had my shoe eaten by an escalator RIGHT OFF MY FOOT. I had an army of salt-of-the-earth friends, a prescription for Lexapro, and a go-to recipe for spaghetti puttanesca. Ten years ago, acne would have crippled me. Now, I looked at my face and saw, very simply, my face: spotted, tired, and fiercely proud.

I used to wish for beauty with unrelenting desperation. What must it be like to be coveted, I wondered. What does the air taste like up there? I recognize that even beautiful people don’t necessarily believe their own beauty (I once tried to interview a friend about this and he replied that he “never saw himself as good looking,” making me snarf up my green juice). Still, I’ve always imagined that to be tagged by beauty is to move through the world with an ease that I had never myself experienced. But the great privilege of growing older is the possibility of self-ownership. So maybe I didn’t have “the look,” according to some absurdly narrow standard, but I had some of the smarts, an eye for wonder, the unerring ability to vocally identify each member of One Direction after only a few notes. There’s a certain self-assurance to be gleaned, over time, from looking in the mirror and seeing exactly what you’ve come to expect. When that is shattered, even by something as paltry as a smattering of whiteheads, it’s a rumble.

It isn’t, however, the seismic dismantling it would have been in youth.

Growing older is the process of endless regulating, of learning what to care about and what to discard. What adult acne taught me was that I’m no longer a person who deals in the currency of beauty. This isn’t about becoming inured to vanity; I still conceal the worst when I’m going out, still play whack-a-zit with toners and masks and salves. But I am gently impressed by my durability, my ability to (sometimes literally) turn the other cheek. If vanity doesn’t disappear with age, it at least changes shape and claims less real estate in your brain, which simply has more important things to care about. Each new zit has given me the opportunity to say, again, that I am more than this face.

Photos by Louisiana Mei Gelpi.

Get more Beauty ?
  • Bmo

    Wow. I love that this article isn’t a bunch of tips on how to cure adult acne, nor does it just follow your path (product wise) of trying to get rid of it. I’ve also been dealing with new-found acne. I had pretty clear skin all though highschool/college and now that’s all changing here in my mid-20s after I got an IUD.
    “But I am gently impressed by my durability, my ability to (sometimes literally) turn the other cheek.” This is definitely something I’m trying to work on. Thank you!

  • Molly

    Yes to all of this. I developed adult acne really recently, about 4 months ago and for the first couple of months I didn’t want to leave the house. Now, I’ve managed to be a bit more ok with it and even went out without make-up a couple of times this week (which doesn’t sound like a big deal but it was!).

  • Great thinking and great writing!

  • Alexis Lambert

    Thank you for this. I really needed it today.

    • Thank you for saying thank you, I really needed that 🙂

  • I absolutely love this! I am in the same boat, and this piece gave me some new perspective.

  • Patrizia Chiarenza

    I have been having acne since i turned 34 and I’m not sure whether it is age, the fact that I got off the pill, my diet, or the natural beauty products I am slowly switching to, but your line: “My doctor suggested cutting out cheese, chocolate and wine, which was very cute and funny.” made me LOL
    I think of changing my diet and being better as far as sweets, dairy and alcohol but then I’d be an adult with acne who is also really craving a piece of cheese or chocolate, with her glass of red wine, so whats the point? I’m going to LIVE and let my pimples be!

    • tmm16

      10000% agreed that I’d rather have acne than not those things as well.

  • Bailey

    This is currently happening to me!! My teen acne went away for ten years and now it’s back at age 27, but exclusively on my chin, upper lip and sometimes my LIPS which is so painful and weirdly embarrassing, I simply cannot. I am trying very hard not to let it get to me like it did as a teen but it’s very difficult. I feel personally victimized by my own adult hormones. Thanks for writing this.

  • Mo

    There’s a lot of talk about under representation in the media. About not seeing familiarity on screen or on print for the vast variety of people and our various identitities. That we limit cultural representation to whiteness. But it isn’t just whiteness. Its a smooth and unstressed complexion we idolize. Our idea of privilege extends past skin color and well into skin texture. Even here, in your wonderfully relatable article. We have beautiful women with artistically placed red beads… Like, we can talk about and we cry about it but we still can’t look at it. We refuse to look at it or we hide it so there for when we show it, it’s shocking and no matter what that person stands for they first and foremost are associated with acne. Even if we were to use a model with acne we only allow the acne for an article about acne…. We’ll avoid showing pimples, that we call blemishes, because it’s not couture.

    • Willa Konefał Davis

      Thank you. That was one of my first observations in this article. I found the content refreshing, and as someone going through a tough spot with my skin, the concept of accepting ones face as it is was actually really comforting… and then alongside it, is just more confirmation that its not actually okay or beautiful. Too gross to be featured in an article.

      Reminds me of articles about how beautiful aging can be, that feature a 60-year-old white female model with long, perfectly gray hair, wrinkles only next to her eyes because her life has been just so grand she couldn’t stop laughing… not reassuring at all.

      • Mo

        The contrast between the images and the narrative does make me think, regardless of how I feel about the dishonesty of showing beads instead of the rough ridges and pores of actually acne. I do find that I liked this article, and Meghan’s bare thoughts. But, it feels like the same dialogue I struggle with since the age of ten. I particularly responded to the arsenal of cures and prescriptions as a “litany of nuclear prescriptions or the creams and lotions that bleach out the bedsheets.” Except that it still reads as an internal dialogue, as something we have to not care about, because we simply don’t have a cure for it, and we’re biologically inclined to not find it attractive. At ten I remember looking in the mirror and not caring for the bumps that started to show between my brow and along my nose line. But it was a new face, I thought she’d go away and I wasn’t concerned. Until family members started pulling me aside at gatherings or cornered me at home to ask why I wasn’t washing my face, and why I was letting this happen to myself. I think that’s what frightens me the most, is that young people are told they should care. It’s seventeen years later and this choice… is not a choice.

    • Andrea

      Yes! I reaaaally believe if I had seen characters in movies and TV with visible acne as a teenager, it would have dramatically improved my self-esteem. There’s a lot of stories now about women hating themselves bc of their weight and overcoming that struggle, but where are the girls who have cried in front of the mirror before school because of their acne? Where’s that story? There’s a whole acne community on instagram and it’s the only time I’ve ever found other women “speaking my truth” in that regard.

      • Mo

        I remember being comforted by Proactive commercials between 14 and 15 and also feeling more worthless. Acne is always the “before” reference, and it is often the epitome of unwanted when it comes to high school simulations and dating. It’s just the most heart warming when cartoons reference someone being ugly, or undesirable, that they cover their faces with tiny red dots.

        • Andrea

          I think it’s also hard that acne is still considered in the media to be a young person thing. As a 20something woman who is working very hard to be respected as a professional, it can really undermine my confidence talking to someone “important” in my line of work knowing I have acne bumps visible. It makes me feel like a child.

  • Andrea

    Thank you for this! I’m 24, and have had “bad skin” since the age of 10–that’s over half my life now! My acne struggles are very much genetic, and it sucks so much. It basically destroyed my self-esteem as a teenager, I couldn’t even look a boy in the eye until I was like 16, and even now every time I’m in bed with a man I have to force myself not to worry if he’s judging the clogged pores on my nose or the cystic zit lurking on my chin. I am still sooo bitter when it comes to people with great skin, and I am very resentful that I “need” to wear foundation every day. However, I don’t actually cancel plans now if I have a bad breakout-something I used to do with frequency. I find my concealer and solider on. Thanks for the reminder that I am more than my face. (Also, I found Ortho Tri Cyclen reaaaally helped with my hormonal acne on my jaw and chin, for those whose skin troubles have been birth control based!)

  • Caitlin Crow

    Thank you for this, Meghan. My experience is quite similar to yours in terms of timeline, and as I approach 36 (and the 6th year of my “new” face), I am trying to shift my focus away from incessant research on the latest diet, supplement, and skincare tricks, and toward the stuff that really matters. Not easy, but getting easier. <3

  • Natavan Quliyeva

    Hi, the same here. I am 28 and i have acnes on my chin. 2 or 3 years ago i used powders and concealers to hide them, but right now i dont use anything. I dont put any make up and my acnes are getting less and less. I drink water and dont bother myself on trifle things in life. So i wish you good luck and thanks for sharing your thoughts.

  • Amazingly well-written, and really needed.

  • Eliza

    I’ve struggled with acne for the last 15 years. I’ve noticed a huge shift in how I deal with my acne emotionally in the last year or two – Now if I feel a cystic coming in or some other horrible knot, I just sort of accept it. I lather on my creams and continue on with my life. I use to feel such intense shame about the state of my face – I would check the mirror to make sure my concealer was perfect obsessively, I would pick and pick and I was so sure that’s all anyone saw. I would base my hair, my outfit, my makeup, solely around if my skin was clear or not. It was exhausting. I’m happy to say I’ve pretty much grown out of that – If I have a pimple then I have a pimple. I’m still awesome. I still look great. I will not let the pimple consume me!!!! I also found a top notch NYC dermatologist who regularly talks me down from the ledge.

    • Amelia

      oooh! care to share a derm recommendation?!

      • Eliza

        Dr. Nazarian, Schweiger Derm!

        • Alix

          Schweiger Dermatology is the best! So many locations, super convenient online scheduling, and can usually fit you in same day for a cortisone injection.

  • Samantha s

    This sentence is so, so lovely “Now, I looked at my face and saw, very simply, my face: spotted, tired, and fiercely proud”. It is so deep and wise.

    I’ve had acne since I was 9 years old. I am now 28. I realized recently that my ‘NORMAL’ is acne. I have never, ever, had the luxury of waking up in the morning to a fresh face. It ebbs and flows in severity, but it is constant. Through the years, I’ve done amazing things! And my acne has hitched a ride the whole time. So, fuck it. I’m spotted, tired and proud. Thank you!

    • Julie

      Since the age of ten, and I am now 30, I too have had acne. Not one single day has it let up. Mostly I just deal and it’s fine but man is it a constant in my life. I wouldn’t stretch to say I’m proud of it but it is definitely my whack, cystic, hormonal normal, and a relief to see that other people have this experience too. Not that I would wish never-ending pubescence on anyone!

  • thank you for this fresh perspective MR!

  • Caroline

    Ah AMEN! I also got an IUD and now have perpetual underground acne along my jawline and I also…don’t care? It’s good to be 27 going on 45 and not really worry too much about this. I noticed this internal switch in myself and was just as pleased and astonished. Yay for aging!

  • Harling Ross

    love this so very much

  • Catherine Bugler

    “I’m no longer a person who deals in the currency of beauty.” LOVE this Meghan! Writing it down and tattooing it on my body to remind me what’s important in this world!

  • ella

    Oh oh oh!!!!!
    Thank you for these stunning words.
    I clicked, expecting just an amusing article about classic beauty dramas, got so.much.more. Just yes to everything. You write beautifully. I feel really good after reading this.

  • This is exactly what happened to my face, too. I had the occasional pimples and mild breakouts in my teens and early 20s, but two years ago I got Mirena. I don’t think that made my acne worse. At least not enough to think it was the cause. Then I tried Tretinoin (mostly for anti-aging, because MR told me to…TBH) and it made my face FREAK OUT!! Exactly how you said yours did. I stopped it maybe 6 months ago and I swear, I can’t get it back to the way it was pre-Tretinoin. Besides the pimples, I think the hardest thing for me is the acne scarring, the dark red spots that won’t budge. It’s just covering my face. When I clear a breakout, I’m left with more spots. I just can’t accept this as my face like you admirably have. I’m still looking for treatments and cures. Mostly for these horrible dark spots.

  • Me

    Love this, and if you’re still looking for a solution, Spironolactone (an oral medication) has been life-changing for my hormonal acne

  • Wow, this is exactly how I feel. It’s never the crippling acne that requires intense medication, but the dumb articles like “5 Smoothies to Clear Your Bad Skin Days” aren’t really applicable.

    I’m still searching for the cure, but it doesn’t affect my mood every day.

    If you’re ever down to meet new people – I live in Cambridge, MA, too!

  • Kelly

    I love this! As someone who has also suffered the woe’s of adult acne I feel this deeply.

    And in case this helps someone out there.. Starting to use an over the counter retinol (The Ordinary 2%) has changed my skin lately. It’s not 100% clear, but it is so so much better! I would get hormonal breakout along by jaw line and they are basically gone since I began using this regularly. I had used another retinol product in the past with zero results and had become really disheartened about my skin, but this has really helped me.

  • margaret lovejoy

    Am always impressed by MR staff members’ honesty and fierceness in articles such as this; however, I’m also saddened by the almost exclusively Western/pharmaceutical route this articles explore. I, too, had horrible adult acne post-HBC and have a Paraguard IUD. Some discussion on MR about cycle-synching, naturopathic approaches to the body, and/or holistic skincare would be an awesome way to open readers’ perspectives and broaden our conceptions of women’s health outside of rote advice from derms, big pharma, and our government’s terrible miseducation. Ideas: Alisa Vitti’s book on reversing PCOS and/or quitting the pill, “Woman Code” (would LOVE to see an interview with her or at least a review of her book and an exploration into cycle synching); Evan Healy skincare profile or other skincare companies that are sustainable, ph-balanced, and kind to the skin’s acid mantle; interview with a naturopath; discussions with women on alt-health, etc. etc.

  • Toronto CS

    I too had beautiful skin in my twenties and then developed adult acne. I eventually went on Accutane and I am so glad I did. I have a handful of scars from just my two year struggle with acne (untreated that would have multiplied). I also got a staph infection in one blemish that took three rounds of oral antibiotics to cure (and itched like you wouldn’t believe). I sometimes looked worse than a burn victim. I think what caused all this was maybe irregular hormones and periods. To get Accutane I had to switch doctors (the first wasn’t effective) and then be referred to a dermatologist by the second (where I live it’s difficult to see a specialist). Accutane is a serious drug but so, so worth it for some.

  • Brie

    I couldn’t relate more to this article. I’ve battled adult acne throughout my 20s and have tried everything. It’s definitely hormonal and THE ONLY thing that has worked is the Skinceuticals line (made for hormonal aging skin). The blemish and age serum is a god send, it’s pricey but so worth it! I recommend trying the LHA gel to cleanse and the blemish and age as a spot treatment. As soon as you feel one of those under the skin monsters – apply a little before bed, it’s either gone or on its way to be gone. I actually went makeup free this summer, never been able to do that.


    This article is very relevant and impressive as you have guided us through your experience wrt the do’s and dont’s. Adult acne is a very common issue nowadays, compounded by the abnormalities of our lifestyle- more work, less exercise, more n more stress. I have also suffered from adult acne and found out that it was the hormonal imbalance that was triggering it. I took steps to correct it. I would recommend visiting the general physician and not the dermatologist to get a check -up. Also, some small changes in our daily routine will help.

  • Rachel

    Great perspective. But I’m curious, have you found ways to clear your adult acne? With diet, medication or other ways?

  • paraplu

    I have been frustratingly going through the same thing with my 31-year-old face that has started intensely breaking out all over my chin. It feels as though it is never-ending; one flattens enough to not be as noticeable just as another one looms. It is embarrassing all the time, but especially within a professional setting. Trying to let it go.