Why Am I Getting Acne as an Adult?

It’s one thing to deal with acne as a teenager, but when breakouts show up in your 20s, 30s, or even 40s, it can feel especially frustrating. Many of my patients feel confused or discouraged when their skin flares up long after high school is over. If you’ve ever thought, “Aren’t I too old for this?” you’re not alone.

Adult acne is increasingly common, especially among women. While conventional treatment often focuses on managing symptoms, naturopathic medicine takes a deeper look at what’s driving the imbalance beneath the surface. Let’s explore why adult acne happens and how a root-cause approach can help you move toward clearer, more resilient skin.

Hormonal Fluctuations

Hormones are one of the most common (and complex) contributors to adult acne. Many women notice breakouts that flare with:

The menstrual cycle (especially premenstrually)
Transitioning off hormonal birth control
Pregnancy or postpartum
Perimenopause and menopause

In these situations, several hormones can play a role, but androgens such as testosterone and DHEA-S are often key drivers. While androgens are essential for mood, energy, and libido, elevated levels or increased skin sensitivity to these hormones can lead to increased oil (sebum) production, clogged pores, and inflamed breakouts, especially around the chin, jawline, and neck.

Hormonal acne often presents in cyclical patterns, flares with stress, and can persist despite topical skincare. Identifying and addressing hormonal imbalances through testing and personalized treatment is a core part of how I help adult acne patients.

Chronic Stress & Cortisol

Stress impacts more than your mental well-being—it can directly influence your skin’s health. In response to stress, your adrenal glands release cortisol, a hormone designed to help you cope with challenges. However, when stress becomes chronic, cortisol stays elevated for too long and can contribute to skin issues like acne.

Here’s how elevated cortisol affects your skin:

Increases oil production, leading to clogged pores
Worsens inflammation, making acne more painful and persistent
Disrupts blood sugar regulation, which can fuel further hormonal imbalances

Even subtle or low-grade stress like poor sleep, a busy work schedule, or emotional strain can keep cortisol high and interfere with skin healing. Supporting the nervous system through practices like acupuncture, breathwork, and lifestyle adjustments is often a missing link in acne care.

Gut & Digestive Health

The gut-skin connection is well-established in both emerging research and naturopathic clinical practice. If your digestive system isn’t functioning well, your body may struggle to eliminate waste efficiently, absorb nutrients, or keep inflammation in check. Here are some signs your gut might be contributing to acne:

Bloating, gas, or indigestion
Constipation or irregular bowel movements
Food sensitivities or frequent skin flares after eating certain foods
A history of frequent antibiotic or antacid use

Healing the gut often leads to noticeable improvements in skin clarity, reduced redness, and fewer inflammatory breakouts. Treatment might include identifying food triggers, restoring gut flora, and improving digestion with targeted herbs or enzymes.

Blood Sugar Imbalances & Nutrient Deficiencies

You don’t need to have diabetes for blood sugar to affect your skin. Frequent spikes from refined carbohydrates, sugary drinks, caffeine, or skipping meals can increase insulin—a hormone that also stimulates sebum production and worsens androgen activity.

Beyond sugar, your skin needs a steady supply of specific nutrients for optimal functioning. Deficiencies in the following can impair your skin’s resilience:

Zinc: Supports wound healing and immune defense
Vitamin A: Promotes healthy cell turnover and oil regulation
Vitamin D: Helps modulate inflammation and immune response
Omega-3s: Help calm inflammation and support skin barrier repair

A nutrient-dense, whole-foods diet with steady meals is a powerful tool in your skin-healing toolkit.

Skincare & Environmental Factors

While adult acne often starts with internal imbalances, what you put on your skin still matters. Harsh scrubs, stripping cleansers, and comedogenic ingredients can weaken your skin barrier and trigger more inflammation. Instead of focusing on “drying out” acne, it’s important to protect the skin barrier, balance the microbiome, and support healing.

It’s also worth looking at hormone-disrupting chemicals in personal care products. Ingredients like parabens, phthalates, and fragrances may interfere with your body’s hormone regulation over time.

A Personalized, Whole Picture Approach

Adult acne is rarely caused by just one thing. That’s why my approach is always personalized and focused on identifying your unique triggers. We’ll look at what’s happening beneath the surface—from hormone patterns to digestive health, stress levels, and daily routines—to build a sustainable strategy that supports your skin from within.

Treatment may include:

Functional testing to assess hormone or gut imbalances
Personalized supplementation based on your needs
Targeted skincare recommendations, tailored to your skin type and goals
Adjunct therapies like acupuncture or red light therapy to reduce inflammation, support circulation, and calm the nervous system

If you’re ready to explore a whole-body approach to clear, balanced skin, I invite you to book a free 15-minute discovery call. Let’s talk about how we can work together to restore confidence in your skin and your health.