Why Adults Get Acne: A Clinician’s Perspective

When most people think of acne, they picture teenagers struggling with breakouts. However, many adults—well into their 20s, 30s, 40s, and beyond—continue to experience acne. At Sheen Vein (Aesthetics and Functional Medicine) here in St. Louis, we often see patients who feel confused or even embarrassed that their skin hasn’t “outgrown” acne. The truth is, adult acne is very common, and it has unique underlying causes that differ from the adolescent type.

Hormonal Shifts and Imbalances

One of the most common drivers of adult acne is hormonal imbalance. Women, in particular, may notice breakouts during menstrual cycles, pregnancy, perimenopause, or when dealing with conditions like polycystic ovarian syndrome (PCOS). Fluctuations in estrogen, progesterone, and testosterone can all stimulate the sebaceous glands, leading to excess oil and clogged pores.

Men are not immune either—imbalances in testosterone or metabolic dysfunction can lead to similar patterns. In our functional medicine clinic, we often order comprehensive hormone testing to uncover these hidden factors.

Stress and Cortisol Overload

Chronic stress is another big contributor. When the body is under constant stress, cortisol (the stress hormone) remains elevated. This disrupts normal skin repair, increases inflammation, and triggers oil production. It’s no coincidence that patients under work stress, caregiving demands, or major life transitions often notice worsening skin.

At Sheen Vein (Aesthetics and Functional Medicine), we emphasize stress management as part of an acne care plan. Lifestyle approaches such as breathwork, exercise, and even red light therapy can help rebalance cortisol levels while improving skin healing.

Gut Health and Nutrition

More and more research links gut health with skin health. A disrupted microbiome, food sensitivities, or blood sugar imbalances can trigger systemic inflammation that shows up on the skin. Diets high in refined carbohydrates and dairy products, for example, are associated with worsening breakouts in many adults.

We routinely perform advanced testing for gut health in our patients. By identifying imbalances like dysbiosis or nutrient deficiencies, we can create a customized nutrition plan that helps clear the skin from within. You can learn more about how the gut and immune system interact in our functional medicine services.

Environmental and Lifestyle Factors

Daily exposures also matter. Heavy use of cosmetics, hair products, and even certain sunscreens can clog pores. For some patients, high humidity or pollution in the St. Louis area aggravates their skin. Sleep quality, alcohol use, and smoking can further weaken the skin’s natural defenses, setting the stage for breakouts.

Underlying Medical Conditions

Sometimes, persistent acne is more than just a cosmetic nuisance—it can be a sign of deeper metabolic dysfunction. Insulin resistance, thyroid disorders, and chronic inflammation all have skin manifestations. That’s why a surface-level treatment alone (such as topical creams) often falls short. At our practice, we look at the whole picture: hormones, metabolism, lifestyle, and environment.

Treatment Approaches

The good news is, adult acne can be managed effectively once the root causes are identified. At Sheen Vein (Aesthetics and Functional Medicine), we take a multi-layered approach:

• Functional testing for hormones, nutrition, and gut health
• Medical-grade skincare tailored to sensitive or acne-prone adult skin
• Lifestyle interventions including stress reduction and dietary adjustments
• Advanced therapies such as laser treatments and platelet-rich fibrin (PRF) to improve skin texture, reduce scarring, and enhance natural healing

For some patients, targeted medications or supplements may also be part of the plan. The key is personalization—because no two cases of adult acne are the same.

Why Early Treatment Matters

Adult acne can be frustrating not just physically but emotionally. Many of our patients describe feelings of embarrassment, anxiety, or even social withdrawal. Addressing acne early reduces the risk of long-term scarring and restores confidence. Just as importantly, it helps uncover deeper imbalances in the body that, if untreated, may contribute to other health issues down the road.

Final Thoughts

If you’re an adult struggling with acne, you’re not alone—and you don’t have to rely on temporary fixes. By identifying the underlying causes, we can create a plan that addresses the root issues and supports both your skin and overall health.

At Sheen Vein (Aesthetics and Functional Medicine) in St. Louis, we combine expertise in aesthetics with functional medicine to help our patients achieve clear, healthy skin that reflects their inner well-being.

If you’re ready to explore a personalized approach to your acne care, schedule a consultation with us today. Visit our contact page to get started.

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