Have you ever stared at your reflection in the mirror and wondered, “Why am I getting breakouts?” We’ve all been there. Whether you’ve dealt with breakouts your whole life or are just starting to face them, one thing most of us can agree on is that they can completely ruin your day (or even your week, month, or longer). Like uninvited guests, they show up at the most inconvenient moments and linger far too long—and the more you mess with them, the worse they tend to get. Even when you’re diligent about your skincare routine and using the highest quality products available, acne still happens, and the reasons behind adult acne can vary. Since addressing acne often involves understanding its underlying causes, we decided to dive into some of the reasons (both common and less obvious) that might be behind your breakouts. We consulted with dermatologist Dr. Hadley King to find out what may be causing your acne and how to treat it.
First, let’s understand how acne forms. “Every acne lesion begins with a microcomedo, a tiny clog within a pore. It’s so minuscule that it’s invisible, but it can develop into a more noticeable comedonal lesion (like a blackhead or whitehead). If bacteria and pro-inflammatory molecules are present, it may turn into an inflamed acne lesion like a pimple or a cyst,” Dr. King explains.
Now, what differentiates blackheads, whiteheads, pimples, and cysts? If you’re breaking out, it’s not uncommon to see any or all of these. “Blackheads and whiteheads occur when pores become blocked by dead skin cells, sebum, and bacteria. These plugs are known as sebaceous plugs and form comedones. Open comedones are blackheads, while closed ones are whiteheads. The dark color of blackheads comes from the oxidation of the open pore. Pimples are inflamed lesions appearing as red bumps (papules) or pus-filled bumps (pustules). Cysts are deep, inflamed lesions beneath the skin, often tender and warm,” shares Dr. King.
12 Reasons You Might Be Experiencing Breakouts:
- Stress
Stress is a major contributor to acne. “Stress triggers the release of adrenaline, cortisol, and other hormones, which can increase sebum production, leading to acne,” says Dr. King. Studies show that higher stress levels often correlate with more severe acne. Managing stress can be challenging, but identifying stressors, prioritizing sleep, and regular exercise can be a good starting point. - Hormones
Hormonal changes, especially those related to your cycle, are a significant factor. “Mid-cycle rises in progesterone and relative increases in testosterone around menstruation stimulate sebum production, resulting in oily skin, clogged pores, and inflammatory acne,” says Dr. King. Acne that appears consistently around the same time each month or around the jawline, chin, neck, back, and chest could be hormone-related. - Sweat
Sweat can also contribute to acne. “Sweat and oil can create a breeding ground for acne-causing bacteria,” Dr. King explains. Sweat increases sebum production, which can clog pores. Make sure to shower right after exercise and use non-comedogenic products on your body. - Environment
Heat, humidity, pollution, and smoke can all trigger acne. Washing your face twice a day can help remove dirt that may settle into pores. - Diet
High sugar intake may also play a role. “Foods with a high glycemic index can spike blood sugar levels, impacting hormones and potentially triggering acne,” says Dr. King. Reducing sugar and artificial sweeteners might help if you notice breakouts after consuming sugary foods. - Dairy
Dairy products, like milk, cheese, and creams, may cause inflammation and excess oil production, leading to acne. - Skincare Products
Non-comedogenic products that do not clog pores and help with skin care are essential. An ingredient like salicylic acid can help clear pores and reduce bacteria. - Hair Care Products and Accessories
Products like hairspray, thick gels, and hair oils can clog pores along the hairline. Hats and headbands can trap dirt and bacteria, so keep them clean. - Dehydration
Dehydrated skin can lead to excess oil production, resulting in breakouts. - Pillowcases
Dirty pillow cases can harbor bacteria, sweat, and oil, leading to acne. Change them frequently and consider silk or satin options for gentler skin contact. - Retinoids
Retinoids help prevent and treat clogged pores by promoting skin cell turnover, reducing healing time for acne. - Other Medication
For persistent acne, consulting a dermatologist is recommended. Prescription options include stronger retinoids, oral antibiotics, birth control pills for hormonal acne, and isotretinoin for severe cases.