The Guy’s Guide to Adult Acne

River ChadGroomingThe Guy’s Guide to Adult AcneThe Guy’s Guide to Adult AcneWe’re all stressed AF. The food we’re eating probably isn’t helping. Everyone told us we wouldn’t have to worry about our hormones going crazy after our teen years. What the heck is going on?By Bob GearingPublished: Nov 10, 2026 9:00 AM EST3 min readTHE YEAR WAS 1997. I’d just made the varsity baseball team as a freshman, and I was ready to shoot my shot with every senior girl who’d give me the time of day. The only problem: I had also hard-launched my pepperoni face. I’m not talking surface-level New York slice stuff—these breakouts were Detroit-style-pizza deep. Every clogged pore had clocked in at the same time, and I was an absolute wreck.For six months, I’d burned through everything the CVS aisles had to offer: Oxy Pads, Stridex, Noxzema, whatever stuff was hawking a promise of clear skin. Nothing worked. My face just got redder, drier, and more irritated. My mom (thank god for her) dragged me to the dermatologist, and I walked out with a prescription for isotretinoin, a.k.a. Accutane. Five months later, my skin was completely clear. My mini CVS stash went into the trash, and I thought that’d be the end of it.I was wrong. I spent years assuming that because I took Accutane as a teenager, I’d paid my dues, but as a 44-year-old dude, I still get the occasional pimple or two—seemingly right before a big work meeting or whenever I have a lot of stuff on my plate. And it still messes with my head. Does my hygiene suck? Are my hormones to blame? Am I sweating too much? Apparently, I’m not the only one.According to Christopher Bunick, MD, PhD, an associate professor of dermatology at the Yale School of Medicine, 83 percent of teen boys will deal with acne before they reach their 20s, which is often due to a surge in testosterone at the time. And while acne typically clears up as testosterone levels stabilize in our 20s, it can make a surprise comeback in our 30s, 40s, 50s, and beyond—with around 20 percent of men in their 30s dealing with breakouts, but only 12 percent seeking treatment from a medical professional. It’s not just a skin issue: Research shows that adult acne is consistently linked to a higher risk of developing anxiety, depression, and reduced self-esteem.“Scientists still aren’t sure exactly what makes some guys more SUSCEPTIBLE TO ACNE than others, but GENETICS AND HORMONES are two leading factors.”Acne (not to be mistaken for folliculitis, which can result from shaving) is mainly caused by a combination of excess oil production and dead skin cells that clog pores. This can create an environment where strains of Cutibacterium acnes—the bacteria naturally found on your skin—become imbalanced and trigger inflammation. This could look like blackheads and whiteheads, raised pustules and papules, or the deeper, more painful nodules or cysts that are more likely to scar. And despite what your instincts tell you, excessively scrubbing your face won’t help—it could actually harm your skin barrier. “You cannot wash away hormones,” says Dr. Bunick. Acne is an inflammatory condition, not a hygiene problem.Scientists still aren’t sure exactly what makes some guys more susceptible to acne than others, but genetics and hormones are two leading factors. Research suggests about 80 percent of your acne risk is inherited. Your genes determine how sensitive your skin is to the hormones (i.e., androgens) that regulate the sebaceous glands and how aggressively your immune system overreacts to fight the inflammation. Then there are the lifestyle factors that play a smaller role but can collectively add up, such as diet (Dr. Bunick is a believer in the gut-skin axis—the idea that an imbalanced gut microbiome can drive systemic inflammation that can predispose you to acne), stress (this spikes cortisol, which also drives oil production and contributes to inflammation), sleep deprivation (same), and testosterone replacement therapy.Though there isn’t a cure for acne yet, there are plenty of treatment options. “Untreated acne doesn’t just affect your skin. It affects how you move through the world,” says Dr. Bunick. “Acne impacts confidence, whether it’s making friends, having a social or dating life, or performance in work, sports, or other extracurriculars.” Earlier intervention means less of a psychosocial toll, less scarring, and (you heard the man) more confidence.So if your bathroom still looks like mine did in the ’90s, it’s time to investigate what might be causing the chaos in your largest organ and learn how to treat it. The stories below will help you get your skin clear and, hopefully, keep it that way.Your Guide to Adult AcneHow to Treat Acne Like an AdultRiver ChadIs TRT Causing Your Acne?River ChadAcne Scars, BegoneRiver ChadThe Paths to Clear(er) SkinRiver ChadCan Acne Be Prevented With a Vaccine?River ChadBob Gearing is a New York-based writer covering men’s grooming from the perspective of a very real (and very sweaty) dude. By day, he’s a well-SPF’d tech sales bro; by night, he’s a red-light mask guy who definitely didn’t think he’d care this much about skincare. When he’s not testing the latest face serum, you’ll find him sweating through a round of golf or holding out hope that the Lions will make the Super Bowl before he dies.