Last updated: Mar 19, 2009
Just when you thought youd escaped your teens and 20s unblemished, you find yourself battling adult acne and pimples in your 30s—and beyond. Hormones can fluctuate like mad in our 30s, 40s, and 50s, as we go on and off the pill, get pregnant, enter perimenopause and, eventually, menopause.


Pimples arent the only resulting problem, either. “There are quite a few conditions that mimic acne, which can make it hard for women to know what they truly have and how to treat it,” says Howard Murad, MD, associate clinical professor of medicine at the University of California, Los Angeles. But diagnosing those red bumps can be easy if you know what to look for. Consider this your clear-skin cheat sheet.

If you notice…red bumps or deep-seated, persistent lumps concentrated around the chin and jawline, or blackheads and whiteheads spread across the skin you might have adult acne

The acne you get in your early adult years erupts for the same reasons it did in high school—primarily due to genetics and hormones. But its not always that estrogen levels are falling and male hormones are increasing, as many people assume. “Women may have normal hormone levels, yet still suffer from acne. The body simply develops a new sensitivity to hormones, which can result in breakouts,” explains Doris Day, MD, clinical assistant professor of dermatology at New York University Medical Center. And in those who are prone, androgens—or male hormones—can overstimulate oil production and interfere with the normal shedding of skin cells, causing pores to clog and bumps, blackheads, and whiteheads to pop up.

Treat it with: Over-the-counter acne products, to start. Go for cleansers, oil-free moisturizers, and spot treatments with pore-clearing salicylic acid or sulfur, both of which are far less drying than benzoyl peroxide. Dr. Murad advises his patients to choose formulas that double as anti-agers, fighting lines with products that contain peptides and antioxidants.

Homemade solutions also exist. “You can create a pimple-fighting paste by mixing a little bit of honey, an antiseptic, a dab of 1 percent cortisone cream, and some aloe gel, which soothes the skin,” Dr. Day says. “Simply apply it to the breakout. Youll get all of the anti-inflammatory effect of cortisone, and itll take some of the angriness out of the pimple.” If your skin doesnt clear after two to three weeks of at-home treatment, see your dermatologist. She can shrink those buried cysts with a shot of cortisone or prescribe a short course of antibiotics—creams and pills—for severe cases of adult acne.

If you notice...redness on your cheeks, nose, chin, or forehead, plus visible blood vessels you might have Rosacea

The exact cause of this chronic inflammatory condition is unknown. Some experts blame it on bacteria; others attribute it to inflammation or a microorganism residing in the oil glands. Without treatment, bother­some blushing can lead to unrelenting redness, bumps, and swelling. Unlike adult acne, “rosacea bumps lack plugs—the sticky clumps that come out when you squeeze a pimple,” says Dr. Murad, who is also the creator of Murad Skincare.

Treat it with: Antioxidant-rich sunscreens, anti-inflammatory moisturizers (with caffeine or soothing botanicals, like licorice extract and feverfew), and gentle cleansers. And cover it using makeup with a green tint, which counteracts crimson. Avoiding things that cause you to blush—caffeine, alcohol, spices, the sun—is a crucial part of treatment, too. If these remedies dont do the trick, see your dermatologist. Shell likely prescribe oral antibiotics or recommend intense pulsed light (IPL) therapy to knock out background redness and laser treatments to target broken blood vessels. One to three treatments, at $400 to $600 a pop, are usually needed for both IPL and laser.

If you notice...small red or white pimples surrounding the hair follicles, usually on your chin you might have Folliculitis

“After age 30, women often experience an increase in facial hair and become more prone to folliculitis, an infection of the facial hair follicles,” Dr. Murad explains. Plucking unwanted chin hairs can damage the follicles, leading to inflammation and redness.

Treat it with: Remedies that slow hair growth and target inflammation that comes from forcibly removing hairs. If your ovaries are producing too much androgen—and thus contributing to excess fuzz—birth control pills can address the problem and minimize hair, Dr. Murad says. If youre prone to facial hair, talk to your doctor about Vaniqa, an Rx cream that reduces facial hair growth over time.