Teenage acne is mostly driven by a surge in androgens, hormones that ramp up sebum production and cause the kind of widespread, oily, inflamed breakouts most of us remember. Adult acne tends to be different in character.

It's often hormonal, but more cyclical. It shows up around the jaw, chin and neck more than the forehead. It tends to be deeper, more cystic, and slower to heal. And it often comes with skin that isn't even particularly oily... sometimes it's dry or sensitive at the same time, which makes treating it more complicated.

The triggers are also different.

Stress is a significant one: cortisol increases sebum production and drives inflammation. Hormonal fluctuations around the menstrual cycle, perimenopause, coming off the pill, or post-pregnancy can all shift the skin's behaviour significantly.

Diet plays a role for some people, particularly sugary foods and dairy, though this varies considerably from person to person.

And then there's the products themselves. I see a lot of patients whose skin is actually being irritated or congested by the wrong skincare, which is a conversation in itself.

There are a handful of ingredients with solid evidence behind them for acne-prone skin, and I want to be honest about what they do and how to use them

If your acne is moderate or persistent, a prescription retinoid is worth a conversation with your doctor. For over-the-counter options, there are some good ones available. Just be realistic about timelines. It takes 12 weeks or more to see meaningful change, and you'll likely experience some initial purging (worsening of breakouts) before things improve. Start low, go slow, and be consistent.

In clinic, we combine all of these ingredients as part of our acne protocol, adjusted to each patient's skin and the severity of what we're dealing with.

CLEANSER

Resist the urge to use a harsh, stripping acne cleanser. Your skin needs to be cleansed, not punished.

The Skingredients PreProbiotic Cleanse is one I reach for regularly, it's creamy, gentle, and actually supports the skin microbiome rather than disrupting it.

The La Roche-Posay Effaclar H Iso-Biome Cleansing Cream is particularly good if you're using a retinoid or prescription treatment, as it's specifically formulated to counteract the dryness those cause. `

The CeraVe Hydrating Cleanser is a brilliant affordable option for sensitive or reactive skin.

SPF

Non-negotiable, every morning.

Post-inflammatory pigmentation (the marks acne leaves behind) gets significantly worse with UV exposure.

The Tocobo Bio Watery Sun Cream SPF50+ is a favourite for acne-prone skin: genuinely lightweight, no white cast, won't block pores. Mineral SPFs are also great for acne-prone skin and something like FLEX from Colorescience will give you a bit of coverage too.