If you think you zapped zits for good back in middle school, you may be surprised to find that adult acne is very real (and sometimes thriving). As an inflammatory skin condition often tied to hormonal changes, acne typically hits the hardest during puberty.

So why do you still wake up at 34 with a massive crater?

While you may stop growing post-puberty, hormonal fluctuations persist long after your growth spurt. Add in stress, genetics, bacteria, contact irritation, and you’ve got a recipe for adult acne.

Resist the urge to get your pimple poppers ready, here’s what may be causing your acne and what you can do about it.

Because you’re going through additional hormonal changes in your 20s and 30s, acne can pop back up.

According to the American Academy of Dermatology, acne is the most common skin condition in the U.S. and the number of adults who have it is actually growing. Acne is also the eighth most common skin disease. *sigh*

Even though acne peaks between the ages of 14 to 17 for girls and 16 to 18 for boys, acne isn’t just a teenager’s plight. Acne is a chronic skin condition that can flare up well into adulthood.

Women are especially unlucky when it comes to adult acne in the mid 20s and up.

A 2018 study of 1,167 teens and adults with acne found during the adolescent years, acne is almost equally divided with 53 percent of cases among girls and 47 percent among boys. When it came to adult acne, 85 percent of cases were among women and 15 percent among men. Sorry, ladies.

There are two subtypes of adult acne: persistent and late onset. Both types of acne can manifest in scarring, inflammation, and changes in pigmentation.

Adult acne in mild forms can look like blackheads or whiteheads. More severe cases may result in deep, painful cysts and redness. Adult acne occurs mostly on the facial region and centers around the jawline, but it can also be found on the chest or neck area.

Persistent acne

Think of persistent acne as that former classmate who won’t stop sending friend requests. You thought you left it behind in high school, but much like the pesky friend, persistent acne is a continuation of the acne you may have experienced during puberty.

Late onset acne

Late onset acne is for those folks whose closest encounter with acne during puberty was a Girl Talk zit sticker. After the age of 25, this group of mostly women experience acne for the first time.

Because acne is hard to miss during puberty, late onset acne is far less common than persistent adult acne. A 2018 study found that 80 percent of women who sought treatment for adult acne fell into the persistent acne category.

There are a number of reasons why adult acne makes a comeback after the age of 25. Much like a Netflix reboot of your favorite early 2000s TV show, there’s more to the acne story. Many of these causes can build upon each other to join the acne party.

1. Genetics

If someone in your family has adult acne, that could be a cause of your own pesky protrusions. A study found that 67 percent of those with adult acne had a family history of acne.

2. Hormones

If you have periods, you know pimples are often a sign your monthly flow is on the way. That’s because adult acne can have a lot to do with hormone fluctuations or excessive male or female hormones.

Hormonal changes can cause inflammation, excess oil, and pH imbalances in the skin. Hormonal acne is typically cyst-like and painful.

Certain triggers for hormonal acne include:

3. Contact irritation

“Try not to touch your face” and “wash your hands” have become 2020 anthems for other reasons, but a failure to do so could also result in adult acne. Contact irritation can also be caused from harsh skin care products or attempting to shave dry skin.

4. Clogged pores

When dead skin cells decide to stay put on your face rather than making their rightful exit, the result is clogged pores. Oil from your hands can transfer to your skin and also result in pore clogging. Yet another reason to try to refrain from touching your face.

5. Bacteria

While not touching your face helps contact irritation, bacteria can build up under the skin and be unreachable by surface cleansers. An annoying bacteria called Propionibacterium can be responsible for the inflammation part of adult acne.

6. Physical stress

Your body can have physical response to stressors that manifest as adult acne.

This can include:

Some studies also point to allergies and smoking as potential causes of adult acne.

7. Emotional stress

Feeling anxious, scared, or depressed can cause an imbalance in your skin. When you’re stressed, your adrenal glands release excess cortisol, the stress hormone. This can create more oil and lead to breakouts.

8. Medications

Certain medications used to treat other ailments such as depression or epilepsy can come with a side effect of acne.

The same can be said for certain birth controls, which are sometimes prescribed as an acne treatment and contraceptive combo. Consult your doctor for any possible negative interactions.

There is no one-size-fits-every-zit treatment for adult acne. Treatment success in acne management varies by individual. People may need to try a variety of treatments to see what their skin swipes right on.

At-home treatments

You don’t necessarily have to visit the dermatologist to treat adult acne. You can possibly DIY your own treatment plan with these household items or over-the-counter remedies.

At-home adult acne treatments include:

Switching up what you eat may or may not help

There is no conclusive evidence that what you eat has an impact on acne. A study out of Turkey surveying a group of teens reported a positive correlation between fat, sugar, and fast food consumption. Other foods thought to have a link to acne include dairy products, whey protein powder, and chocolate. So much for that period chocolate cupcake you were craving.

It’s important to note that food sensitivities can cause inflammation, which in turn can lead to acne. Your body may see the food as a threat and go all Norton AntiVvirus on it by launching an immune attack.

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Medical treatments

You can get over-the-counter (OTC) or prescription-strength products to help kick acne to the curb. Doctors may prescribe medical treatments for adult acne that are either topical or oral.

Topical treatments may provide instant relief to your skin, while oral medications do their thing from inside your body.

Medical adult acne treatments include:

Wash your face

Raise your hand if you’re 30+ with no skin care routine. No need to be ashamed. With so many products out there, it can be overwhelming to find what works best for your skin.

Just washing your face every day is one step closer to giving acne the boot (without a 30-step skin care routine).

If you can only manage to wash your face once a day, do it at night. If you wear makeup, start by removing it. Use a specific facial cleanser and leave the bar soap in the bathtub. The skin on your face and on your bum have different needs, so they need different products.

Use lukewarm water and spread products with your fingertips for 60 to 90 seconds before reaching for the washcloth. Let the product do the work before you wipe it off. Pat down with a soft towel and you’re done.

There isn’t one particular pimple that pops up to tell you to schedule a dermatology appointment. If home remedies or OTC meds don’t do the trick, a dermatologist can help sort out what route to try next.

Deep, persistent cysts particularly around the inner thighs, armpits, or groin area could be a sign of a different condition called hidradenitis suppurativa.

Redness in the form of small bumps could also actually be rosacea. A dermatologist can help to treat your skin’s particular grievances so you don’t have to play the guessing game with home remedies.

Acne affects more than just teenagers. Adult acne is particularly present among women. Acne can result in inflammation, scarring, and redness. It can be caused by a number of factors including genetics, bacteria, irritation, stress, and medications.

Home remedies and medical treatments are both an option. A dermatologist can also point you in the right direction.