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During the teen years, acne is seen as a rite of passage, affecting even the clearest complexion almost overnight. You may be surprised to learn, however, that many adults, especially women, may also be struggling to keep their skin healthy – even if they didn't have acne as teenagers, according to Toronto dermatologist Lisa Kellett.

"It's very common," she says. What's more, acne can refer to a couple of pimples on your face—right up to pimples everywhere, including the neck, chest and back, says Dr. Kellett.

Causes of acne begin at puberty

According to the College of Family Physicians of Canada, acne is not caused by poor hygiene, eating lots of greasy foods or chocolate or drinking lots of pop. In fact, hormones, specifically androgens, cause acne.

Here's what happens:

1. During puberty, androgens put oil-producing sebaceous glands into high gear to produce lots of the oily stuff known as sebum. These sebaceous glands are attached to hair follicles on the face.



2. The skin cells in these hair follicles shed rapidly and can get stuck together, plugging the opening of the follicle and causing it to swell up with sebum.



3. Enter skin bacteria known as P. Acnes. When it connects with the sebum-swollen plugged hair follicles, it can cause the wall of the hair follicle to burst and spread inflammation to surrounding skin.



4. The result? Acne lesions, better known as blackheads, whiteheads, pimples or nodules

Hormones also cause adult acne

Hormones that send the sebaceous glands into over-drive also cause adult acne in men and women, which can begin in the early-to-mid 20s and last well into middle age. Almost half of adult women experience oily skin and pimples in the week before their period, as a result of hormonal fluctuations related to the onset of menstruation.

Other causes of adult acne in women include:

• ovarian cysts



• pregnancy



• use of too heavy or cream-based cosmetics that cause pores to become blocked.

Do's and don'ts of good skin care—for everyone, at any age

While acne can't be cured, it can be controlled, says Dr. Kellett, who recommends good skin care at every life stage.

• wash your face twice a day using a mild soap and water



• eat a balanced diet of nutritious foods



• drink lots of water every day, up to 8 large glasses



• get the amount of sleep you need



• get some exercise most days



• opt for skin products, including lotions and makeup, that are water-based and oil-free – nothing creamy



• keep oil-containing hair products such as hair spray and styling gels away from your face



• remove sport helmets and sweaty head bands as soon as your activity is finished and wash them often



• protect your skin from ultraviolet light: use a water-based, oil-free sunscreen with an SPF of 30 or higher that offers both UVA and UVB protection.

• wash your face more than twice a day. It will just dry skin out and increase irritation, which can lead to breakouts.



• scrub your face vigourously—use fingertips only



• squeeze, pinch or pick at pimples. It will just push the infection further into your skin, causing more swelling and redness and raising risk of permanent scarring. Oil from your hands can also block pores.



• wear tight headwear, such as bands or collars which can cause friction and irritation, clogging pores



• use sun tanning as a way to treat acne.