Oily hair products, seafood, genetics, stress, cosmetics, or maybe it’s just inherited.

Whatever the reason, most people think they know why they have acne long after those awkward, puberty-ridden teen years have passed. In fact, more adults continue to suffer from acne in their 20s, 30s, 40s and beyond, but why people continue to get acne is still unclear.

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The truth, according to dermatologists, depends on the individual, and yes, some oily or greasy products may cause clogging in the skin. Genetics can also play a role in whether kids will grow into adults with acne as well as stress, which may lead to break outs, but all are speculation. None of these acne causes have medically been proven.

Dermatologists say that one of the biggest myths about adult acne is diet. Food doesn’t cause flare-ups, according to John Brancaccio, clinical professor of dermatology at New York University, who has heard that seafood is a major cause of acne.

“The cause is again difficult, because we still don’t know the cause of acne,” said Brancaccio. “Diet is very controversial. There’s very little medical evidence to prove diet is a cause of acne.”

Acne happens when the oil glands secrete into the hair follicle and the pores of the skin. Once clogged, it becomes inflammatory, flares and causes pimples. Dermatologists recommend retinoids, prescription medication designed to prevent follicles from clogging up as well as over-the-counter topical antibiotics like benzoyl peroxide.

Hormones Rebound

Brancaccio said that adult acne is more prevalent in women than in men. In fact, according to the American Dermatology Association, more than 17 million adults are diagnosed with acne in the U.S., most are women. The age of patients affected by acne has also gradually increased from 20.5 years to 26.5 years or age.

Part of the reason why women may have more episodes of acne is because of the estrogen imbalance they often suffer during their monthly menstrual cycles.

“Hormones influence the causation of acne,” said Brancaccio. “Acne usually begins in the teen years when hormones start to develop. In women, it’s known that they have hormones that influence the oil gland. Women have a cyclical episode with estrogen, which is why it is more common in women than in men.”

However, Brancaccio added that one thing women should not believe is that their make-up is causing pimples and other break-outs, unless the make-up is overly oily. This Acne Cosmedica is a term used to describe women who think cosmetics are the cause of their acne. But it’s just not true. Most cosmetics, particularly those that are non-comedogenic, should not cause clogging.

“If you use Vaseline on your face or heavy stage makeup, it’s possible, but with most cosmetic lines, like Clinique, Almay, it’s very uncommon,” said Brancaccio. “It’s probably not the case in most of them but not all.”

Dr. John Fowler, clinical professor at the University of Louisville in Kentucky agreed that hormones, not cosmetics are the culprit with women suffering from acne. However, he added that people should be careful with their skincare regimes, not over-washing their skin or using too many products, which can strip their skin of natural oils, then replace them with moisturizers. He mentions that astringents, toners and moisturizers are often over-used, which may lead to break outs.

“Oily or greasy products, not necessarily cosmetics, can go into pores and produce acne,” said Fowler. “Cosmetics shouldn’t be greasy and oily. It adds to acne.”

Genetics may play a role. For some patients who have both parents with severe acne, their chances are usually higher of suffering from flare-ups than those who have one parent with break-outs. “It’s interesting, because it doesn’t follow a pattern of inheritance,” he said. “We often see siblings who have good skin and others with severe acne. In my experience, if both parents have severe acne, the chances are that the children often have it as well.”

Stress could be a factor in adult acne, but it still has not been clinically proven. “We blame stress for a lot of things, and it plays a role in many patients with acne,” Fowler said. “It’s hard to measure, but it’s something we see clinically.”

Fowler recommends several things to help prevent adult acne:

— Use a good cleanser, not a harsh one, at least once or twice a day. It doesn’t have to be harsh soap but one that kills acne bacteria.

— Avoid moisturizer or other skin hair care products with oils and greases. Some people think they have to use cleanser and moisturizer, and they tend to overuse products and dry out skin, then use moisturizers and clog up pores. Simplify your skin care regime and don’t overdo it with astringents, toners or moisturizers.

— Products that contain benzoyl peroxide are effective for mild, moderate acne. There are also a variety of different prescription topical medications.