Adult Acne & Breakouts: A Pharmacist’s Guide to Clearing Spots Without Damaging Your Skin

By Lauren O’Reilly, Pharmacist 

Acne isn't just a teenage problem. Many adults continue to experience breakouts into their 20s, 30s and beyond, and it's particularly common for women to notice acne around the chin and jawline. 

But treating acne isn't about reducing sebum as much as possible. The aim is to manage congestion and inflammation while protecting the skin barrier. 

As Millie's in-house pharmacist, I'm often asked about the right combination of cleansers, acids, spot treatments, moisturisers and SPF. My advice is usually to simplify things first. You don't need ten products – you need the right products for you, used consistently. 

Why some people are more prone to acne 

Acne develops when hair follicles become blocked with sebum (oil), dead skin cells and other debris. This can lead to blackheads and whiteheads, while inflammation can result in papules, pustules, nodules and cysts. 

But this doesn't explain why some people are much more prone to acne than others. There isn't one single cause. Genetics play a role, and some people's skin is more sensitive to the hormones that stimulate oil production. The way the hair follicle behaves, how much sebum the skin produces and how readily inflammation develops can all influence whether a blocked pore becomes an acne lesion.  

This is also why acne isn't a sign that you're not washing your face properly. In fact, over-cleansing and scrubbing can irritate the skin and make breakouts harder to manage, although I do understand the temptation to do this – it will only aggravate the skin. 

Hormonal fluctuations can be particularly important in adult female acne. Some women notice breakouts around their period, while hormonal changes associated with starting or stopping contraception, pregnancy or perimenopause can also influence acne. Adult acne is also more common in women, and a family history of acne can increase your likelihood of developing it. 

Chin and jawline breakouts are often described as "hormonal acne", but the location alone doesn't prove that hormones are the cause. Persistent lower-face acne can sometimes be hormone-related, but skincare products, medications and other factors can contribute too. If you're getting persistent or painful breakouts, particularly if you're developing nodules, cysts or scarring, it's worth getting the cause assessed rather than continually adding more skincare. 

The acne routine I'd start with 

The biggest mistake I see is trying to treat spots with lots of strong products at once. This can leave the skin dry (to the point of flaking), irritated and uncomfortable – and make it much harder to work out what is actually helping. 

A simple routine could look like this: 

1. Start with the right cleanser 

If congestion and blackheads are your main concern, CeraVe SA Smoothing Cleanser is an option I'd consider. It contains salicylic acid, which can help with clogged pores and exfoliation. 

I wouldn't automatically use an exfoliating cleanser twice a day, though. If your skin starts feeling tight, dry or irritated, that's a sign to scale back. 

This is where I like having a gentler cleanser alongside it. CeraVe Hydrating Cleanser can be used in the evening or on alternate days to keep the skin comfortable and support the skin barrier. 

For younger or particularly sensitive acne-prone skin, Cetaphil Gentle Skin Cleanser is another product I really like. It's a good example of why treating acne doesn't have to mean using an aggressive cleanser. It's also particularly popular with teenagers experiencing hormonal skin. I would advise against washing more than twice a day, as excessive cleansing can irritate the skin. 

2. Use an evidence-based acne treatment 

One ingredient I don't want people to overlook is benzoyl peroxide. 

Benzoyl peroxide has good evidence behind its use in acne and is available over the counter in Ireland. It helps reduce bacteria associated with acne and also has anti-inflammatory effects. This is a treatment that pharmacists can recommend for mild acne, and is kept behind the counter in Pharmacies. 

If you're introducing it, start cautiously because it can cause dryness, redness, peeling or irritation. It can also bleach hair and fabrics. 

This is one situation where more isn't necessarily better. A thin layer used appropriately and consistently, and often starting with alternate day application rather than daily, is more sensible than repeatedly attacking individual spots with lots of different products. Introduce one new product or treatment at a time unless otherwise advised by a specialist or your Pharmacist, so that you can assess how your skin is tolerating that product and whether it is having a benefit.  

3. Know which active ingredient you're actually using 

There are lots of acne ingredients, but they don't all do the same thing. 

Salicylic acid vs glycolic acid 

Both are exfoliating acids, but they have different properties. 

Salicylic acid is oil-soluble and can penetrate into the pore, which makes it particularly useful for congestion and blackheads. 

Glycolic acid is an alpha hydroxy acid that primarily works on the skin's surface. It can be useful for texture and pigmentation, but I wouldn't automatically choose it over salicylic acid when there is an active breakout. 

Salicylic Acid and Retinol 

I am often asked if these can be used together, and the answer is: potentially, but you don't necessarily need to use them at the same time. 

If you're new to active ingredients, introduce one at a time and see how your skin responds. Combining several potentially irritating ingredients from day one can leave you with a compromised barrier rather than clearer skin. 

Topical retinoids are established acne treatments, but some are prescription-only in Ireland and are not suitable during pregnancy. 

4. Don't skip moisturiser because you have acne 

This is one of the biggest misconceptions about acne-prone skin. 

You can have oily or congested skin and still have a damaged or dehydrated skin barrier. 

Using too many drying products can leave skin tight, flaky and irritated. That can make it much harder to tolerate acne treatments consistently. 

For a lightweight option, Murad Clarifying Water Gel is a non-comedogenic moisturiser designed for blemish-prone skin. 

If your skin becomes particularly dry or irritated from active treatments, La Roche-Posay Cicaplast B5 Face Serum is another option I'd consider for supporting the skin barrier. I wouldn't describe it as an acne treatment – its role is to help when your skin needs more comfort and barrier support, and could be particularly helpful for those with acne rosacea. 

5. SPF still matters when you have acne 

I would never leave SPF out of an acne routine. There can be a misconception that all SPF products lead to congestion, because people may have used one that didn’t agree with their skin – but it’s all about finding the right one, and protecting your skin from harmful UV rays. 

This is especially important when you're using active ingredients that can make the skin more sensitive or irritated. Consistent sun protection is also important when you're dealing with post-acne marks, as UV exposure can make pigmentation more noticeable. 

Look for a high-protection, non-comedogenic SPF that feels comfortable enough to use every day. 

For oily or blemish-prone skin, La Roche-Posay Anthelios UVMune 400 Oil Control Invisible Fluid SPF50+ is a good option to consider. 

Another is La Roche-Posay Anthelios Oil Correct SPF50, which has a mattifying finish and contains niacinamide and salicylic acid. 

For another option specifically formulated for blemish-prone skin, Bioderma Photoderm AKN Mattifying Fluid SPF30 is designed for acne-prone skin and has a mattifying finish. 

The best acne-friendly SPF is ultimately one you'll use generously and consistently. 

6. Redness and Rosacea 

If your skin is persistently red, flushes easily, feels hot or uncomfortable, or you have small bumps alongside significant redness, it may be worth considering whether you're dealing with acne rosacea. 

For someone with acne rosacea or redness-prone skin, Bioderma Sensibio AR is an example of a gentler product aimed at soothing and reducing the appearance of redness. It's non-comedogenic and unfragranced. Also, with acne rosacea, I recommend getting specialist advice from one of our skin experts as there can also be skin sensitivity and it is treated differently to acne alone. 

This is another reason I wouldn't recommend simply adding stronger acids whenever someone develops bumps. 

7. Blackheads and post-acne marks need patience 

Blackheads aren't dirt or a sign of dirty skin, and squeezing them isn't the answer. 

A blackhead forms when a blocked follicle is exposed to air and its contents darken. I would strongly advise against squeezing spots or trying to clean out blackheads, as this can worsen acne and contribute to scarring. If extractions are required, they are best done by a professional, like with our skin specialists in our Millie’s Naas Salon.

For congestion, a consistent routine containing an appropriate ingredient such as salicylic acid is a much better approach. 

Once the acne itself is under control, you can think more about post-acne marks. 

For oily, blemish-prone skin where someone also wants an antioxidant and vitamin C serum, SkinCeuticals Silymarin CF is one example. It combines 15% L-ascorbic acid with silymarin, ferulic acid and salicylic acid. 

I'd see this as a more advanced addition rather than something everyone with acne needs. 

Professional skin support can also have a role 

Sometimes you can have a cupboard full of skincare and still not know what your skin actually needs. 

At Millie's in Naas, our skin specialists can look at your existing routine and help you work out whether you're over-treating your skin, missing something important or simply using products that aren't right for your skin. 

We also offer Dermalux LED, which can be incorporated into a professional skincare approach where appropriate. 

The important thing is that professional treatments should complement, rather than replace, an appropriate home routine and medical care when needed. 

Can supplements play a role in acne-prone skin? 

Skincare is the mainstay of managing acne, but nutrition can also be part of the bigger picture. I wouldn't recommend relying on a supplement instead of an evidence-based topical treatment, particularly if you're experiencing persistent or inflammatory acne. 

And if you've genuinely tried appropriate topical treatment without improvement, or you're developing painful, nodular or scarring acne, that's the point to speak to your GP rather than continuing to experiment with skincare.