"Second Puberty” Could Be Causing Your Adult Acne, Dermatologists Explain Why

We need to discuss the switch up that comes with aging and “second puberty” in your 20s. After the hormonal chaos of teenage years, you would think we could catch a break. But sometimes mother nature has other plans, leaving many blindsided by what some call a “second puberty” in their 20s. While it’s not a medical term, “second puberty” is a popular catch-all phrase describing the physical and hormonal shifts many face once they hit adulthood. It can happen at any time in your 20s and 30s, and while you can’t skip the jump scare of change (sorry!), you do have the power to learn what works best for you and your body.

The journey to finding what works during this season can be overwhelming, but don’t stress, we’ve asked all the right questions to some very qualified people. Teen Vogue turned to board-certified dermatologists to learn all about acne, one of the most common symptoms of “second puberty” and America’s number one skin condition. According to the American Academy of Dermatology, 50 million Americans are affected by acne each year. 15% of adult women are affected by acne. .

Acne can pop up unannounced, especially in hormone sensitive areas like the chin and jawline, even if you had no skin issues in your teens. It can feel helpless to figure out what to do on your own, so we spoke to some experts. They shed some much needed light on why you may be hit with acne during your “second puberty” and the many ways to take control of your acne treatment both skin deep and beyond.

• Dr. Lindsey Marie Zubritsky, MD, FAAD, a board certified dermatologist
• Dr. Alexis Stephens, DO, FAAD, FAOCD, a board-certified dermatologist whose specialities include skin of color and hyperpigmentation
• Dr. Jenny Liu, MD, FAAD, a board-certified dermatologist and an assistant professor of dermatology

“Second puberty” is very real and more than just an internet buzzword. “It does reflect a real and common phenomenon tied to hormone shifts. So, yes, while it may sound trendy, it’s grounded in something dermatologists see regularly,” says Dr. Liu. The symptom of adult acne is more common than we hear about, adds Dr. Zubritsky. ”As a dermatologist, adult hormonal acne is one of the most common issues I see in clinic. So, you aren't alone. There is nothing you are doing wrong to cause your acne.”

Hormones really are the main character when it comes to “second puberty” acne. You may notice breakouts during sensitive periods like menstruation, coming on or off of birth control and even during pregnancy. The hormonal changes during these times can lead to increased oil production which clogs your precious pores. “For some, it’s a continuation of teenage acne; for others, it appears for the first time in adulthood. Women are especially prone due to monthly hormonal fluctuations and changes related to birth control or pregnancy,” says Dr. Stephens.

We’re going to have to hold your hand when we say this, but it doesn’t stop there. The causes of adult acne are much broader than just genetics or hormonal changes. Lifestyle factors also play a part. “Adult acne can be driven by hormones, especially androgens, stress, diet, poor sleep, and skin care or makeup products that clog pores,” says Dr. Stephens. The list may be long, but thankfully, there is a ton of research on effective solutions. You may start seeing improvements from even the simplest of tweaks in your day-to-day routine, like “washing your pillowcases every 2-3 days, cleaning your cell phone and ensuring a well-balanced diet,” says Dr. Zubritsky. Just don’t expect a magic pill to solve acne overnight and be cautious of any popular hacks that claim instant results. This is a long game.

Sometimes the call is coming from inside the house so turn your attention to your current skin care routine before introducing something new. “Start by reviewing your skin care and makeup products—make sure they’re labeled non-comedogenic,” says Dr. Stephens, which basically means opting for products formulated to not block your pores. We know that creating shopping lists from other people’s skin care hauls can be tempting, but rather than searching for trending brands, focus on checking labels for “evidence-based ingredients like salicylic acid, benzoyl peroxide, azelaic acid, or retinoids—all of which help regulate oil, reduce inflammation, and keep pores clear,” suggests Dr. Liu.

Body acne is most common on the chest, back and shoulders (and even the booty!) You can totally use face products to treat your problem areas but the skin on your body is much thicker. It can handle more heavy duty formulas with a higher percentage of active ingredients so you’re better off going for sprays and washes tailor-made for the body. “Look for body-specific formulations—such as benzoyl peroxide washes, salicylic acid sprays, or exfoliating pads. Gentle exfoliation and breathable clothing also help,” advises Dr. Liu.

You may have heard that having acne means you need to improve your facial hygiene or drink more water, but experts say these myths simply don’t have enough evidence to back them up. “Acne is a medical condition—not a hygiene issue or a reflection of how well they care for their skin,” says Dr Liu on cleansing. “Washing your face more frequently won’t necessarily help and can even backfire by irritating or drying the skin,” she adds. “Diet may play a modest role, with some studies suggesting a link between high-glycemic foods and dairy with acne in certain individuals, but it’s highly individual.” Dr. Zubritsky agrees, saying that the culprit is more complex than what you eat. “While everyone is quick to blame diet, acne usually requires a mix of skin care and sometimes prescription treatment.”

Skin care is never one size fits all so relying on TikTok and Reddit may lead you on an expensive cycle of trying out products with little results. Realistically, there is no quick fix and patience is your bestie when you’re trying out a new skin care routine. However, if your skin isn’t getting better over time, don’t be afraid to turn to a professional for some guidance. “If you’re not seeing improvement within a couple of months, see a board-certified dermatologist. There are prescription options that can safely and effectively treat adult acne, including hormonal therapy,” says Dr. Stephens.

Depending on how severe your acne is, seeking out expert help early can help you achieve your skin goals and reduce the risk of scarring. “The longer you wait to get it treated, the more likely it is to scar,” warns Dr. Zubritsky. “If acne is persistent or cystic, it’s best to see a dermatologist early—prescription options like topical or oral retinoids, spironolactone, or antibiotics may be needed,” says Dr. Liu.

Alongside the do’s, there are also a few don’ts. The biggest one is resisting the urge to touch and pick your skin. The last thing you want to do is prolong the healing time of a zit or spread the bacteria from a popped pimple to other areas of your face. Mid-breakout, it’s often best to give your skin some alone time. “Avoid picking at lesions, as this increases the risk of scarring,” warns Dr. Liu.

Avoiding further irritation is particularly important for deeper complexions. Post-inflammatory hyperpigmentation often lasts longer in melanin-rich skin and can be just as stressful as the acne itself. “The best prevention is avoiding trauma—no picking or popping. Treat inflammation early, and always wear sunscreen, even if you have deeper skin,” says Dr. Stephens. Dark marks are inevitable, but certain ingredients do wonders at fading them after long term use. “Look for ingredients like azelaic acid, niacinamide, tranexamic acid, and retinoids to gently fade spots over time. And again, patience is key—dark marks can take weeks to months to fade, but with consistency, they will,” adds Dr. Stephens.

The impacts of adult acne go way beyond the frustration of breakouts. It also takes its toll on self esteem and confidence when socialising, while at work and when dating. When you grow up hearing that acne is just a teen phase, it can feel “unexpected or embarrassing” when it develops in adulthood, says Dr Liu. “If acne is affecting confidence or daily life, it’s completely valid to seek help,” she says. It’s important to be kind to yourself and remember that you are so much more than your skin. After all, “clear skin doesn’t define your worth,” says Dr. Zubritsky.

It can also be helpful to try separating your identity from your skin condition. While you can’t give your skin a manual on how to act, we are in the driving seat when it comes to our minds. “I always remind patients that acne is a medical condition—it’s not your fault. Focus on what you can control, consistency with treatment, lifestyle, gentle self-talk, and don’t hesitate to seek mental health support,” says Dr. Stephens. It’s reassuring to know that some simple mental reframing can help you take on the world with confidence, knowing that “second puberty” acne never lasts forever. It’s just a chapter in your journey and there are plenty of tools to support you through it. “Makeup can be a great tool—not to hide, but to empower,” suggests Dr. Stephens. “And remember, clear skin is a journey, not an overnight destination.”