In short: Acne is common in adults, especially women, and often affects the lower face and jawline. It is caused by oil glands, blocked pores, skin bacteria and inflammation, with hormones, some medicines, certain skincare products and genetics playing a part. NICE recommends prescription creams and gels as first-line treatment, with antibiotic tablets for more severe acne and specialist treatment such as isotretinoin for severe or resistant cases, which now comes with strict MHRA safety measures.

This guide, written by a Ready Health prescribing pharmacist, explains what causes adult acne, how it is treated in line with current UK guidance and when to seek help. It is for people in Wigan, Standish, Chorley, Horwich, Bolton and nearby.

Why do adults get acne?

Acne develops when oil glands produce more oil, dead skin cells block pores, and bacteria and inflammation turn blocked pores into spots. In adults, contributing factors include:

Hormonal changes: around periods, pregnancy, perimenopause, or starting or stopping hormonal contraception
Conditions such as PCOS: especially if acne comes with irregular periods or excess hair
Medicines: including some steroids, anabolic steroids, certain epilepsy medicines and lithium
Skin and hair products: heavy, oily or comedogenic products can block pores
Family history: acne often runs in families
Smoking: linked with acne in adults

Acne is not caused by poor hygiene, and scrubbing harder usually makes it worse. Evidence that specific foods cause acne is limited and mixed.

What does adult acne look like?

blackheads and whiteheads
red, inflamed spots and pustules
deeper, painful lumps (nodules) or cysts, often on the jaw and chin
dark marks or scarring after spots heal, especially in darker skin tones

Some conditions look like acne but need different treatment, such as rosacea (flushing and spots in the middle of the face) and perioral dermatitis (small spots around the mouth). A clinician can tell them apart.

How is adult acne treated in the UK?

The NICE acne guideline (NG198) recommends a 12-week course of treatment based on severity, with a review afterwards.

Severity	Usual first options	Points to know
Mild to moderate	Prescription gel or cream combinations, such as a retinoid with benzoyl peroxide, or a topical antibiotic with benzoyl peroxide or a retinoid	Can cause dryness and irritation at first; retinoids are not used in pregnancy
Moderate to severe	A topical combination, or a tetracycline-type antibiotic tablet plus a topical treatment	Antibiotic tablets are not used alone and are usually reviewed by around 6 months
Women who also want contraception	A combined hormonal contraceptive alongside topical treatment may be considered	Suitability depends on individual risk factors
Severe, scarring or not responding	Referral to a consultant dermatologist-led team; isotretinoin may be considered	Strict safety monitoring applies (see below)

Most treatments take 6 to 12 weeks to work. A prescriber will decide what is suitable after assessing your skin, health, pregnancy plans and other medicines.

What should I know about isotretinoin safety?

Isotretinoin is a highly effective treatment for severe acne, but it has important risks and can only be started by, or under, a specialist with expertise in this medicine. Under MHRA safety measures introduced in 2023 and updated in January 2026:

it causes serious birth defects, so anyone who could become pregnant must follow a Pregnancy Prevention Programme, including reliable contraception and pregnancy testing, during treatment and for one month afterwards
mental health and sexual function are assessed before treatment and monitored at every follow-up, because of reports of mood changes and sexual side effects
patients complete an acknowledgement of risk form and are given a patient reminder card
from January 2026, the MHRA removed the requirement for two prescribers to agree treatment for under-18s, replacing it with other safeguards, including a patient information video and national audit

If you are taking isotretinoin and notice low mood, anxiety, thoughts of self-harm or changes in sexual function, contact your prescriber promptly. Report suspected side effects through the MHRA Yellow Card scheme.

What can I do at home to help acne?

wash affected areas no more than twice a day with a gentle cleanser and lukewarm water
use non-comedogenic moisturisers, make-up and sunscreen
avoid picking or squeezing spots, which increases scarring
apply treatments to the whole affected area, not just individual spots
pharmacy benzoyl peroxide products can help milder acne

When should I see a clinician about acne?

pharmacy products have not helped after about 12 weeks
you have painful nodules or cysts, scarring or dark marks
acne is affecting your mood or confidence
acne started suddenly in adulthood with other symptoms, such as irregular periods or excess hair

Frequently asked questions

Is adult acne different from teenage acne?

The causes are the same, but adult acne more often affects the lower face and jawline, and is more common in women.

Do I need blood tests for acne?

Not usually. Tests may be helpful if there are signs of a hormone condition such as PCOS.

Can acne scars be treated?

Treating active acne early is the best way to prevent scarring. A specialist can advise on scar treatments once acne is controlled.

Will acne come back after treatment?

It can. NICE suggests a maintenance topical treatment may be needed to keep acne under control.

Key takeaways

Adult acne is common and treatable.
Prescription creams and gels are first-line, with antibiotic tablets for more severe acne.
Give treatments 12 weeks to work, then review.
Isotretinoin is for severe or resistant acne, prescribed by a specialist with strict MHRA safety measures.
Seek help early if acne is scarring or affecting your mental health.

Sources and further reading

Last reviewed: October 2026 by Shamir Patel, Independent Prescribing Pharmacist, Ready Health. This article is general information and does not replace advice from your own clinician.

If acne is affecting you, you can book a skin consultation at Ready Health in Standish, Wigan. A clinician will assess your skin, discuss suitable treatment options and arrange referral if specialist care is needed.