Acne is one of the most commonly reported skin conditions in Australia, and most people run into it at some point. It shows up in teenagers, yes – but also in adults well into their 30s, 40s, and beyond, and it can range from a few blocked pores to deep, painful lumps that leave lasting scars. The good news is that it's well understood, and knowing what tends to drive it makes your next step much clearer.
In brief
- Acne happens when hair follicles become blocked by sebum and dead skin cells, triggering bacterial growth and inflammation
- There are four main types: comedonal, inflammatory, nodular, and cystic – most people have a mix
- Hormones, not poor hygiene or chocolate, are the most commonly cited driver in adults
- Over-the-counter options include benzoyl peroxide, salicylic acid, niacinamide, azelaic acid and retinol; some retinoids are prescription-only in Australia
- Deep, raised or recurring blemishes, breakouts that are leaving scarring, or breakouts that haven't shifted after 8–12 weeks of over-the-counter care are worth a visit to a GP or dermatologist
- SPF 50+ matters even more when you're using active ingredients – especially in the Australian sun
Here's what's worth knowing, from what tends to drive breakouts to when it's time to see someone.
What acne is
Acne is a condition of the hair follicles and sebaceous (oil-producing) glands. When excess sebum mixes with dead skin cells, it can block the opening of a follicle. The bacterium Cutibacterium acnes – which lives naturally on the skin – then multiplies inside the blocked follicle, triggering inflammation.
The four types of acne
Most people have more than one type at once, which is one reason a proper look from a professional is useful.
- Comedonal acne: blocked follicles without significant inflammation – blackheads and whiteheads
- Inflammatory acne: red, tender papules and pus-filled pustules caused by the immune response to C. acnes
- Nodular acne: large, firm, painful lumps deep in the skin that don't come to a head
- Cystic acne: the most severe form – deep, pus-filled cysts that are more likely to scar
Adult breakouts are common
Acne is widely seen as a teenage problem, but it doesn't reliably stop at 20. Breakouts in adulthood are commonly reported in women in their 30s and 40s, and men can develop them too, though the patterns linked to hormonal change are more commonly described in women. If you've noticed your breakouts seem to follow a pattern, that's worth raising with a GP, who can look into what's behind it.
What causes acne
Four factors work together to produce acne: excess sebum production, follicle blockage, C. acnes overgrowth, and inflammation. The question is what's setting those factors in motion.
Hormones
Androgens – hormones including testosterone – stimulate the sebaceous glands to produce more sebum. This is why acne spikes during puberty, when androgen levels surge in both sexes. In adults, hormonal fluctuations around the menstrual cycle, pregnancy, perimenopause, and conditions like polycystic ovary syndrome (PCOS) can all play a part. Breakouts linked to hormonal change are often described around the jawline, chin and lower cheeks – but a pattern on its own isn't a diagnosis, and only a GP can tell you what's actually going on.
Diet – what the evidence actually says
The idea that chocolate and greasy food cause acne is largely a myth. Some studies suggest a link between high-glycaemic diets (lots of refined carbohydrates and sugary foods) and acne, and between dairy consumption and acne, but the research is not definitive and neither factor explains acne on its own. If you notice a consistent pattern between what you eat and your skin, it's worth paying attention to – but cutting out food groups without a clear signal is unlikely to change much.
Hygiene – the over-cleansing trap
Poor hygiene does not cause acne. Acne forms deep inside the follicle, not on the skin's surface. Over-washing, scrubbing, or using harsh cleansers strips the skin's protective barrier, which can actually worsen irritation and prompt more oil production as the skin tries to compensate. Cleansing gently twice a day is enough.
Skincare and comedogenic ingredients
Some skincare products can bring on breakouts – a pattern called acne cosmetica. Heavy oils (coconut oil, for example), certain silicones, and some emollients can block pores in people who are prone. Over-exfoliation and alcohol-heavy toners disrupt the barrier and can provoke breakouts. If your skin got worse after adding a new product, the product is worth investigating first.
What the options look like
What suits you depends on the type and severity of what you're dealing with. Mild to moderate congestion and surface breakouts can often be looked after with over-the-counter (OTC) products; deep, raised or recurring blemishes are a conversation for a GP or dermatologist.
Over-the-counter ingredients available in Australia
Benzoyl peroxide is one of the better-studied over-the-counter actives for breakout-prone skin. It works inside the blocked follicle and has a mild keratolytic (pore-clearing) effect, helping reduce the appearance of blemishes and visible congestion. Look for concentrations of 2.5–5% to start – these are generally reported to perform about as well as higher concentrations, with much less dryness and irritation. Formulations at these strengths are widely stocked in Australian pharmacies.
Salicylic acid (BHA) is oil-soluble, meaning it can get inside the pore and help clear the buildup behind blackheads and whiteheads. It's particularly well-suited to visible congestion and is available in cleansers, toners, and serums at concentrations from 0.5% to 2%.
Niacinamide (vitamin B3) helps reduce the look of excess oil and has calming, soothing properties. It's well-tolerated even on sensitive skin and works well alongside other actives. It won't shift established breakouts on its own, but it supports the skin and helps reduce the appearance of redness.
Azelaic acid is a calming, well-tolerated active that helps even the appearance of the marks that often linger after a breakout heals. It's one of the gentler actives, making it a strong option for sensitive skin and for people with darker skin tones who are prone to visible dark marks.
Retinoids are vitamin A derivatives that support skin cell turnover and the appearance of smoother, clearer-looking skin. Over-the-counter retinol is the version you'll find on the shelf in Australia; other retinoids are prescription-only here, so they belong in the conversation below rather than on the OTC list.
Prescription care
When over-the-counter care isn't enough – or breakouts are deep, recurring, scarring, or you'd like the underlying cause looked at – a GP or dermatologist can assess what's going on and talk you through what's available. Some options can only be prescribed by a dermatologist, with monitoring and strict safety requirements. There are prescription options some people find helpful for this — a GP or dermatologist can advise whether they make sense for you.
Professional in-clinic options
- In-clinic procedures: some options for deep, painful lumps are only available in a clinic, and whether they're appropriate is a clinical decision made in person
- Chemical peels: AHA and BHA peels can help with the appearance of congestion and the marks left after a blemish
- LED therapy: blue-light LED is sometimes used alongside a routine; reported results are modest
Building a routine around breakout-prone skin
The most common mistake with breakout-prone skin is doing too much. Piling on multiple actives can disrupt the skin barrier, causing redness, sensitivity, and paradoxically more breakouts. A simpler approach, consistently applied, tends to go further.
A practical routine
Morning
- Gentle, non-stripping cleanser
- Non-comedogenic moisturiser (don't skip this – dehydrated skin produces more oil)
- SPF 50+ sunscreen – every single day, without exception
Evening
- Gentle cleanser
- Targeted product: salicylic acid or benzoyl peroxide (not both at once, at least to start)
- Non-comedogenic moisturiser
Try any new product on a small patch of skin first and wait 24–48 hours before using it more widely.
What to avoid
- Physical scrubs and exfoliating brushes, which can cause micro-tears and irritation
- Alcohol-based toners, which strip the barrier
- Heavy oils (coconut oil, marula oil, olive oil) on breakout-prone areas
- Fragranced products on active breakouts
- Picking, squeezing, or popping – this pushes inflammation deeper and significantly increases the risk of scarring
A note on SPF in Australia
Australia's UV index is among the highest in the world, and many of the actives used on breakout-prone skin – retinoids, AHAs, benzoyl peroxide, and some prescribed products – increase the skin's sensitivity to UV damage. Daily SPF 50+ matters even more when you're using these. Look for non-comedogenic formulations labelled "oil-free" or "for breakout-prone skin" if you're concerned about your sunscreen blocking pores.
When to see a professional
OTC products are a reasonable starting point for mild to moderate breakouts, but some situations genuinely need a professional.
See a GP or dermatologist if:
- Your skin hasn't improved after 8–12 weeks of consistent over-the-counter care
- You're getting deep, raised or recurring blemishes – lumps under the skin rather than surface spots
- You're seeing scarring – this is worth having looked at early
- Your breakouts follow a pattern you'd like explained, or you have other symptoms you're wondering about – a GP is the right person to investigate
- Your skin is affecting your mood, confidence, or daily life – this is a completely valid reason to seek help, not a secondary concern
A GP can advise on what's appropriate, refer you to a dermatologist, and investigate hormonal factors. You don't need a specialist as a first step – a good GP is the right first stop. If this has been going on a while, is spreading, or is bothering you a lot, a GP or dermatologist is the right person to take a proper look.
Frequently asked questions
Does diet cause acne?
The short answer: probably not in the direct way most people think. Some studies suggest a link between high-glycaemic foods, dairy and acne in people who are already prone, but the evidence isn't strong enough to support blanket dietary restrictions. If you consistently notice your skin worsens after eating certain foods, it's worth trialling an elimination and seeing whether there's a genuine connection. But cutting out entire food groups without a clear personal pattern rarely makes the difference people hope for.
Why are my breakouts worse now than they were as a teenager?
Breakouts in adulthood – especially in women – are more often linked to hormonal fluctuations than to the general androgen surge of puberty. Stress, the menstrual cycle, stopping or starting hormonal contraception, pregnancy, perimenopause, and PCOS can all be part of the picture, and a GP is the right person to work out which. Skin also tends to be drier in adulthood, which means harsh products aimed at teenage skin can cause more damage than they fix.
Can I use a retinoid and benzoyl peroxide together?
If you've been prescribed a retinoid, follow your prescriber's directions on combining it with other products. As a general rule with any active routine: introduce one thing at a time, follow with moisturiser, and wear SPF 50+ daily.
How long will it take to see results?
Most topical actives take at least eight weeks to show meaningful improvement, and full results can take three to six months. This is one of the most common reasons people give up on products that would have worked – impatience and product-hopping. Start with one thing, give it 8–12 weeks of consistent use, and assess before adding or changing anything.
Is it safe to use retinoids if I have dark skin?
Retinoids are used across all skin tones. The main consideration for people with medium to dark skin is that irritation and post-inflammatory hyperpigmentation (PIH) – the dark marks left after a breakout or irritation – can be more pronounced. Starting with a low concentration, introducing the product slowly, and pairing it with SPF 50+ daily minimises this risk; if you've been prescribed a retinoid, your prescriber can guide you. Azelaic acid is a good complementary ingredient for helping even the appearance of existing PIH.
What about deep, painful or scarring breakouts?
Deep, recurring or scarring breakouts sit firmly in medical territory, and what's appropriate is an individual medical decision made with a doctor who has seen your skin. There are prescription options some people find helpful for this — a GP or dermatologist can advise whether they make sense for you.
The bottom line
Acne is a recognised medical condition, not a hygiene problem or something to push through. A lot of people are over-treating and under-supporting their skin barrier – simplifying your routine, using well-studied actives consistently, and wearing SPF every day tends to get you further than layering every product at once. If over-the-counter care isn't cutting it after a few months, a GP is the right next step.
This guide is general information, not medical advice. If something about your skin worries you, see a GP or dermatologist.