Dermatologists explain why those pimples are popping up past puberty—and how to get rid of them fast.

There are some things you may miss about your teenage years-say, the ability to stay up all night and then sleep until noon. One thing that’s likely not on your nostalgia list? A sprinkling of pimples on your face. 

But it turns out that many of us notice blemishes at the same time we start to encounter wrinkles. A 2012 study published in the Journal of Women’s Health found that acne affects nearly half of all women ages 21 to 30, a quarter of women ages 31 to 40, and 12 percent of women ages 41 to 50. 

No matter how old you are, pimples usually form in the same time-honored way: Pores-which contain oil glands-become blocked, letting dirt, bacteria, and cells build up and form a plug.

For most women, hormonal changes, either around the monthly cycle or during a menopausal shift, are the culprit. But dietary imbalances and stress also cause acne flare-ups. “Acne in adults is like a whistle blow. Often, it’s a sign that something else not quite right is going on,” says Michael Murray, ND, a naturopath and coauthor of The Encyclopedia of Natural Medicine. (Read more about the causes of adult acne here.)

So, how do you get rid of it? Here, dermatologists explain the best adult acne treatments you can try to clear up those pesky bumps fast.

Eat fewer refined carbs

“Eating chocolate or a lot of junk food doesn’t by itself seem to cause acne, but not having a balanced diet and eating too many refined carbs can cause problems,” says dermatologist Albert Lefkovits, MD, director of the Park Avenue Center for Advanced Medical and Cosmetic Dermatology in New York City. 

In a 2007 study, Australian researchers found that people who followed a low-glycemic index (GI) diet (which is low in refined carbohydrates like those found in white bread) had a 22 percent decrease in acne lesions, compared with a control group that ate more high-GI foods. Scientists suspect that raised insulin levels from the carbs may trigger a release of hormones that inflame follicles and increase oil production. According to a more recent 2016 review of research analyzing how your diet may impact breakouts, researchers concluded that “compelling evidence shows that high glycemic load diets may exacerbate acne.”

If you suspect your diet may be the culprit, steer clear of these high GI foods (meaning they have a score of 70 or higher) and see if you notice a difference: sugary snacks and beverages, white bread, bagels, corn flakes, instant oatmeal, white rice, potatoes, pretzels, popcorn, and certain fruits, like watermelon.

Consume less milk

A 2006 Harvard study found that girls who drank two or more glasses of milk daily had about a 20 percent higher risk of acne than those who had less than a glass a week. Other studies suggest that skim milk in particular, which is higher in sugar than whole milk, might be a culprit, according to the American Academy of Dermatology. (Another hypothesis is that hormones in these dairy products play a role.) Surprisingly, yogurt and cheese don’t seem to cause the same effect in your skin, research finds.

Even though more research needs to be done to understand the connection between dairy and acne, if you regularly drink milk, consider switching to a non-dairy alternative like almond milk. Look for something that has fewer than 10 grams of sugar per serving. 

Try topical antibacterials and retinoids

For mild to moderate acne, dermatologists often suggest an acne face wash with bacteria-killing benzoyl peroxide (to minimize irritation, 3.5 percent strength should be your max if you have sensitive skin), along with a prescription topical antimicrobial such as clindamycin or erythromycin. If yourather go with a gentle face wash for sensitive skin, you can use that and apply a benzoyl peroxide acne spot treatment instead.

Stronger cases may call for prescription retinoids (such as Retin-A or Tazorac), which “are really the standard of care for most acne therapy,” says Joshua Zeichner, MD, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. Newer drugs, such as Epiduo and Ziana, combine retinoids with antibacterials and may be more effective than separate products. Because retinoids also have anti-wrinkle properties (they help stimulate collagen production), they are especially beneficial for adult acne sufferers.

Look for salicylic acid

Among the most popular OTC acne treatments is salicylic acid, which is incorporated into gels, wipes, creams, and sprays. Salicylic acid reduces swelling and redness and unplugs pores. To keep skin from becoming too dry, look for formulas geared to adult women, not teens. Aim for 2 percent salicylic acid to start. 

Manage your stress

“Stress doesn’t create skin disease on its own, but it can make any existing issues worse,” says Beth McLellan, MD, director of dermatology at Jacobi Medical Center and researcher at Montefiore Einstein Center for Cancer Care in New York City. 

Researchers haven’t established just why stomach-churning anxiety creates skin blemishes, but they point the finger at stress hormones such as cortisol for increasing inflammation levels in the body and stimulating oil glands. In any case, managing stress through exercise, meditation, or whatever method helps calm your nerves may also calm your skin. 

Consider blue light therapy

Blue light rays penetrate follicles to kill off acne-causing bacteria. For severe cases, photodynamic therapy adds a topical solution called Levulan to blue light therapy. Note that these treatments can cause temporary redness and may not be covered by insurance. Dermatologists’ fees start at about $250 per session for blue light therapy and $800 for photodynamic therapy.

If you’re on a budget and have mild to moderate adult acne, an at-home device like the Neutrogena Light Therapy Acne Treatment Mask could be a good alternative, but may not be as effective as in-office treatments.

Ask your derm about Aldactone

Long used to treat high blood pressure, prescription Aldactone (spironolactone) is now getting a second life as a treatment for hormonal acne. The drug (a tablet taken orally) blocks receptors of the hormone androgen, helping to limit the testosterone surges that can prompt pimples.

Pick up tea tree oil

Less irritating than its chemical cousin benzoyl peroxide, tea tree oil has a long history of fighting mild to moderate acne outbreaks. The oil, which comes from the leaves of a tree native to Australia, has antiseptic properties that help reduce acne-causing bacteria on the skin and quell inflammation in skin cells. 

“We’ve seen it work against a wide range of organisms, including 27 of the 32 strains of acne-causing bacteria,” says Murray. Multiple studies, including a review of research in the International Journal of Dermatology, back the plant’s power. You can find tea tree oil in a wide variety of soaps, skin washes, and topical solutions. Look for a minimum concentration of 5 percent of the oil to test how your skin reacts. If you find it is too irritating as an all-over treatment, you can use tea tree as a simple spot treatment for more stubborn pimples.

Cut back on salt

Some doctors suspect that sodium has consequences for skin, because the iodine frequently found in table salt and some seafood may worsen acnebreakouts. In fact, one 2016 study found that patients suffering from acne consumed significantly higher amounts of salty foods compared to an acne-free control group.

Stick to low-sodium versions of packaged foods, try to keep your overall salt consumption below 1,500 mg a day (per the American Heart Association’s guidelines), and stay away from these healthy foods that are secretly loaded with salt. 

Pop a birth control pill

Oral contraceptives can help normalize hormonal surges and regulate monthly cycles so that oil glands don’t go into overdrive, says Dr. Zeichner. Doctors may prescribe one of four brands of birth control pills-Yaz, Beyaz, Estrostep, and Ortho Tri-Cyclen-that are FDA approved for treating acne. As always, patients taking oral contraceptives should be aware of potential birth control side effects, including blood clots or vaginal dryness.

Swap out your daily moisturizer

The skin care products you apply to your face regularly can have a big impact on your complexion. You shouldn’t skip moisturizing if you have acne, especially if you’re using drying treatments-but the type of moisturizer you use can make a difference. “Even acne-prone teenagers need to moisturize to keep their skin barrier healthy. The skin barrier can become damaged from drying acne products and medications,” Arielle Kauvar, MD, director of New York Laser & Skin Care and clinical professor of dermatology at New York University School of Medicine, recently told Prevention.

Be sure to stick with oil-free, noncomedogenic, fragrance-free moisturizers if you’re struggling with irritation. This ensures your moisturizer won’t further clog your pores or exacerbate existing breakouts. The following dermatologist-approved moisturizers for oily, acne prone skin are a good place to start.