At 38 years old and male, why would i still break out with acne?

Blame genetics: It is not uncommon for people in their 30's to still have acne; although it should be much less than your teenage years. A lot of this is due to genetics, as most patients with acne in their 30s report family members with the same problem.

Acne: While it is disappointing to have acne after the teen years, it is not uncommon. It is mostly related to testosterone levels (i.e., just being a male), and most of us want our testosterone. Persistent acne (and a specific late form of it called "rosacea") are quite treatable with simple antibiotics and topical solutions.