Table of ContentsView AllTable of ContentsCommon CausesAcne at Various Life StagesGeneticsMythsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Common Causes
Acne at Various Life Stages
Genetics
Myths
Frequently Asked Questions
Verywell / Joshua Seong
For being the most common skin condition in the United States, affecting nearly 50 million people at any given time, it is a remarkably misunderstood condition. This is partly attributed to the fact that it’s a complex condition. The following factors all often have to come together to produce acne.
Physiological Factors
Three major physiological acne-causing factors have to come together in order for acne to develop:
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The Role of Hormones
We know that acne isn’t around for your entire life. Your skin, at some point, was clear. Why then does acne seem to suddenly appear? In a word: hormones.
Hormones play a huge role in acne development. The major players here are androgen hormones: estrogen and testosterone.
Androgen hormones, specifically testosterone, stimulate the sebaceous glands to swell and produce more oil. There is indication that androgens also make the pore a more favorable home for acne-causing bacteria. Estrogen and progesterone also play a role in acne development, considering that acne is also common during pregnancy and menopause, but the exact influence they have on the sebaceous glands isn’t as clear.
Simply put, if the three trigger factors are present in the skin, hormones are the match that ignites acne development.
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Less Common Causes
Although these aren’t considered primary causes of acne, these may trigger or exacerbate breakouts for some people. They include:
Most of the time, pimples that develop due to certain drugs aren’t truly acne at all but rather a type of rash that causes acne-like eruptions. If you’re taking any medication and develop acne or a rash, let your healthcare provider know right away.
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While the teen years are the most common, and prime years for acne development,acne is common during other life stagesbecause of hormonal shifts in the body.
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Acne does have a genetic component to it, as it does tend to run in families. There is not a specific gene that causes acne. Rather the factors that make acne more likely to develop are traits that can be passed down.
If your parents or siblings had acne at any point in their lives, you are more likely to develop it at some point too.
Is Acne Hereditary?
There is probably no other skin condition that is linked to so many myths, misunderstandings, and confusion about its causes and development than acne. These old wives' tales seem to hang on, and stop many people from getting the appropriate treatment, or even seeking treatment in the first place.
These things do not cause acne:
Also, acne isn’t contagious, so you can’t catch it from someone else.
While diet doesn’t cause acne, there is a possible connection between certain foods and acne severity. More research needs to be done to prove a definitive link, but studies suggest that dairy products, as well as high-glycemic-index foods (i.e. refined carbs), may make existing acne worse.
A Word from Verywell
But acne is treatable. If you’re not getting good results with over-the-counter acne products, there are plenty of prescription acne medications that may work for you. Give your healthcare provider a call to start the treatment process.
Acne is the result of four processes that lead to the blockage of hair follicles and the formation of pimples:
Genetics may predispose certain people to acne, while hormonal changes are known to play a role in acne breakouts.
Androgens (male hormones) appear to be the hormones most responsible for acne. This includes the hormonestestosterone, dihydrotestosterone (DHT), anddehydroepiandrosterone (DHEA).High levels ofinsulinandgrowth hormone (GH)are also linked to worsening acne.
In women, hormonal fluctuations during the menstrual cycle play a key role inadult-onset acne, while stress, hormonal contraceptives, and smoking are considered risk factors. Some studies suggest that women are four times more likely to experience adult-onset acne than men.Learn MoreDoes Stress Cause Acne?
In women, hormonal fluctuations during the menstrual cycle play a key role inadult-onset acne, while stress, hormonal contraceptives, and smoking are considered risk factors. Some studies suggest that women are four times more likely to experience adult-onset acne than men.
Learn MoreDoes Stress Cause Acne?
It is not entirely clear why some people havecystic acne, but it is thought that a severe inflammatory response weakens the lining ofsebaceous glandsthat produce sebum (oil). This can cause sebum, dead skin cells, and bacteria to seep into deeper tissues, causing infection and the formation of cysts and nodules.
Acne scarsare usually the result of a severe acne breakout, during which hair follicles can become clogged with sebum, bacteria, and dead skin cells. This can cause the follicle wall to rupture, leading to the formation of a scar.In some cases, the rupture can cause a raised scar called a hypertrophic scar, most typically on the torso.
Possibly. Diet can influence hormone levels, and some foods areknown to cause inflammationthat may make acne worse. Foods like milk and added sugar can increase insulin levels, which might also contribute. At present, there is no consensus as to whether a change of diet will necessarily improve acne.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology.Acne: Who gets and causes.American Academy of Dermatology.Adult acne.Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson, DS, et al.Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945-73.e33. doi:10.1016/j.jaad.2015.12.037Ju Q, Tao T, Hu T, Karadağ AS, Al-khuzaei S, Chen W.Sex hormones and acne.Clin Dermatol. 2017;35(2):130-137. doi:10.1016/j.clindermatol.2016.10.004Dréno B.What is new in the pathophysiology of acne, an overview.J Eur Acad Dermatol Venereol. 2017;31 Suppl 5:8-12. doi:10.1111/jdv.14374Juhl CR, Bergholdt HKM, Miller IM, Jemec GBE, Kanters JK, Ellervik C.Dairy intake and acne vulgaris: A systematic review and meta-analysis of 78,529 children, adolescents, and young adults.Nutrients. 2018;10(8) doi: 10.3390/nu10081049Masterson KN.Acne basics: Pathophysiology, assessment, and standard treatment options.J Dermatol Nurse Assoc.2018 Jan/Feb/10(1S):S2-10. doi:10.1097/JDN.0000000000000361Iftikhar U, Choudhry N.Serum levels of androgens in acne & their role in acne severity.Pak J Med Sci. 2019;35(1). doi:10.12669/pjms.35.1.131Kim H, Moon SY, Sohn MY, Lee WJ.Insulin-like growth factor-1 increases the expression of inflammatory biomarkers and sebum production in cultured sebocytes.Ann Dermatol. 2017;29(1):20. doi:10.5021/ad.2017.29.1.20Rocha MA, Bagatin E.Adult-onset acne: prevalence, impact, and management challenges.Clin Cosmet Investig Dermatol. 2018;11:59-69.Thiboutot D, Del Rosso JQ.Acne vulgaris and the epidermal barrier: is acne vulgaris associated with inherent epidermal abnormalities that cause impairment of barrier functions? Do any topical acne therapies alter the structural and/or functional integrity of the epidermal barrier?J Clin Aesthet Dermatol. 2013;6(2):18-24.Connolly D, Vu HL, Mariwalla K, Saedi N.Acne scarring-pathogenesis, evaluation, and treatment options.J Clin Aesthet Dermatol. 2017;10(9):12-23.Ogawa R.Keloid and hypertrophic scars are the result of chronic inflammation in the reticular dermis.Int J Mol Sci. 2017;18(3). doi:10.3390/ijms18030606Romańska-Gocka K, Woźniak M, Kaczmarek-Skamira E, Zegarska B.The possible role of diet in the pathogenesis of adult female acne.PDIA. 2016;6:416-20. doi:10.5114/ada.2016.63880
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology.Acne: Who gets and causes.American Academy of Dermatology.Adult acne.Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson, DS, et al.Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945-73.e33. doi:10.1016/j.jaad.2015.12.037Ju Q, Tao T, Hu T, Karadağ AS, Al-khuzaei S, Chen W.Sex hormones and acne.Clin Dermatol. 2017;35(2):130-137. doi:10.1016/j.clindermatol.2016.10.004Dréno B.What is new in the pathophysiology of acne, an overview.J Eur Acad Dermatol Venereol. 2017;31 Suppl 5:8-12. doi:10.1111/jdv.14374Juhl CR, Bergholdt HKM, Miller IM, Jemec GBE, Kanters JK, Ellervik C.Dairy intake and acne vulgaris: A systematic review and meta-analysis of 78,529 children, adolescents, and young adults.Nutrients. 2018;10(8) doi: 10.3390/nu10081049Masterson KN.Acne basics: Pathophysiology, assessment, and standard treatment options.J Dermatol Nurse Assoc.2018 Jan/Feb/10(1S):S2-10. doi:10.1097/JDN.0000000000000361Iftikhar U, Choudhry N.Serum levels of androgens in acne & their role in acne severity.Pak J Med Sci. 2019;35(1). doi:10.12669/pjms.35.1.131Kim H, Moon SY, Sohn MY, Lee WJ.Insulin-like growth factor-1 increases the expression of inflammatory biomarkers and sebum production in cultured sebocytes.Ann Dermatol. 2017;29(1):20. doi:10.5021/ad.2017.29.1.20Rocha MA, Bagatin E.Adult-onset acne: prevalence, impact, and management challenges.Clin Cosmet Investig Dermatol. 2018;11:59-69.Thiboutot D, Del Rosso JQ.Acne vulgaris and the epidermal barrier: is acne vulgaris associated with inherent epidermal abnormalities that cause impairment of barrier functions? Do any topical acne therapies alter the structural and/or functional integrity of the epidermal barrier?J Clin Aesthet Dermatol. 2013;6(2):18-24.Connolly D, Vu HL, Mariwalla K, Saedi N.Acne scarring-pathogenesis, evaluation, and treatment options.J Clin Aesthet Dermatol. 2017;10(9):12-23.Ogawa R.Keloid and hypertrophic scars are the result of chronic inflammation in the reticular dermis.Int J Mol Sci. 2017;18(3). doi:10.3390/ijms18030606Romańska-Gocka K, Woźniak M, Kaczmarek-Skamira E, Zegarska B.The possible role of diet in the pathogenesis of adult female acne.PDIA. 2016;6:416-20. doi:10.5114/ada.2016.63880
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Dermatology.Acne: Who gets and causes.American Academy of Dermatology.Adult acne.Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson, DS, et al.Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945-73.e33. doi:10.1016/j.jaad.2015.12.037Ju Q, Tao T, Hu T, Karadağ AS, Al-khuzaei S, Chen W.Sex hormones and acne.Clin Dermatol. 2017;35(2):130-137. doi:10.1016/j.clindermatol.2016.10.004Dréno B.What is new in the pathophysiology of acne, an overview.J Eur Acad Dermatol Venereol. 2017;31 Suppl 5:8-12. doi:10.1111/jdv.14374Juhl CR, Bergholdt HKM, Miller IM, Jemec GBE, Kanters JK, Ellervik C.Dairy intake and acne vulgaris: A systematic review and meta-analysis of 78,529 children, adolescents, and young adults.Nutrients. 2018;10(8) doi: 10.3390/nu10081049Masterson KN.Acne basics: Pathophysiology, assessment, and standard treatment options.J Dermatol Nurse Assoc.2018 Jan/Feb/10(1S):S2-10. doi:10.1097/JDN.0000000000000361Iftikhar U, Choudhry N.Serum levels of androgens in acne & their role in acne severity.Pak J Med Sci. 2019;35(1). doi:10.12669/pjms.35.1.131Kim H, Moon SY, Sohn MY, Lee WJ.Insulin-like growth factor-1 increases the expression of inflammatory biomarkers and sebum production in cultured sebocytes.Ann Dermatol. 2017;29(1):20. doi:10.5021/ad.2017.29.1.20Rocha MA, Bagatin E.Adult-onset acne: prevalence, impact, and management challenges.Clin Cosmet Investig Dermatol. 2018;11:59-69.Thiboutot D, Del Rosso JQ.Acne vulgaris and the epidermal barrier: is acne vulgaris associated with inherent epidermal abnormalities that cause impairment of barrier functions? Do any topical acne therapies alter the structural and/or functional integrity of the epidermal barrier?J Clin Aesthet Dermatol. 2013;6(2):18-24.Connolly D, Vu HL, Mariwalla K, Saedi N.Acne scarring-pathogenesis, evaluation, and treatment options.J Clin Aesthet Dermatol. 2017;10(9):12-23.Ogawa R.Keloid and hypertrophic scars are the result of chronic inflammation in the reticular dermis.Int J Mol Sci. 2017;18(3). doi:10.3390/ijms18030606Romańska-Gocka K, Woźniak M, Kaczmarek-Skamira E, Zegarska B.The possible role of diet in the pathogenesis of adult female acne.PDIA. 2016;6:416-20. doi:10.5114/ada.2016.63880
American Academy of Dermatology.Acne: Who gets and causes.
American Academy of Dermatology.Adult acne.
Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson, DS, et al.Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945-73.e33. doi:10.1016/j.jaad.2015.12.037
Ju Q, Tao T, Hu T, Karadağ AS, Al-khuzaei S, Chen W.Sex hormones and acne.Clin Dermatol. 2017;35(2):130-137. doi:10.1016/j.clindermatol.2016.10.004
Dréno B.What is new in the pathophysiology of acne, an overview.J Eur Acad Dermatol Venereol. 2017;31 Suppl 5:8-12. doi:10.1111/jdv.14374
Juhl CR, Bergholdt HKM, Miller IM, Jemec GBE, Kanters JK, Ellervik C.Dairy intake and acne vulgaris: A systematic review and meta-analysis of 78,529 children, adolescents, and young adults.Nutrients. 2018;10(8) doi: 10.3390/nu10081049
Masterson KN.Acne basics: Pathophysiology, assessment, and standard treatment options.J Dermatol Nurse Assoc.2018 Jan/Feb/10(1S):S2-10. doi:10.1097/JDN.0000000000000361
Iftikhar U, Choudhry N.Serum levels of androgens in acne & their role in acne severity.Pak J Med Sci. 2019;35(1). doi:10.12669/pjms.35.1.131
Kim H, Moon SY, Sohn MY, Lee WJ.Insulin-like growth factor-1 increases the expression of inflammatory biomarkers and sebum production in cultured sebocytes.Ann Dermatol. 2017;29(1):20. doi:10.5021/ad.2017.29.1.20
Rocha MA, Bagatin E.Adult-onset acne: prevalence, impact, and management challenges.Clin Cosmet Investig Dermatol. 2018;11:59-69.
Thiboutot D, Del Rosso JQ.Acne vulgaris and the epidermal barrier: is acne vulgaris associated with inherent epidermal abnormalities that cause impairment of barrier functions? Do any topical acne therapies alter the structural and/or functional integrity of the epidermal barrier?J Clin Aesthet Dermatol. 2013;6(2):18-24.
Connolly D, Vu HL, Mariwalla K, Saedi N.Acne scarring-pathogenesis, evaluation, and treatment options.J Clin Aesthet Dermatol. 2017;10(9):12-23.
Ogawa R.Keloid and hypertrophic scars are the result of chronic inflammation in the reticular dermis.Int J Mol Sci. 2017;18(3). doi:10.3390/ijms18030606
Romańska-Gocka K, Woźniak M, Kaczmarek-Skamira E, Zegarska B.The possible role of diet in the pathogenesis of adult female acne.PDIA. 2016;6:416-20. doi:10.5114/ada.2016.63880
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