what causes acne - man looking in mirror

What Causes Acne?

Acne is the most common skin disease. You may still be wondering, what causes acne? An estimated 80% of the US population has experienced this condition at some point in life. You’ve probably had it during your teenage years.

A buildup of skin cells, microbes, and dried sebum that block hair follicles cause acne. These all lead to the formation of pimples, blackheads, whiteheads, and in more severe cases, cysts and abscesses. Acne can occur on any part of the body. But it’s mostly seen on the face, chest, back, and shoulders.

Doctors can diagnose acne simply based on a skin examination. While mild cases don’t need medical treatment, moderate cases may require oral antibiotics. Severe cases may use isotretinoin as treatment.

In this article, we’ll cover what causes acne, common triggers, and skin lesions that come from acne.

what causes acne - girl pointing to acne on her face

What Causes Acne?

There are multiple factors that can cause acne. The most common is an interaction between hormonal changes, skin oils, and bacteria. These create inflammation of hair follicles, which leads to acne.

Sebaceous glands produce skin oils known as sebum, which are attached to hair follicles. The role of sebum is to lubricate the skin and hair. In normal conditions, sebum and dead skin cells pass from the glands to hair follicles. It then goes through the skin pores to the surface of the skin.

In the case of acne, excess sebum and dead skin cells clog the pores either partially or completely. As a result, skin pores become inflamed and infected, which leads to pimples. In some cases, it affects deeper layers of the skin and leads to cysts and abscesses.

Researchers believe hormonal changes play an important role in acne. This is due to the fact that acne occurs more frequently during puberty and during a woman’s menstrual cycle.

Cutibacterium acnes is the bacterium involved in acne. It’s normally found in the skin as well as the mouth, ear, colon, and conjunctive. This bacterium multiplies and creates skin irritation and inflammation in clogged pores. Secondary skin infections can also occur and further worsen the inflammation.

what causes acne - woman with pimples and blackheads on chin

Skin Lesions Associated with Acne

There are several skin lesions that are characteristic of acne. The severity of the symptoms varies from one person to another.

Blackheads and Whiteheads

Blackheads also called open comedones, develop when pores aren’t completely blocked. These are small, flesh-colored bumps with a dark center.

When the pore is completely blocked, a whitehead, or closed comedones, develops. Whiteheads look similar to blackheads but don’t have a dark center.


Papules are small, red, solid tender bumps on the skin. When these papules contain pus at the tip, we know them as pimples. These pimples have a white center surrounded by red, inflamed skin.


Nodules are firm bumps filled with pus, located in the deeper layers of the skin. Like nodules, cysts also contain pus but are larger than nodules.


Abscesses are even larger and deeper lesions filled with pus. They don’t happen too often but are a possibility.

Types of Acne

There are three different levels of acne: mild, moderate, and severe. We classify mild acne as skin with a few blackheads or whiteheads that are not inflamed. There may also be some pimples present.

Moderate acne has a higher presence of blackheads, whiteheads, pustules, and pimples.
Individuals with severe acne experience a lot of blackheads, whiteheads, pimples, and pustules. They may also have cysts that can progress to abscesses.

Conglobata is the most severe form of acne. It causes severe lesions on the abdomen, arms, buttocks, and scalp. It can also leave scars. Acne fulminans and pyoderma faciale are two more types of severe acne.

what causes acne - bowl of potato chips

Triggers That Cause Acne

There are certain triggers that can make acne develop or become more severe. To manage your acne, it’s important to be aware of these triggers and avoid them when possible.

Certain medications, especially testosterone, lithium, and corticosteroids are potential triggers for acne.

Hormonal changes are considered a risk factor for acne. Androgens are particularly involved when acne develops during puberty in both boys and girls. For women, hormonal changes during the menstrual cycle can trigger acne too.

Stress makes many skin conditions worse, and acne is not an exception. While stress doesn’t seem to cause acne, research shows that it can make it worse. Acne may also cause stress, fatigue, and have a negative impact on sexual activity.

Your diet also has a major impact on the development and worsening of acne. High carbohydrate foods like bread, pasta, and chips are the main culprits.

Chocolate also remains a controversial topic. Some studies found chocolate worsens acne symptoms. Others suggest excess sugar and milk could affect it. Recent studies suggest dairy consumption could also affect acne.

Omega 3 fatty acids, antioxidants, Vitamin A, zinc, and fiber are still under review as to how beneficial they are to manage acne.

Most people experience a mild form of acne that they can manage at home. Mild soaps, hypoallergenic personal care products, and over-the-counter medication can help. However, if you experience moderate or severe acne with growing infected or painful lesions, contact your doctor. They can provide a helpful treatment for the condition.

Now that you know what causes acne, you can be more conscious of triggers and taking care of your skin to prevent breakouts in the future.

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