What Actually Causes Acne?

There is a lot of noise about what causes acne, and much of it is wrong. The real picture is biological, and understanding it helps explain why acne is nobody's fault and why surface fixes so often fall short.

The core causes

Acne comes down to a few processes working together. The oil glands produce more oil than the skin needs. Skin cells lining the pore shed unevenly and clump together, blocking it. Bacteria that naturally live on everyone's skin multiply in that blocked, oily environment. Finally, the body's immune system responds with inflammation, producing the redness and swelling associated with acne.

These four processes are covered in more detail in our guide to The Four Drivers of Acne.

What role do hormones play?

Hormones are one of the biggest influences because they stimulate the skin's oil glands. This is why acne commonly develops during puberty, why it often flares around the menstrual cycle, and why adult acne is particularly common in women.

In most cases, this reflects how sensitive the skin's oil glands are to normal hormone levels rather than indicating an underlying hormonal disorder.

What does not cause acne?

Contrary to popular belief, acne is not caused by poor hygiene, chocolate, greasy food or not washing your face enough.

While certain lifestyle factors may influence acne for some individuals, they are rarely the root cause. Genetics also play an important role, meaning that if acne runs in your family, you may be more likely to experience it yourself.

Understanding the real biological causes of acne helps people move away from myths and towards evidence based care.

Frequently Asked Questions

Is acne caused by hormones?

Hormones are a major driver because they stimulate the skin's oil glands. However, this usually reflects the skin's sensitivity to normal hormone levels rather than a hormonal disorder.