Why Do I Get Acne

Acne affects almost everyone at some point in their lives. The common skin condition known as acne is brought on by clogged hair follicles beneath the skin. Dead skin cells and sebum, an oily substance that lubricates your skin and hair, block the hair follicles.

We should understand what we are dealing with and how to manage our skin condition because acne can sometimes be detrimental to our mental health as it affects our face and body.

This article may be helpful if you have acne 

What is acne

Almost everyone has at least a few breakouts during their teenage years. Who will experience more severe acne outbreaks is impossible to predict. However, it can sometimes be devastating for the patient because it affects visible body parts and often causes facial redness. Most people's acne usually disappears by the time they are in their thirties, but some still experience acne in their forties and fifties.

A skin condition known as acne affects the hair follicle, hair shaft, and sebaceous gland, which is called the pilosebaceous unit. Clinically speaking, it primarily affects the face and trunk and is characterised by:

  • Comedones- Comedones are the skin-colored, small bumps that are commonly found on the forehead and chin of people with acne
  •  Papules- A papule is a raised, pimple-like skin growth that does not produce pus
  •  Pustules- A pustule is a swelling of the skin that contains a yellowish fluid called pus. It's essentially a large pimple
  •  Nodules- Nodules are raised solid or cystic bumps in the skin that are larger than one centimetre (cm) but less than two centimetres (cm)
  •  cysts- Cystic acne is a form of inflammatory acne that results in the formation of painful, pus-filled pimples deep beneath the skin
  • Scarring-Acne scarring is a complication of acne

 From mild comedonal acne to severe nodulocystic acne, which can be permanently disfiguring, the disease can range in severity. Acne can have a significant negative psychological and social impact on patients in addition to physical lesions.1,2

What are the types of acne?

  • Mild- The primary lesions are comedones. Pustules and papules may be present, but they are typically few and insignificant (fewer than 10)
  • Moderate- 10 to 40 papules and pustules in a moderate number. There are also a fair number of comedones (10 to 40). Occasionally, mild truncal disease
  • Moderately severe-a great deal of papules and pustules (40 to 100), typically with a lot of comedones (40 to 100), and occasionally (up to 5) more significant, deeper nodular inflamed lesions. The face, chest, and back are typically the most widely affected body parts
  •  Extremely severe- lesions include nodulocystic acne, acne conglobata, which has many large, excruciating nodules and pustules as well as numerous smaller papules, pustules, and comedones6

Body acne

Body and back acne are frequent issues. body Acne affects 10% of people at some point. Although it typically begins during puberty, acne has become more prevalent in adults.

Acne frequently appears on the butt, neck, shoulders, upper arms, and chest. Additionally, body acne is so typical that it has its colloquial name: bacne.

Body Acne or back acne can be caused by the same factors that cause acne on the face. Breakouts can occur anywhere on the body as a result of overactive oil glands, an excess of dead skin cells, and bacteria that cause acne.4

Causes of acne

many different factors can contribute to acne, the following are some typical ones:

  • high or excessive oil production within the pore
  • Dead skin cells accumulate in the pore
  • bacterial growth within the pore

Although some elements could make your acne worse, such as:

hormones- Acne may develop as a result of an increase in androgens, or male sex hormones. These typically rise during puberty in both boys and girls, causing the sebaceous glands to enlarge and produce more sebum. Pregnancy-related hormonal changes can also bring on acne.

Family background-If either of your parents had acne, researchers think you might be more likely to have it too.

  • Medications- Acne can be brought on by some medicines, including hormone-containing, corticosteroid-containing, and lithium-containing ones
  • Age- Acne can affect anyone at any age, but teens are more likely to experience it3

Symptoms of acne

Acne is most commonly found on the face and shoulders. It can also affect the trunk, arms, legs, and buttocks. Among the skin changes are:

  • Skin bumps crusting
  • Cysts
  • Papules (small red bumps) 
  • Pustules (small red bumps containing white or yellow pus) 
  • Skin eruptions which are surrounded by redness
  • scarring of the skin
  • Whiteheads
  • Blackheads
  • Blackheads (comedones)

Acne can be diagnosed by your doctor by looking at your skin. In most cases, testing is unnecessary. Bacterial culture may be performed to rule out infection if large pus bumps persist or with certain patterns of acne,5

Risks factors

Experts are still unsure of the exact reasons why some individuals develop acne while others do not. However, some risk factors should be mentioned.

Strong risk factors are:

  • age 12 to 24 years-The time when acne is most likely to appear is during puberty. Your body goes through numerous hormonal changes during this time
  • Genetics- Acne may run in families. You'll likely get acne if your parents did. According to one study, you are more likely to develop more severe acne at a young age if both of your parents had acne. It was also discovered that you have a higher chance of developing adult acne if one or both of your parents did5
  • Increased production of sebum and oily skin-people who has acne also have larger sebaceous follicles, Sebaceous glands are stimulated to grow and produce more sebum by androgens, which is most prevalent during puberty
  • Medications- Some medications, such as androgens, and corticosteroids (topical, oral, or injected), can either cause or exacerbate acne eruptions

Weak risk factors are:

  • Endocrine disorders-Severe acne is more common in people who have endocrine disorders like polycystic ovary syndrome, hyperandrogenism, or precocious puberty
  • Dietary factors- Even though the Western diet has been linked to an increase in the prevalence of acne, these findings are constrained by their inability to distinguish between genetic, environmental, and dietary influences
  • Female sex/oestrogens-Although oestrogen is known to reduce sebum production, its role in acne is unclear. Oral contraceptives frequently aid in reducing this cyclical worsening of acne in women, who frequently notice it getting worse before their periods
  • obesity/insulin resistance- In people between the ages of 20 and 40, obesity has been linked to a higher prevalence of acne7


Main complications from acne, can be acne scars and hyperpigmentation. 

Acne scars- Scarring can occur with any type of acne spot, but it is more common when the most serious types of spots (nodules and cysts) burst and damage nearby skin.

Scarring can also occur if you pick or squeeze your spots, so avoid doing so.

Acne scars are classified into three types:

  • Ice pick scars are small, deep holes in the skin's surface that appear to have been punctured with a sharp object
  • Rolling scars are caused by bands of scar tissue forming beneath the skin, giving the skin's surface a rolling and uneven appearance
  • Boxcar scars are skin depressions or craters that are round or oval

If you develop acne scars, we suggest you seek advice from a dermatologist who might suggest laser treatment. 

hyperpigmentation-Acne hyperpigmentation occurs when a dark spot appears in the place of a previously gone pimple. Darker skin tones are more likely to develop hyperpigmentation scars. Dark spots appear when skin cells produce an excessive amount of melanin.

 Acne hyperpigmentation may fade over time, but if the original spots were deep, the hyperpigmentation may be permanent.

 Although some topical therapies and laser treatment can speed up the process, it can take months or years.

 Hyperpigmentation acne differs from other types of acne in that it appears as a dark spot or patch on the skin rather than a raised pimple. Other types of acne manifest as inflamed lesions known as comedones.8

Management and treatment for acne

Acne treatment vary according to severity. Acne symptoms can improve after months of treatment.

Prescription acne medications include

  • Topical retinoids-work by exfoliating the skin's surface to remove dead skin cells, which helps stop them from accumulating inside hair follicles
  • Benzolyn peroxide- acts as an antiseptic to reduce the number of bacteria on the skin's surface
  • Topical antibiotics- aid in killing skin bacteria that can infect clogged hair follicles. They can be applied once or twice a day as a lotion or gel
  •  azelaic acid-If the side effects of benzoyl peroxide or topical retinoids are particularly irritating or painful, azelaic acid is frequently used as an alternative treatment for acne

Azelaic acid works by removing dead skin cells and killing bacteria.

A month of azelaic acid use is usually required before your acne improves.

  •  Antibiotics pills-To treat more severe acne, antibiotic tablets (oral antibiotics) are typically used in combination with a topical treatment
  • combined oral contraceptive pill for women-Hormonal therapies can often help women with acne, especially if the acne flares up around their periods or is linked to hormonal conditions like polycystic ovary syndrome

If you have severe acne or prescription medications are not working, your doctor can refer you to a skin specialist (dermatologist).9

When to seek medical attention

If you have mild acne, talk to your pharmacist about treatment options.

If these do not control your acne or if it is causing you great distress, consult your doctor.

If you have moderate to severe acne or develop nodules or cysts, you should see a doctor right away because they must be treated properly to avoid scarring.

Resist the urge to pick or squeeze the spots, as this can result in permanent scarring.

Treatments can take up to three months to work, so don't expect to see results right away. When they do begin to work, the results are usually positive.9


Almost everyone has at least a few breakouts during their teenage years, for some people, acne can result in acne scars or hyperpigmentation, and managing inflammatory acne can be draining and difficult.  Some people believe acne is a minor issue, but it can have a negative impact on our mental health and self-esteem, so it must be properly treated and managed.


  1. Koo J. The psychosocial impact of acne: patient's perceptions. J Am Acad Dermatol. 1995 May;32(5 Pt 3):S26-30. Abstract (http://www.ncbi.nlm.nih.gov/pubmed/7738224?tool=bestpractice.bmj.com)
  2. Karimkhani C, Dellavalle RP, Coffeng LE, et al. Global skin disease morbidity and mortality: an update from the Global Burden of Disease Study 2013. JAMA Dermatol. 2017 May 1;153(5):406-12. Abstract (http://www.ncbi.nlm.nih.gov/pubmed/28249066?tool=bestpractice.bmj.com)
  3. Nancy Garrick DD. Acne [Internet]. National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2016 [cited 2022 Nov 29]. Available from: https://www.niams.nih.gov/health-topics/acne
  4. Kumar B, Pathak R, Mary PB, Jha D, Sardana K, Gautam HK. New insights into acne pathogenesis: Exploring the role of acne-associated microbial populations. Dermatol Sin. 2016;34(2):67-73. doi:10.1016/j.dsi.2015.12.004
  5. [cited 2022 Nov 30]. Available from: https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/acne
  6. Acne - causes [Internet]. nhs.uk. 2017 [cited 2023 Jan 18]. Available from: https://www.nhs.uk/conditions/acne/causes/
  7. Log in | bmj best practice [Internet]. [cited 2023 Jan 18]. Available from: https://bestpractice.bmj.com/topics/en-gb/101/pdf/101/Acne%20vulgaris.pdf
  8. Al-Qarqaz F, Bodoor K, Baba A, Al-Yousef A, Muhaidat J, Alshiyab D. Post-acne hyperpigmentation: Evaluation of risk factors and the use of artificial neural network as a predictive classifier. Dermatol Reports [Internet]. 2021 Oct 6 [cited 2022 Dec 4];13(3):8223. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611517/
  9. Acne [Internet]. nhs.uk. 2017 [cited 2022 Nov 30]. Available from: https://www.nhs.uk/conditions/acne/
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Mariam Nikolaishvili

Bachelor of medicine, Tbilisi State University, Georgia

I am Mariam Nikolaishvili, a sixth-year medical student. I decided to become a doctor when I was 5 years old, and I haven’t changed my mind since. Being a dermatologist and helping people with various skin conditions is my primary objective. I chose to participate in the Klarity internship because I have always loved to write and wanted to learn more about writing for the medical field.

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