Causes of Acne

Acne develops as a result of blockages in follicles. The formation of a plug of keratin and sebum is the earliest change.

Enlargement of sebaceous glands and an increase in sebum production occur with increased androgen (DHEA-S) production at adrenarche. The microcomedo may enlarge to form an blackhead or whitehead.

In these conditions the naturally occurring largely commensual bacteria Propionibacterium acnes can cause inflammation, leading to inflammatory lesions (papules, infected pustules, or nodules) in the dermis around the microcomedo or comedo, which results in redness and may result in scarring or hyperpigmentation

Primary causes

Exactly why some people get acne and some do not is not fully known. It is known to be partly hereditary.

Several factors are known to be linked to acne:

Family/Genetic history. The tendency to develop acne runs in families. For example, school-age boys with acne often have other members in their family with acne as well. A family history of acne is associated with an earlier occurrence of acne and an increased number of retentional acne lesions.

Hormonal activity, such as menstrual cycles and puberty. During puberty, an increase in male sex hormones called androgens cause the glands to get larger and make more sebum.

Stress, through increased output of hormones from the adrenal (stress) glands, although modern tests have said otherwise and point to this not being a cause.