Many people are surprised to discover that acne actually has a root cause and isn’t some spontaneous disease that shows up one day on their face. Contrary to popular opinion, it’s not a disease that can just simply be “outgrown” – it has a distinct trigger, and oftentimes, reducing symptoms of acne vulgaris is as easy as preventing it from arising in the first place. If you’re struggling with the shame and embarrassment of painful blemishes and are running out of hope, keep reading to learn how to stop acne in its tracks by learning more about what causes it.

What Causes Acne? (A Visual Guide)

There is no one, singular cause of the disease formally known as “acne vulgaris.” Any of its many underlying triggers could be a catalyst for acne pimples on your skin. Being able to properly identify what your triggers are could help prevent future breakouts.

  • What Bacteria Causes Acne? Propionibacterium acnes - acne bacteriaAcne is actually caused by a bacterium called “Propionibacterium acnes.” A typically non-pathological bacterium that exists on everyone’s skin, acnes mixes with sebum and skin cells to clog pores and cause the stereotypical manifestation of acne blemishes.
  • Medical Conditions that Cause Acne: Health issued detected from acneIf your skin keeps breaking out despite attacking it full-force with a variety of creams and pills, then you may need to visit your physician to rule out underlying medical conditions. Some of the more common conditions that may cause breakouts include PCOS (Polycystic Ovarian Syndrome), diabetes, congenital adrenal hyperplasia, autoimmune disorders (including celiac disease), and thyroid disorders (such as Hashimoto’s.)
  • Diseases that Cause Acne: Skin problem with acne diseasesSeveral illnesses can manifest as acne on your face and body. These include acne conglobata, acne fulminans, pyoderma faciale, and gram-negative folliculitis. This variety of acne tends to be extremely severe, painful, ulcerative, and highly resistant to conventional treatment.
  • Foods that Cause Acne: Top 6 foods that cause acneThere are many misconceptions about diet and its relationship to acne. Some experts argue that it plays no role in acne, whereas others firmly attest to its causality. You can learn more about what foods cause acne.

Is Acne Genetic?

When you look in the mirror, do you see your dad’s eyes, your aunt’s smile, and your mother’s acne?

Before you call your grandparents up and start berating them for passing on the genetic predisposition to acne onto you, it’s important to realize that while yes – acne is highly genetic – there are many factors that you can still control.


The bottom line is that there is no such thing as an “acne gene.” You didn’t inherit pimples from your ancestors.

However, what you did inherit includes:

  • Excessive androgen and androgen sensitivity: The more androgen your body produces, combined with an increased sensitivity to this hormone, means that you may be more likely to have acne.
  • Predisposition to acne cysts: While it’s hard to blame your parents for the spot on your nose, if you’re prone to acne cysts, then you most likely got that “gift” from your parents or grandparents.
  • Immune disorders that can cause acne: Since certain immune disorders are known to cause acne, it’s very likely you got that disorder from your predecessors and, therefore, your acne.
  • Sebum levels: Everyone has varying degrees of sebum (skin oil) on their skin. Some people are naturally oilier than others, and that can lead to clogged pores and breakouts.

If you have the genes for acne and have noticed an increase in breakouts, remember that you can still control the condition of your skin. A genetic predisposition to acne doesn’t necessarily always warrant acne outbreaks.

These five tips can help you control your genetic acne:

  1. Follow a gentle skincare regimen. Read more about the best acne products here.
  2. Change your diet and lifestyle.
  3. Practice better stress management.
  4. Aim to get a minimum of 7-8 hours of sleep at night.
  5. Pay a visit to your dermatologist.

Just because your parents or grandparents had acne doesn’t mean the cycle has to continue with you. Educate yourself and apply that understanding and you can finally overcome this debilitating disease and regain your confidence.

Is Acne Contagious?

Acne Contagious MythSome people may hesitate to share makeup brushes with their acne-prone friends or may flinch away from a hug lest a pimple-studded cheek accidentally touches theirs.

The good news is that P. acnes is not pathological: you can’t catch it from your friends and they can’t catch it from you. Everyone has it on their skin, so don’t stress about contracting it from casual contact.

No matter how close you are to your best friend, don’t share makeup brushes, hats, or sports gear without first cleaning them thoroughly. A sudden rash on your peer’s forehead can signal a more dangerous, highly contagious condition. Keep an eye out for crusting, weeping, and oozing on your skin and report it to your dermatologist immediately if you observe any similar symptoms.

If you do develop a sudden acne breakout overnight, though, don’t panic! You can learn how to get rid of acne fast here.

Top Causes of Acne: Myths and Facts

Regardless of the type of acne that you have, there are four primary causes of acne. If you’re able to prevent these triggers from occurring, you may be able to stop acne from forming on your skin. Read more about how to prevent acne here.

  1. Bacteria: Acne vulgaris simply cannot form without the presence of P. acnes. To have acne, you must also have the corresponding acne-causing bacteria.
  2. Hormones: Androgen, the male hormone, can cause acne breakouts in both males and females by causing overactive sebaceous glands.
  3. Excessive Oil: Oil production is also regulated by hormones, and having too much of it can clog your pores.
  4. Clogged Pores: Marrying excessive sebum, oil, and bacteria together in your pores can lead to a clog, which is a major trigger for acne pimples.

As you can see, each trigger is reliant upon the other. Having all four combined is a guaranteed maelstrom of blemishes and zits.

Acne myths busted

Conversely, there are many strongly held beliefs about certain acne triggers. For instance, certain lifestyle factors can play into your predisposition to acne.

These include:

  • Smoking: If you smoke, stop now. Not only can it lead to tooth decay, cardiovascular disease, and cancer, it can also cause acne breakouts. 42% of smokers have acne versus just 10% of non-smokers.
  • Kissing: While acne itself isn’t contagious, you can still develop “friction acne.” If your significant other has a beard, they may abrade your skin with it and trigger a breakout. Heavy, greasy lip balms can also lead to clogged pores around the mouth.
  • Makeup: Unless your cosmetics specify that they are “non-comedogenic, ” then they can indeed cause acne. To minimize this risk, wash your face carefully at night to remove all traces of makeup.
  • Stress: In periods of high stress, many people claim that their acne has gotten worse. But is that the truth? Yes! While scientists aren’t sure exactly why, they believe it lowers your immune system, making you more acne prone.
  • Hygiene: Getting clear skin isn’t as straightforward as the ever-insulting proclamation to “just wash your face!” but having a gentle skincare regimen can help reduce your outbreaks. On the other hand, over-washing and harsh astringents can make your skin worse. Dirt itself does not cause acne, though.
  • Medications: Certain prescription drugs can actually cause acne, too. If you started new medicine and started getting zits, take a hard look at your medicine cabinet. Lithium, corticosteroids like prednisone, DHEAs, anticonvulsants, and barbiturates are all guilty of causing acne.
  • Chocolate: What’s worse than having acne? Having acne and not eating chocolate! The good news is that there is no evidence whatsoever that indicates that chocolate causes breakouts. Keep enjoying it in moderation as part of an otherwise healthy diet. Find more details about diet and acne here.

Acne facts

People of all ages suffer from acne, not just teenagers.

Being able to separate the facts from the fiction will give you a strong starting point in learning how to prevent your acne – and getting you back on the path for clear skin! You can learn more about how to clear acne here.

Acne Diagnosis

Since acne vulgaris is a legitimate skin disorder, it is typically easily diagnosed during a medical examination by a healthcare professional.

To obtain a diagnosis of acne, a dermatologist will:

  1. First, they will examine your skin carefully in good lighting to confirm that you have acne. Occasionally they will obtain a skin sample (biopsy) to rule out other infections or diseases, but a visual inspection is generally sufficient.
  2. If you are diagnosed with acne, they will next grade the acne on a severity scale. It can range from Grade I (mostly comedonal) to Grade IV (cystic and nodular). The type of acne you have will largely determine your acne grade. Learn more about the types of acne here.
    Acne grades
  3. Next, they will recommend a course of treatment for your acne. More mild acne may respond well to topicals such as retinoids, but more severe acne may warrant antibiotics or even isotretinoin.
  4. After prescribing treatment, they will require that you follow up during a set period to determine how well your treatment is working. If you achieve remission, they may advise you remain on your medicine or switch you to a maintenance regimen. If not, they may adjust your medicine to help you attain clear skin.

Sometimes, other conditions may appear to resemble acne on your skin. That is why it is absolutely critical to visit your doctor to confirm a diagnosis.

These conditions appear similar to acne, but are not actually caused by the P. acnes bacteria:

  • Folliculitis,
  • Perioral Dermatitis,
  • Staph Infection,
  • Sebaceous Hyperplasia,
  • Rosacea,
  • Keratosis Pilaris.

They will not respond to conventional acne treatment and will require intervention from a dermatologist or physician.

What is Actually the Main?

If there were just one thing to be implicated in causing acne, it would have to be the Propionibacterium acnes bacteria. Without it, the disease would not be considered acne; with so many other diseases that seem visually similar to acne vulgaris, the presence of the bacterium is vital for proper diagnosis.

What Type of Acne do You Have?

Types of Acne Lesions

However, since P. acnes isn’t malignant on its own, it works in unison with:

  • Hormones,
  • Sebum,
  • Clogged Pores.

Most of the time, if you have acne, then you have an excess of androgens, sebum, and poor cellular desquamation. (That means that your body isn’t able to shed dead skin cells easily, leading to clogged pores and acne breakouts.)

Fortunately, having these pre-existing conditions doesn’t automatically mean that you’re doomed to a lifetime of unwanted blemishes. You can balance your hormones, encourage proper cellular turnover, and even reduce your bacteria and sebum production by taking specialized medications for your skin.

These include:

Learn more about acne medication here.

Knowledge is power, and knowing what causes your acne can be incredibly empowering. Merely throwing creams and balms at your skin without thoroughly understanding their mechanism of action can halt your progress and even make your skin worse.

Controlling your acne triggers can prevent these blemishes from appearing on your face, chest, or back in the first place, sparing you from the misery and agony of ugly breakouts and lingering scars and redness.

Now that you know what causes acne, you can apply your newfound wisdom and save yourself from future pain and embarrassment. You (and your skin!) deserve both that serenity and that clarity.