Acne Part I: Why Do Some People Get Acne?

What exactly is acne and what causes it?

Sanaz Majd, MD

Acne can do a big number on our self-esteem.  I myself suffered from acne when I was younger, and I remember always wanting to cover up my face.  I was so embarrassed to go outside and socialize.  And I would occasionally encounter another socially unskilled person who would come up to me and say, “what’s that on your face?!” not realizing that what they were pointing to, was my sad attempt to hide a big zit with makeup! 

Why do some people get acne so badly, while others are blessed with beautifully clear skin?  This will be the topic of the next two episodes.  Today, I’ll discuss acne’s causes, and next time I’ll tell you the various ways to treat it.

What Is Acne?

The medical term for acne is “acne vulgaris” (and it has nothing to do with acne being “vulgar”).  Up to 90% of teenagers suffer from acne, but many adults and even post-menopausal women get it as well, although its rates tend to decline with age. 

Acne is really a disorder of the sebaceous follicles underneath the skin.  It is found on the parts of the body containing high number of sebaceous (or oil-producing) glands – like on the face, chest, upper arms, and back.  There are several ways these follicles can go wrong:

  • they can overproduce debris and oils

  • they can house a special type of bacteria called, not coincidentally, P. Acnes

  • they can overreact on the skin of people whose bodies are generally more prone towards inflammation

What Causes Acne?

There are various potential causes of acne.  Here are the most common culprits:

  • Genetics -- Those who suffer from acne often have a family member afflicted with it, like a parent.  Unfortunately, there’s not much you can do about it if your parents passed on the zitty genes to you. 

  • Hormones -- Testosterone and other hormones, like DHEAS which spikes during puberty, cause sebaceous follicles to produce more gland material, and hence more acne.

  • Medications -- There is a list of medications that can cause or exacerbate acne.  These include:  certain anti-seizure medications, lithium that is often used to treat bipolar disorder, and steroids. Even vitamin B2, B6, and B12 have been found to cause acne.

  • Cosmetics and moisturizers -- Although makeup alone is not the cause of acne, certain makeup that is oil-based, rather than water-based, can actually worsen the situation.  I suggest looking for the words “non-comedogenic” on all skin products, which means it won’t clog pores, otherwise known as comedones.


About the Author

Sanaz Majd, MD

Dr. Sanaz Majd, a board-certified Family Medicine physician who graduated from Drexel University College of Medicine in Philadelphia. She sees everything from pediatrics to geriatrics, but her special interests are women's health and patient education. She also loves to teach, and has been doing so since her college days.

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