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Why some people get acne

Normal hormone changes at puberty.  A change in hormones occurs just before puberty in boys and girls. This is quite normal and results in an increase of sebum from the grease glands. This is typical around the age of 11–14 years, but may be earlier in some people, as puberty is starting earlier in both boys and girls. Increasing levels of androgens, growth hormone and a factor called insulin growth factor-1 (IGF-1) may all affect acne. The oil produced by the grease glands acts as a 'food' to the Propionibacterium acnes (P. acnes) bacteria. More sebum leads to more P. acnes which in turn causes inflammation.  

Heredity. Acne can run in families. If your parent, brother or sister has or had acne, you are more likely than average to have it yourself. Studies of twins have suggested that acne is genetic.
Smoking. Studies on the effects of smoking on acne have been contradictory, with the exception of those that have shown that adult females who smoke tend to get more severe problems with acne around the lower jaw line and an increased number of blocked pores.
Medications. Some drugs can cause acne. The best-known example is anabolic steroids taken by body-builders, but phenytoin (for epilepsy), vitamin B12 (for anaemia) and lithium (for mood swings) can also produce acne. Occasionally, chemicals in the workplace, such as industrial oils, are responsible. Some recent reports have suggested that some protein and whey shakes may contain ingredients that trigger or exacerbate acne.
Skin-lightening creams may contain strong steroids that can exacerabate acne and cause skin infections. ALWAYS consult your doctor before using these products!
Contraceptive pill. Combined oral contraceptives contain both oestrogen and a progestin. Oestrogen usually improves acne, whereas some progestins can make it worse. There are various types of progestin, some of which are better than others. Check the label on your pill packet: ‘gestodene’, ‘desogestrel’, ‘norgestimate’ and the pill containing ‘drospirenone’ (Yasmin) are better choices if you have acne. A medication called Dianette contains a progestin called cyproterone acetate. This is good at reducing hormones called androgens, and is available for severe acne in the UK. It also acts as a contraceptive, and is licensed for this use in some parts of Europe but not in the UK.
Polycystic ovary syndrome. If you are a woman and you have irregular and/or missed periods as well as an increase in hairiness and acne, you might have polycystic ovary syndrome. It is important to see your doctor if you suspect this diagnosis!
Make-up. Some make-ups are 'comedogenic' and make acne worse. Look for 'anti-comedogenic' products when selecting a make-up or treatment that you apply to the skin. If the product is comedogenic, it may cause acne that is made up of lots of blackheads and whiteheads all over the face. It is important for anyone with acne to select oil-free make-up. Foundations containing silicone are preferable, and matt powders can reduce a shiny skin texture.
Environment. Hot and humid environments at work can worsen acne, Moving to a hot humid country can make acne worse. For this reason, the armed forces are reluctant to enlist individuals who have moderate/severe acne, in case they have to be posted to the tropics.

Fast Facts Obesity
Fast Facts medical handbooks are written for doctors, read by patients too. The new edition of Fast Facts: Acne by Drs Layton, Thiboutot and Bettoli is out now.

Acne is one of the ten most common diseases worldwide, and the inflammatory skin disease seen most often by family physicians and dermatologists. Fast Facts: Acne provides an overview of all available treatments, including their potential side effects, and advises on the best treatment for all different types of acne. 

Written by: Alison Layton
Edited by: Alison Layton
Last updated: Friday, October 21st 2016


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Comments on this article

Posted by Optional on 15/11/2015 at 09:16

Hi I am struggling with acne I have had acne for a while but I managed to get rid of it by drinking water and just trying to stay healthy however for some odd reason it has come back after a very long time and I am very conserned and I just dont know what to do I feel like I've tried everything please could you help me thank you.

Posted by Elle x on 14/07/2014 at 09:17

What creams are best for acne I have suffered with acne since yr 6 am now goin into yr9 but my acne gets worser and all over my body could u give me some more ideas please x

Posted by Konke Cekiso on 15/06/2013 at 09:31

Iam konke cekiso,this is a 3rd year since i suffered from acne,ihave been trying many products including Gotha Ostrich Oil Soap and Re-gen cream,but they did no make any changes,my face is even itching now,its painful,and now am desparate,am afraid to walk in public with my face like this,please good South Africans,help me

Posted by Khalid on 16/11/2011 at 05:16

I am a teenager and i have a lot of acne into my face..i want a help from someone who can give me a solution..

Posted by Optional on 15/10/2010 at 09:03

my face is full of red spots and acne ....they just go n come at regural intervals. Wat can i do????

Posted by elona on 03/10/2010 at 09:56

Im a teenager and i have some acnes not to much but they are , the problem is that when they show-up , they doesnt move from there about 5-6 days . i dont wear make-up , i dont attakt them ..soo whats the problem

Posted by Will on 28/09/2010 at 03:56

I get spots round my cheeks and near my mouth, i've been using 'Witch' every night and some mornings and it does help a lot

Posted by jul on 24/06/2010 at 12:08

Why do we get spots on our face and back?dont get them any place else?

Posted by sarah on 03/01/2010 at 09:53

i have a few big red spots on my forehead cheeks and chin and blackheads on my nose , i have tryed freederm , clean & clear , and oxy gels but they do not work , i have also tryed 2 face scrubs and they dont work , i tryed leaning my head over the kettle when it has been boiled but it dont work , nothink works. please someone help me ! i need to get rid of them ,im scared people will take the mick out of me. i am now washing my face in the morning with clean & clear then washing my face at night with garnier skin naturals skin scrub but that dont work eaither! someone give me a solution that actualy works.

Posted by Anonymous on 28/12/2009 at 04:42

i have a few spots on my forehead chin and cheeks i dont like using lots of treament do you have any natural ways to get rid of them (i have sensitive skin) thanks

Posted by carly on 01/12/2009 at 07:52


Posted by Mat on 28/08/2009 at 05:03

Ok so I got told that hot water can get rid of spots or ease this week I started to splash hot water on my face mornings and evenings and it works well,It eases spots like stops the redness and it makes the blackheads pop out :). Try it for a week.

Posted by Emma on 21/06/2009 at 10:39

I use Panoxyl Aquagel... it has helped me soooo much, and I highly recommend it. I went to my doctor and asked for it as my friend used to use it too and it helped her. Used once a night, i did have to wait about 2 weeks to see improvement but it does work, dont give up :D I started on strength 5 then went up to 10. The doc will be able to prescribe what level suits you :) I also found that if I put any gel on my hair and dont wash it off fully before i go to bed it makes my skin bad, as all the gel gets onto my pillows. This may not be the same with everyone but I thought it might help someone... :D Good Luck!!

Posted by dalia on 27/03/2009 at 05:50


Posted by amir on 12/01/2009 at 10:40

This information is very usefull and im glad i found this site!jus add some more medical gels or creams wich improve acne! thankyou bye


View what people have said about acne and spots | Why some people get acne

Fascinating facts

The worst ages for spots are 16-18 years for women and 18-19 years for men, but people of any age can get them

Acne was more severe in teenagers 20 years ago than it is now

More people in their 20s and 30s seem to have acne these days

At 40 years of age, 5 women in 100 and 1 man in 100 have acne

The ancient Egyptians relied on a spot cream made from bullocks' bile, ostrich egg, olive oil, salt and plant resin, mixed to a paste with flour and milk

Americans spend $100 million a year buying acne treatments

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