What is acne anyway?

The causes of acne explained

3 minute read

Person in denim jacket and red nail polish squeezing pink balloon with black text "Acne" against a purple background
We’re here to tell you what we know, but don’t take it as medical advice. Talk to your medical provider about your specific health concerns.

Acne is so common that about 85% of teenagers and twenty-somethings battle at least minor acne every year. But why? What is acne, anyway? First off, knowledge is power. This guide will explain exactly what acne is and where it comes from! Just remember that you’re not alone, and you don’t have to suffer.

Illustration of pores with text "Healthy," "Whitehead," "Blackhead," "Papule," "Pustule," "Cyst/Nodule," Sebaceous gland"

Do I have acne?

One blackhead counts as acne! Acne is a spectrum, and can appear in many forms, from clogged pores to small inflamed bumps (called papules) to large cysts. Some people don’t think that clogged pores count as acne, but they do! Clogged pores are also known as comedones, which can be open (blackheads) or closed (whiteheads), and might lead to more inflamed and larger blemishes that we all commonly associate with acne. The more inflamed a zit gets, the higher the chance it’ll leave a scar behind.

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Who can get acne?

Teenagers aren’t the only ones who can suffer from acne. Adults do, too—especially women! Almost half of women in their 20s and a quarter of women in their 30s deal with acne.

Illustration of an infant with acne on face with caption "Acne can even happen to babies!"

Not-so-fun fact: almost 20% of newborns up to three months old, and even infants and small children, face acne problems. This happens when mothers pass androgens to their babies, stimulating the child’s sebaceous glands. Just like with teens and adults, these glands enlarge and release more oil, overwhelming the pores.

What causes acne?

Illustration with text "Normal Follicle:" "Open pore," "Hair follicle," "Sebaceous gland" beside image with text "Inflamed Acne:" "Pore lining ruptures," "Inflammation and tissue destruction"

First, acne starts in the pore. Dead skin cells lining the pore start to collect instead of sloughing off like usual. Hormones called androgens increase how much sebum your body makes, and these natural oils begin to collect in your pores. (FYI, this is why bodybuilders taking anabolic steroids can get severe acne, since these steroids increase androgens!) Normally, these skin cells slough off just fine, but sometimes a change in the life cycle of the cells mean they clog up instead. Next, this sludgy mix hanging out in your pores gets exposed to bacteria that naturally live on the skin. Unfortunately, these bacteria (called P. acnes) thrive in the extra oil in the pore. Lastly, like a perfect storm, the cells, the oil and the bacteria fill up and overflow, leaking out into the nearby tissue, causing further inflammation and larger breakouts.

Shattered red lollipop against a neutral background

Luckily, there are ways to limit acne. Using a customized-for-you skincare solution like Curology can help, and addressing triggers like diet and stress can be important as well — you can find tips like this in our other guides. Be sure to keep reading!

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