What Causes Acne Permanently?

Acne is a common skin concern that affects many people worldwide, and understanding its causes is essential for effective treatment. In this article, we will explore the factors that contribute to acne and how they can affect your skin permanently. From hormonal imbalances to lifestyle choices, we’ll delve into the various reasons why acne may linger and provide tips for prevention and management. So, if you’re looking for insights into what truly causes acne to persist, keep reading to gain a clearer understanding of this frustrating skin condition.

Hormonal Imbalance

Androgen hormones

Acne is often linked to hormonal imbalances. Androgens, such as testosterone, play a significant role in acne development. These hormones stimulate the sebaceous glands to produce more sebum, an oily substance that helps keep the skin lubricated. However, an excess of androgens can lead to an overproduction of sebum, which can clog pores and contribute to acne formation.

Estrogen and progesterone hormones

Estrogen and progesterone, which are primarily found in female bodies, also play a crucial role in maintaining skin health. These hormones promote the growth of the skin and help regulate the production of sebum. However, an imbalance in estrogen and progesterone levels can lead to increased sebum production and potentially contribute to acne development.

Stress hormones

Stress can trigger hormonal imbalances, resulting in acne breakouts. When you experience stress, your body produces cortisol, commonly known as the stress hormone. Increased cortisol levels can stimulate the sebaceous glands, leading to excessive sebum production and skin inflammation. This can create an environment conducive to acne formation.


Family history

Your genetic makeup plays a significant role in determining your susceptibility to acne. If your parents or close relatives had acne, you may have a higher likelihood of developing it as well. Genetic factors can influence the size and activity of your sebaceous glands, the sensitivity of your skin to hormones, and the effectiveness of your body’s natural acne-fighting mechanisms.

Genetic variations

Certain genetic variations can increase your vulnerability to acne. Variations in genes involved in sebum production, inflammation response, and skin cell turnover can affect your acne risk. These genetic factors can influence how your body processes hormones, how efficiently your pores shed dead skin cells, and how susceptible your skin is to inflammation.

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Acne can be inherited through a combination of genetic and environmental factors. While specific gene variants may increase your susceptibility to acne, it doesn’t mean you are guaranteed to develop it. Your genetic predisposition interacts with environmental triggers to determine the likelihood and severity of your acne.

Clogged Pores

Excess sebum production

When your sebaceous glands produce an excessive amount of sebum, it can mix with dead skin cells and other debris, leading to clogged pores. Sebum is meant to lubricate and protect your skin, but when there’s an excess, it can become a breeding ground for acne-causing bacteria.

Dead skin cells

As your skin naturally sheds dead skin cells, they can sometimes accumulate and block your pores. When dead skin cells mix with sebum and other impurities, they form a plug that prevents the skin’s natural oils from reaching the surface. This can contribute to the formation of acne lesions.

Bacterial overgrowth

Bacteria known as Propionibacterium acnes (P. acnes) naturally reside on the skin. However, when there’s an overgrowth of these bacteria, they can contribute to the development of acne. P. acnes can aggravate inflammation, further clog pores, and contribute to the formation of painful and inflamed acne lesions.


Immune response

When your body perceives an invasion by bacteria or other foreign substances, it initiates an immune response. This immune response can cause inflammation in the affected area, including the skin. Inflammation is a natural defense mechanism, but excessive or prolonged inflammation can damage the skin and contribute to the formation of acne lesions.

P.acnes bacteria

Although P. acnes bacteria naturally reside on the skin, their overgrowth can trigger an inflammatory response. When these bacteria accumulate within clogged pores, they can release molecules that activate the immune system and cause inflammation. This can lead to redness, swelling, and the formation of different types of acne lesions.

Follicle wall damage

As acne lesions develop, the follicle walls can become damaged. Inflammation and increased sebum production can weaken the follicle walls, making them more susceptible to rupture. When the follicle walls break, the contents of the clogged pore can spill into the surrounding skin, leading to the formation of inflammatory acne lesions.


High glycemic index foods

High glycemic index (GI) foods, such as sugary snacks, white bread, and processed carbohydrates, can contribute to acne breakouts. These foods cause a rapid spike in blood sugar levels, leading to increased insulin production. Elevated insulin levels can trigger an excess release of androgens, which can stimulate the sebaceous glands and increase sebum production, potentially worsening acne.

Dairy products

Some studies suggest that consuming dairy products, especially high-fat dairy, may worsen acne symptoms. Milk contains hormones, including androgens and insulin-like growth factor 1 (IGF-1), which can influence sebum production and skin cell growth. Additionally, dairy products can also increase the production of insulin in the body, further exacerbating acne symptoms.

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Processed and fried foods

Processed and fried foods are often high in unhealthy fats, additives, and preservatives. These foods can contribute to inflammation in the body, including the skin. The excess consumption of processed and fried foods can disrupt the delicate balance of hormones and increase the risk of developing acne.

Environmental Factors

Air pollution

Exposure to air pollution, including particulate matter and pollutants, can negatively impact the health of your skin. Air pollutants can penetrate the skin and trigger oxidative stress, inflammation, and cellular damage. Additionally, certain pollutants can also interact with sebum, potentially worsening acne symptoms and contributing to clogged pores.

Humidity and sweat

High humidity and excessive sweating can create a favorable environment for acne development. When sweat mixes with sebum, dead skin cells, and bacteria, it can clog pores and lead to acne breakouts. Additionally, humid conditions can also hinder the skin’s natural shedding process, further increasing the risk of clogged pores.

Irritants and allergens

Exposure to irritants and allergens can irritate the skin and trigger inflammatory responses, potentially leading to acne flare-ups. Common irritants can include harsh chemicals in skincare products, fragrances, certain fabrics, and even excessive friction from clothing or accessories. Identifying and avoiding these triggers can help reduce the likelihood of acne breakouts.



Corticosteroids, commonly prescribed for various medical conditions, can sometimes trigger or worsen acne. These medications can increase the production of sebum and suppress the immune system, leading to clogged pores and increased susceptibility to bacterial overgrowth. If you’re experiencing acne while taking corticosteroids, it’s essential to discuss it with your healthcare provider.


Lithium, a medication often used to treat bipolar disorder, has been associated with acne breakouts. The exact mechanism behind lithium-induced acne is not fully understood, but it is believed to be due to its impact on sebum production and the skin’s response to hormones. If you’re concerned about acne as a side effect of lithium, consult with your doctor for possible alternatives or management strategies.


Certain anticonvulsant medications, such as phenytoin and carbamazepine, have been linked to acne development. These medications can disrupt the normal hormonal balance in the body, potentially leading to increased sebum production and acne breakouts. It’s important to work closely with your healthcare provider if you’re experiencing acne as a result of your anticonvulsant medication.

Cosmetics and Skincare Products

Comedogenic ingredients

Some cosmetics and skincare products contain comedogenic ingredients, which have the potential to clog pores and contribute to acne formation. These ingredients can vary from person to person, so it’s essential to pay attention to how your skin reacts to different products. Avoiding products labeled as comedogenic and opting for non-comedogenic alternatives can help minimize the risk of acne breakouts.

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Heavy and occlusive products

Heavy and occlusive products, such as thick creams or oils, can create a barrier on the skin’s surface, trapping sebum and impurities. This can lead to clogged pores and acne formation. If you have acne-prone skin, choosing lightweight and non-greasy products can help maintain the skin’s balance without exacerbating acne symptoms.

Incompatible formulations

Using incompatible skincare products together can create adverse reactions, including acne breakouts. For example, combining exfoliating products that contain salicylic acid with harsh cleansers can strip the skin of its natural oils, leading to an overproduction of sebum. It’s important to choose compatible products and establish a skincare routine that meets your skin’s specific needs.

Hygiene Habits

Frequent touching of the face

Frequently touching your face can introduce dirt, bacteria, and oils from your hands onto the skin’s surface. This can potentially lead to clogged pores and acne formation. It’s essential to resist the urge to touch your face and to keep your hands clean to minimize the transfer of impurities.

Dirty pillowcases and towels

Sleeping on dirty pillowcases can expose your skin to accumulated oils, dead skin cells, and bacteria. Similarly, using dirty towels to dry your face can reintroduce impurities onto your skin. Regularly changing and washing your pillowcases and towels can help maintain a cleaner environment for your skin and reduce the risk of acne breakouts.

Excessive scrubbing or washing

While proper hygiene is essential in managing acne, excessive scrubbing or washing can be counterproductive. Scrubbing too vigorously or using harsh cleansers can irritate the skin, disrupt its natural balance, and potentially worsen acne. Gentle cleansing and avoiding harsh physical exfoliation can help maintain the skin’s integrity and reduce the risk of irritation.

Certain Health Conditions

Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a hormonal disorder that can cause various symptoms, including acne. PCOS is characterized by an imbalance of hormones, particularly an excess of androgens. These hormonal imbalances can trigger increased sebum production and acne breakouts. If you suspect PCOS may be contributing to your acne, it’s crucial to consult with a healthcare professional for proper diagnosis and management.

Cushing’s syndrome

Cushing’s syndrome is a rare condition characterized by high levels of cortisol in the body. Elevated cortisol can disrupt the normal hormonal balance, increase sebum production, and contribute to acne development. If you suspect Cushing’s syndrome may be underlying your acne, it’s essential to seek medical attention to investigate and address the underlying cause.

Acne fulminans

Acne fulminans is a severe form of acne characterized by sudden and explosive onset. It is often accompanied by systemic symptoms such as fever, joint pain, and weight loss. Although the exact cause of acne fulminans is unknown, it is believed to involve a combination of genetic factors, hormonal imbalances, and immune system dysregulation. Treating acne fulminans typically involves a comprehensive approach and the supervision of a dermatologist.

Acne can have multiple underlying causes, and understanding them can help in its prevention and management. Hormonal imbalances, genetic factors, clogged pores, inflammation, diet, environmental factors, medications, cosmetics, skincare products, hygiene habits, and certain health conditions all contribute to acne development. By addressing these factors and working with healthcare professionals, you can develop personalized strategies to minimize the occurrence and severity of acne. Remember, there is no one-size-fits-all solution for acne, so it’s important to find what works best for you and your skin.