What causes acne?

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Acne is a common condition occurring mainly in adolescence. The causes are multifactorial; but blockage of the sebaceous duct with surrounding inflammation is the main pathological process of acne.


The skin consist of four distinct layers; the epidermis, the basement membrane, the dermis, and the subcutaneous fat layer. Sebaceous glands are found in the dermis. These are inactive until puberty. These glands are responsible for the production of sebum; a greasy substance on the skin surface via hair follicles. Sebaceous glands are found in high number on the face and scalp.

Secretion of androgen hormone in adolescence leads to increased production of sebum. Growth of bacteria called propionibacterium acnes causes inflammation and blockage of pilo-sebaceous duct. This results in closed comedones (whiteheads) and open comedones (blackheads). Pustule formation also occurs. These are the three cardinal features of acne.

Face, back and chest are the areas commonly affected by acne.

Some other causes of acne.

Facial acne is occasionally found in infants. It is thought to be due to the influence of maternal androgen.

Acne may occur secondary to corticosteroid therapy or Cushing's syndrome.

Oil acne is an industrial disease seen in workers who have prolonged contact with oil or diesel and is common on the legs and other exposed sites.