Worldwide there are about 60 million people who are suffering from acne. Most people develop acne during adolescence. It is most prevalent in those aged 16 to 18 years. The exact cause of acne is unknown, but doctors believe it results from several related factors. One important factor is an increase in hormones called androgens (male sex hormones). These increase in both boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy or starting or stopping birth control pills can also cause acne.

The most common reasons for acne are:

• There are higher levels of sex hormones at puberty than in younger children.
• These hormones are converted in the skin to dihydrotestosterone (DHT) which stimulates oil glands to enlarge.
• The oil glands, called sebaceous glands, produce sebum. The more sebum, the more likely it is that acne will be troublesome.

Researchers believe that the tendency to develop acne can be inherited from parents

• If sebum and keratin (dead skin cells) block the skin pores, comedones can develop.
• The wall of the follicles may rupture.
• Bacteria and comedonal debris cause acne pimples or pustules (inflammatory lesions).

Aggravating factors
Some people may have particularly severe acne due to:

• Genetic factors (family members have bad acne). Researchers believe that the tendency to develop acne can be inherited from parents. For example, studies have shown that many school-age boys with acne have a family history of the disorder.
• Hormonal factors (higher levels of androgenic hormones) due to:
  • Polycystic ovaries (common)
  • Enzyme deficiency eg sterol hydroxylase deficiency (very rare)
  • Excessive corticosteroids (eg Cushing’s disease) (rare)
  • Psychological stress and depression

• Environmental factors such as:
  • High humidity causing swelling of the skin
  • Cosmetics especially certain moisturisers, foundation and pomades (watch out for lanolin, petrolatum, vegetable oils, butyl stearate, lauryl alcohol and oleic acid)
  • Petroleum oils.
  • Pressure from headbands & chin straps (eg: “fiddler’s neck”).
  • Pressure from sports helmets or equipment, backpacks, tight collars, or tight sports uniforms

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  • Stress can also cause the production of hormones, such as cortisol, which can aggravate acne. Stress brings upon different hormone levels. With hormone changes the body prompts the skins oil glands to enlarge, secreting more oil. Which causes white heads, black heads and pimples.
  • Certain medications. Vitamins are good for your body, But an excess of vitamins B1, B6 and B12 can cause acne flare-ups. These vitamins are good for the skin, but avoid overuse.
  • Picking and squeezing can actually send the infection deeper into the skin and can cause scarring.