How acne develops and why

How Does Acne Really Develop? Our MDacne Dermatologist Explains

Curious about how those pesky breakouts started? Our MDacne dermatologist is here to break down how acne really develops—and, most importantly, how to get rid of it.

Our skin has sebaceous glands that produce an oily substance called sebum, which empties onto the skin’s surface through small openings known as pores. When things are working smoothly, sebum keeps our skin soft and protected. However, with acne, things take a different turn.

The Development of Acne

Here’s the short version: acne starts when the skin cells at a pore’s opening form a plug. This plug blocks the sebum from reaching the surface and causes the sebaceous gland to swell. With more sebum trapped inside, it becomes easier for acne-causing bacteria, Cutibacterium acnes, to grow.

Once the bacteria take hold, they produce chemicals and enzymes that attract white blood cells, leading to inflammation. Inflammation is the body’s response to injury or infection and is marked by swelling, redness, heat, and pain. When the wall of this plugged follicle eventually breaks down, it spills all its contents (sebum, bacteria, and dead skin cells) into the surrounding skin, leading to the red, painful pimples or cysts that we know as acne.

The Root Causes: Genetics and Hormones

The main factors that influence acne are genetics and hormones. Genetics determine how sensitive your sebaceous glands are to hormones. If your glands are highly sensitive, acne is likely to be more severe. Hormonal changes—like higher testosterone levels—can lead to increased sebum production, especially in those with normal or low gland sensitivity.

How to Clear Up Acne for Good

To effectively clear your skin, use the right topical anti-acne ingredients for your specific skin type. Not sure where to start? Try our free MDacne app: take a selfie, and we’ll assess your skin and recommend the best treatments. Additionally, avoid foods that can trigger breakouts and always use oil-free sunscreens and non-comedogenic cosmetics.

For more in-depth advice on acne prevention, check out our blog. We're here to keep you informed and help you kick acne out of your life for good!

To find the right acne treatments for your unique skin, take the free skin assessment by clicking here.