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What causes face breakouts?

Face breakouts can be frustrating and embarrassing. Most people will experience acne at some point in their lives. Acne is caused when dead skin cells, oil, and bacteria clog your pores. This leads to red, swollen bumps on your face, neck, chest, back, and shoulders. While acne is common, especially among teenagers, understanding what causes pimples can help you prevent and treat breakouts. In this article, we’ll explore the most common causes of acne and how to tackle each one.

Hormonal Changes

Hormone fluctuations are one of the leading causes of acne. During puberty, hormone levels rise, which triggers oil glands in your skin to produce more sebum. Excess sebum mixes with dead skin cells and bacteria, plugging pores and causing breakouts. Hormones also explain why acne is common among teenage girls.

During the menstrual cycle, hormone changes can lead to breakouts in women. Acne may flare up during the week before your period when estrogen levels dip. Some women also experience premenstrual acne caused by sensitivity to progesterone.

Pregnancy can trigger acne as hormone levels shift rapidly. Some women develop acne during pregnancy, while others find their acne improves. Hormone changes like these are common acne causes:

  • Puberty – rising androgen hormones stimulate oil glands
  • Menstrual cycle – progesterone and estrogen changes
  • Pregnancy – increased estrogen, progesterone and androgens
  • Menopause – declining estrogen

While you can’t control your hormones, you can treat hormonal acne with medications like birth control pills or spironolactone which regulate hormones. Seeing a dermatologist can help identify if hormones are behind your breakouts.


Your genetics play a major role in acne development. Research shows acne has a hereditary component. If your parents had severe acne, you’re more likely to struggle with breakouts.

Studies reveal over 80% of acne cases stem from genetics. Your genes determine how your oil glands function, how they respond to hormones, how quickly skin cells shed and inflammation. People prone to acne may have hyperactive oil glands that are oversensitive to androgens.

You also inherit certain proteins that predispose you to acne. Genetic factors that can cause acne include:

  • Overactive oil glands
  • Increased sebum production
  • Slower skin cell turnover
  • Increased inflammation
  • Higher androgen receptors

While you can’t change your genetics, you can treat and prevent acne despite a genetic predisposition. Seeing a dermatologist can help create an acne treatment plan tailored for your skin type.

Oily Skin

Having excessively oily skin is another common acne cause. Your skin type is largely determined by genetics. Some people naturally produce more sebum. The oil glands in your skin secrete sebum to keep your skin moisturized. But too much sebum can lead to clogged pores and acne.

Those with overactive sebaceous glands tend to have oilier skin. Oily skin provides the perfect environment for acne-causing bacteria to thrive. People with oily skin also exhibit faster skin cell turnover. This shedding of dead skin cells mixes with oil, clogging pores.

Oily skin may be more prone to these acne causes:

  • Enlarged oil glands
  • Increased sebum production
  • Excess dead skin cells
  • Clogged pores
  • Higher levels of acne-causing bacteria

Managing oily skin is key to preventing acne. Here are some tips for oily, acne-prone skin:

  • Use oil-free, non-comedogenic products
  • Cleanse skin twice a day
  • Use acne-fighting ingredients like salicylic acid and benzoyl peroxide
  • Try blotting papers and mattifying powder to control shine
  • Avoid heavy creams and oils

Prescription acne medications can also regulate excess oil and treat breakouts.


Can stress cause acne? Research confirms the mind-skin connection. Stress doesn’t directly cause acne, but it can exacerbate factors like oil production and inflammation. This leads to more breakouts.

When you’re stressed, your body ramps up production of cortisol and other hormones. These hormones rev up oil production which can clog pores. Stress also impacts your immune system. This causes increased inflammation, leading to red, painful pimples.

Studies demonstrate students have higher acne severity during exam periods. Stress impairs your skin’s ability to heal and fight off bacteria. People under stress may experience more acne due to:

  • Increased oil production
  • Slowed skin cell turnover
  • Reduced immunity against acne bacteria
  • Greater inflammation

Managing your stress levels can help prevent stress-induced breakouts. Relaxation techniques like meditation, yoga and deep breathing curb cortisol. Getting enough sleep promotes skin cell regeneration. Exercise also lowers stress and improves immunity against acne.

Poor Diet

Your diet affects the health of your skin. Certain foods can increase inflammation, oil production and insulin levels. This creates an acne-promoting environment. Greasy, high glycemic foods often get blamed for acne.

Research suggests diets high in refined carbs and unhealthy fats may worsen acne. These foods quickly spike blood sugar and insulin levels. This stimulates oil-producing glands and inflammation. Studies link intake of foods like pizza, pasta, white bread, chips, cookies and soda to increased acne.

Milk and dairy products are also accused acne triggers. Milk contains hormones and bioactive molecules that ramp up oil secretion and irritation. Whey protein in dairy may trigger inflammatory breakouts.

Here’s how poor dietary habits can promote acne:

  • Increased inflammation
  • Elevated oil production
  • Faster sebum secretion
  • Higher insulin and androgen activity

Adopting an acne-fighting diet high in veggies, fruits, lean proteins and healthy fats can improve breakouts. Drinking water, green tea and limiting dairy, sugar and refined carbs helps too.


Acne is closely tied to a strain of bacteria called Propionibacterium acnes, or P. acnes. This bacteria naturally resides in your pores. When pores become clogged with sebum and dead skin, it creates the ideal breeding ground for P. acnes.

As the bacteria proliferate, your immune system mounts a response, unleashing inflammatory chemicals. This results in red, swollen pimples. Those with acne tend to harbor higher levels of P. acnes in their pores. Some strains of this bacteria are more virulent and linked to severe inflammatory acne.

Factors that encourage overgrowth of acne bacteria include:

  • Plugged pores and sebum buildup
  • High sebum production
  • Inflammatory response to the bacteria
  • Resistance to treatment

Using topical or oral antibiotics can help control acne bacteria. Benzoyl peroxide and retinoids also fight P. acnes by unplugging pores. Probiotic supplements may inhibit growth of bad strains of acne bacteria as well.


Skin care products, pollutants and environmental factors can irritate your skin and worsen acne. Ingredients in cosmetics, cleansers and moisturizers can clog pores and cause contact dermatitis. This leads to red, itchy pimples.

Look for oil-free, non-comedogenic and fragrance-free products labeled “won’t clog pores.” Avoid harsh scrubs and astringents which strip skin. Switching products or eliminating irritants can improve acne.

Outdoor pollutants like dirt, dust and vehicle exhaust also promote breakouts. These particles cling to skin, plugging pores while inducing free radical damage and inflammation. Always cleanse after being outdoors.

Even simple friction and pressure on skin can spur breakouts. Cell phones, helmets, tight collars, backpacks, baseball caps and blankets placed on the face often cause acne mechanica. Changing sheets frequently keeps dirt and oils from building up.

Other acne irritants to avoid include:

  • Occlusive clothing and headgear
  • Cosmetics containing pore-clogging ingredients
  • Hair products – pomades, gels, mousses
  • Skin drying acne products like toners and astringents
  • Scrubbing or over-washing skin
  • Sweat and sports equipment
  • Sunscreens and cosmetics that cause clogged pores

Spot-testing products before full use can reveal irritants. Always apply a fresh pillowcase nightly and wash regularly.


Certain medications are linked to acne as a side effect. Because hormones are involved in acne, any medication impacting your hormone levels can cause breakouts.

Hormonal birth control like oral contraceptives and progesterone-only methods may lead to acne in some women. The mechanisms aren’t fully understood. Birth control pills containing androgenic progestins seem most problematic for acne-prone women.

Other medications associated with acne include:

  • Corticosteroids
  • Testosterone and anabolic steroids
  • Lithium
  • Phenytoin
  • Isoniazid
  • Halides
  • IV corticosteroids

If you suspect medications are causing your breakouts, talk to your doctor about switching prescriptions or altering the dose. Never stop taking prescription medications without medical supervision.

Breakout Culprits by Medication Type


  • Oral contraceptives
  • Hormone replacement therapy
  • Testosterone/steroids


  • Topical, oral and injected forms

Anti-seizure medications

  • Phenytoin
  • Phenobarbitol
  • Carbamazepine




  • Cyclosporine
  • Azathioprine

Bromides and iodides

IV corticosteroids


Acne is a complex skin condition with no single cause. Multiple factors like hormones, genetics, bacteria, inflammation and medications contribute to breakouts. By understanding what triggers your pimples, you can better prevent and treat acne.

Adopting acne-fighting habits like a healthy diet, gentle skin care and stress relief will also help reduce breakouts. If over-the-counter methods don’t improve your acne, see a dermatologist. Prescription retinoids, antibiotics, birth control and isotretinoin can target acne at its root causes for clear, glowing skin.