When you get acne, the quickest way to treat it is by finding out what caused it, and therein lies the problem—it isn’t always easy to tell. So today we’re breaking down the common causes of acne and sharing with you how to identify which one might be the cause of yours.

Quick Refresher:

Acne is a common skin condition that occurs when your skin experiences inflammation in the pilosebaceous unit (the part comprising your hair follicle, hair shaft, and sebaceous glands). It comes in various forms — whiteheads, blackheads, cystic pustules, and so on — that come from many different causes, and there are a variety of ways you can treat it. When you know what causes your acne, you won’t have to try every solution, just the right ones. 

Cause # 1: Dirty Surfaces

This could be your pillowcase, your blanket, your phone, your headphones, your glasses, or your hands. These things that physically touch your face can accumulate bacteria from a build-up of dirt and oil when they aren’t changed, laundered, or sanitized frequently.

This bacteria can irritate your skin, causing inflammation that could manifest into acne. If your acne appears in one spot on your face, like one cheek or the top of your nose or under your chin, then it may be caused by the bacteria from objects that have touched your face.

Note that bacteria-induced acne is very different from fungal acne and what works for the former will not immediately work for the latter. An appropriate dose of benzoyl peroxide cream, AHA, or salicylic acid can save your skin if it’s bacteria causing the acne — just remember to keep it hydrated and moisturised when you apply it to prevent further irritation.

Cause # 2: Physical Trauma

Dermatologists call acne provoked by physical trauma – such as pressure, friction, rubbing, squeezing, or stretching – ‘acne mechanica’. This could be induced by your clothes, like wearing straps or belts that are too tight or wearing heavy equipment in sports, like football shoulder pads or fencing masks.

Because the object holds and rubs sweat against your skin, it induces further sebum production. This can be fixed by letting your skin breathe with looser clothing, changing clothes after a workout, and/or washing your face after a good sweat. If your acne appears on your back or shoulders, try to recall and keep track of what you wear and how it fits you. You can also consider changing your detergent and see if anything changes.

Acne mechanica can also be induced by picking at your skin, in which case the solution is, of course, to stop. Dr. Zakhary recommends knowing your triggers and changing your environment to make it harder to pick, as well as considering therapy and consulting with your physician for possible medication. 

Cause # 3: Occupational Hazards

If your work exposes you to an excessive amount of oil, coal tar, cigarette smoke, toxic chemicals, or more than a healthy amount of sunlight, then consider that your acne might be the result of occupational hazards. Acne caused by occupational hazards can be as simple as comedonal acne (i.e. blackheads, whiteheads) or as complicated as cystic lesions. 

In such cases, dermatologists would normally prescribe topical anti-acne creams or oral antibiotics, depending on their assessment of your skin. Taking preventative measures and working in an environment with good conditions also go a long way in eliminating acne as an occupational hazard altogether. You don’t have to quit your job: simply being conscious of what your skin is exposed to in your occupation can help you figure out how to address it.

Cause # 4: Fungus

Otherwise known as malassezia folliculitis, fungal acne is caused by an overgrowth of fungi that is normally found in our microbiome. This overgrowth can be caused by internal factors such as previous medical conditions like diabetes or HIV, prolonged usage of antibiotics, and even cases such as obesity, pregnancy, or usage of birth control pills. Simple Skincare Science names a lot of the causes that increase fungus, so check it out if you have the inkling fungus overgrowth might be causing your acne.

Fungal overgrowth can also be induced by external aggravators, like sweat being occluded under hot and humid weather. If you sleep with your hair still wet, you may be risking yourself to fungal infections on the scalp and even the back of your neck. 

Fungal acne is often mistaken for bacterial acne. It isn’t trickier to treat per se, just more difficult to detect because it resembles normal acne so much that even dermatologists can misdiagnose you. A difference you might want to take note of is how it looks: if your acne appears as uniform red bumps and pustules instead of varying sizes, then it might be fungus-induced acne. 

In that case, it’s best to avoid fermented skincare (say goodbye to your K-beauty essences until your skin is cleared) and opt for a very minimal routine for a few days instead. Think low pH cleanser, a simple moisturiser (it can be as bare as simply using pure squalane oil), and sunscreen. To treat the acne itself, some studies have shown that simply leaving ketoconazole cream on the affected area for five minutes can be effective. Another treatment that works effectively is azelaic acid, which reduces the expression of TLR-2 expressions that lead to fungal acne.

Cause # 5: Hormone Fluctuations

Studies have shown how fluctuations or disruptions of particular hormones can cause acne. These fluctuations can be provoked by the natural changes in your body during puberty or adolescence, or by pre-existing conditions that affect the balance of your hormone levels.

Hormonal imbalances can also be induced by your lack of sleep or choice of diet. If you frequently consume foods with simple sugars (e.g. pasta, white rice) or binge on chocolate, for example, then it can raise the levels of the hormone insulin in your body. An excessive amount of insulin not only risks you to serious medical conditions like diabetes, but also prompts your oil glands to produce more sebum, thus increasing your risks to acne. 

Another extensively studied acne-inducing hormone includes androgen, high levels of which commonly  trigger acne. Recent findings reveal a greater prevalence of acne post-puberty, usually indicating underlying endocrine disorders such as polycystic ovary syndrome (PCOS), alopecia, and so on. To treat such cases, it’s best to consult properly with your dermatologist and obstetrician. Some contraceptives containing androgenic progestin may provoke acne, so make sure to properly consult with your doctor to find what could work for you.

Acne induced by hormonal fluctuations have a tendency to relapse if you do not treat it internally. A study found that a key difference between adolescent and adult acne among females is where it appears: adolescent acne tends to appear prominently on the forehead, t-zone, and chin, whereas adult acne typically appears on the jawline and around the mouth. If your acne keeps reappearing in the same places, ask your physician about testing your hormone levels and see if anything is amiss. 

While the topical products on the shelf can work on treating the zits that are already there, making healthier changes in your lifestyle and consulting with licensed medical professionals will make it less cumbersome to treat acne in the long run.

So, did we miss anything? We’ve just got one final note to remember: acne can be caused by a combination of these causes. You might have to experiment a little on what solution works, but it’s still best to narrow down your parameters so you don’t waste time, money, and emotional energy (battling acne is tough, we get it).

Minimize your routine, keep track of your lifestyle, and get a physical examination if you can, just to make sure — the faster you narrow down the cause, the sooner you can get to a solution that works.



TBN, delivered.

Pursue your own better normal. Sign up for our weekly newsletter to receive the latest in beauty, mental health, movement, culture, food, travel, and more!


You have Successfully Subscribed!