7th June 2025

Cause

Acne is a multifactorial disease with the following primary pathogenic factors:

• Increased sebum production stimulated by androgens, within sebaceous follicles
• Follicular hyperkeratinisation leading to follicular plugs (comedones)
• Proliferation of Cutibacterium acnes within sebum in hair follicles
• Release of inflammatory cells and mediators leading to development of papules, pustules, nodules and cysts.

Other factors that could contribute to acne pathogenesis include:

• Genetic factors (high prevalence among identical twins)
• High glycaemic index diets, dairy and meat products high in leucine 
• Hormonal factors (menstrual period related, hyperandrogenism, polycystic ovarian syndrome) 
• Mechanical trauma
• Cosmetics
• Topical corticosteroids 
• Oral medications (corticosteroids, lithium, iodides, antiepileptic medications)