There are two main causes of acne:
1. Genetic/hereditary factors
Genes may contribute to acne, and genetics is often linked to the most severe form – nodulocystic acne. In many instances, the affected person has inherited the tendency for this more severe form of acne from one (or both) parents.
Unfortunately, this type of acne often starts at a younger age (before 10) and tends to persist for much longer into adulthood.
The affected person may use the correct skin products, follow the perfect diet, and not have any hormonal imbalances, and yet they still get this more severe form of acne. Fortunately, many parents who have themselves suffered from this form of acne will take their young teenagers to the doctor at the first hint of trouble.
2. Hormonal factors
All acne is hormonally linked. But, in most people there won’t actually be a hormonal problem as such. Most girls and young women will only get a flare of acne before their menstrual cycle. This is regarded as normal.
There are, however, a number of medical conditions (e.g. polycystic ovarian syndrome) that may cause a hormonal imbalance in women. As a result of this imbalance, the affected person produces too much of the male hormone testosterone. This will cause increased oiliness of the skin, blackheads and whiteheads, and a more severe form of acne.
In addition, these individuals often have more dark hair on their face, nipples and pubic area.
It’s important that hormonal imbalances like polycystic ovarian syndrome (PCOS) are diagnosed early and treated appropriately. If these conditions aren’t treated properly, it can lead to more severe acne, scarring and even infertility.
Reviewed by specialist dermatologist, Dr Ian Webster, MB ChB(UCT) FF DERM (SA), February 2018.