Cause and Symptoms of Acne: Inclusive and Beyond Biology

Treat the cause, not the symptoms” –Have you heard of this phrase?

I aspire to know the cause of the disease much as possible before beginning treatment. It makes me look at treatment more meaningfully and offers satisfaction. How about you?

Let’s find out the cause of Acne and the resulting symptoms.

This blog will be about

Symptoms of Acne

The Cause of Acne from a Biology Perspective

  • Is Acne Hereditary?
  • Hormonal Imbalance: The Leading Cause of Acne!
  • InflammationThe Recently Identified Cause of Acne
  • P. acnes- Identification of Acne Causing Gene!
  • Poor Digestion
  • Diet Considerations for Acne (Will be in Next Post)

Acne Genesis and Indian Ayurveda

Acne Beyond Biology

Bottom Line

Symptoms of Acne

You might have been through several treatments and medications with side effects and still suffering from acne flare-ups and breakouts. Or you are looking for simple prevention from this mind-penetrating and mentally depressing skin disease disfiguring the skin that is challenging your self-esteem deep inside. It is more of a teenage epidemic affecting the world and 50 million Americans.
Acne infected image of Chests of two men and face of a woman

Acne can show up anywhere in the body. But the more prone areas are

  • Face
  • Back
  • Shoulder
  • Neck
  • Chest

They are the areas where the location of oil-producing sebaceous glands is dense.

What is the difference between ordinary form and acne-prone skin?

In normal skin, the skin cells renew regularly in an orderly fashion removing dead cells from the skin. However, in the case of acne-prone skin, the dead cells get stuck inside the follicle, with excess oil on the skin clogging the pore. Bacteria meddle in and aggravate Acne. Depending on the severity of the infection, Acne can show up in different types outside/inside the skin, such as:

  • Whitehead
  • Blackhead
  • Small red tender bumps
  • Pimples, papules (pus at their tip)
  • Nodules (painful, solid lumps on the surface of the skin)

The Cause of Acne from a Biology Perspective

Is Acne Hereditary?

Does Acne Run in Your Family?

If both of your parents have Acne, you run a higher risk and have a good chance of getting it. But if that gene is recessive, you might not show it, but your kid might.

There are experiments. With twins and fraternity genes to determine the hereditary nature of Acne, the expert analysis of these results affirms it. So, yes, it can be hereditary.

Hormonal Imbalance: The Leading Cause of Acne!

Pathogenesis of Acne


Hormone imbalance during puberty (Acne vulgaris, hormonal Acne), menopause, and any other scenario can trigger Acne.

The acne pathogenesis diagram provides you, in a nutshell, the genesis of Acne. The leading cause of Acne is classically attributed to the hormone fluctuation around puberty- a hallmark of reproductive maturity during the human growth cycle. Puberty raises the sex hormone (androgen) level.

This elevation androgen level (sex hormone) initiates a cascade of events starting with stimulation of the sebaceous gland, which produces more excess oil than usual. Massive cell proliferation and heavy shedding of dead cells become muddy with the oil and clog the skin pore—the bacterial invasion of the clogged pore and proliferation results in inflammation and bleeding of a pimple.

This is the historical understanding of Acne.

InflammationThe Recently Identified Cause of Acne

New studies implicate the involvement of inflammations, the first step as the cause of acne development via free radicals (Journal of Clinical and Aesthetic Dermatology 9 (1) 2016, 25-30), and oxidative Stress. Free radical damage to the skin’s natural oil or sebum appears to set the inflammatory process. Dr. Whitney Bowe, MD, recommends adding many antioxidants to her acne-prone patients (ref: The beauty of Dirty Skin, 2018, p131.by Dr. Whitney Bowe).

P. acnes- Recent Identification of Acne Causing Gene!

An unbalanced microbiome on the Face May Be Key to Acne Development,” – writes Dermatologist Dr. Emma Bernard in a publication with her colleagues in Medical Xpress, April 6, 2017.

This above statement comes from a recent study with 72 people, 38 with Acne and 34 without.

In this comparative clinical study, a sample of the skin follicles (collected by OTC pore-cleansing strips) was collected from acne sufferers and was analyzed by DNA shut gun sequencing. People suffering from Acne were found to contain a higher level of genes of the P. acne strain than a group of people not having Acne.

In the clinical group suffering from Acne, associated genes relate to producing pro-inflammatory compounds such as bacterial toxins. They have the potential to cause harm to the skin.

In the latter group, the bacterial community was enriched with bacterial metabolism. This situation seems vital in preventing harmful bacteria from colonizing the skin.

This experiment was repeated with another ten individuals.

For the first time, this experiment shows an acceptable genetic difference between acne sufferers and individuals with no acne.

Poor Digestion

Poor digestion results in inadequate removal of toxins by the liver purge toxins to the bloodstream, which can result in Acne, says Dr. Nigma Talib in her book “Younger Skin Starts in the Gut.”

The gut bacteria can also affect Acne as the gut-brain-skin and produce a neuropeptide called substance P which affects sebum production that, in turn, is related to Acne.

Diet Considerations for Acne (Next Post)

There are compelling pieces of evidence from studies available that diet does play a role in Acne. The jury is still out. More studies are necessary to confirm.

Foods with low glycemic index, antioxidants, and fatty acids have attracted mainstream attraction as banishing blemishes.

Acne Genesis and Indian Ayurveda

Per Indian Ayurveda, excess Pitta in the gut can result in a breakout of Acne. It can create acute inflammation and indigestion in the body. Cleansing the body, particularly the liver and blood, by consuming herbs and diet will reduce Pitta. Here are some guidelines for diet and lifestyle to reduce Pitta.

  • What not to eat: Go low or eliminate Caffeine and alcohol. Limit your hot, spicy, oily, fermented, and fried food.
  • What to Eat: Eat plum, watermelon, Kale, and asparagus. Hydrate the body by drinking fresh and filtered cold water to remove toxins. Eat Amalaki, one component of Triphala, for good digestion. Use neem (https://www.banyanbotanicals.com/neem-tablets-10/), one of the most potent herbs that help reduce Pitta and eliminate toxins from blood naturally.

Adopt a Healthy Life Style

  • Exercise preferably in the morning and evening and avoid hot middays. Take a moon bath instead of a sunbath.
  • Relieve Stress by including appropriate Yoga in your life.

Talk to an Ayurveda Doctor for a recommendation before using any product, diet or if you are considering any lifestyle change.

Beyond Biology- External Sources and Acne Breakout

There are factors for acne breakout that can be held accountable beyond biology. Things might be creeping in without your knowledge, or you may have gotten used to it. Acne is not infectious. So there are no worries there.

Check if you are using oily makeup: Is that makeup clogging your pores and causing Acne? To alleviate this cause, use makeup that has been marked with non-comedogenic.

Be Diligent About On-Spot Treatment: If you are doing an on-spot treatment with the OTC treatment options like Benzoyl peroxide, Salicylic acid, or Sulphur, do not overdo it, nor use it too often. It can dry out your skin, and your body responds by producing more oil to keep you at bay. This excess oil can result in discolorations.

Choose Your Hair and Shower Products Carefully: Avoid products containing sulfates, silicone, and overly loaded with moisturizing agents. Clean your hair tilting your head so the water coming from hair cleansing does not tough touch your body. So you avoid clogging your pore.

There are multiple gentle products available that work well. Pick and choose for your skin or test them until you find one.

Exfoliate Your Skin Gently: You need not scrub your skin heavily to clean it up. Be patient and be soft on your skin. Heavy scrubbing depletes your natural skin oil. To balance this situation, your body produces additional oil. You know by now what excess fat does to you.

Bottom Line

Knowing the underlying cause helps you get educated about Acne. Clogged pore creates bumps on the skin’s surface, hiding your natural skin. The bacterial intervention of the clogged pore aggravates Acne into nasty pimples and nodules.

Hormonal drift, inflammation, genetics, and P. acnes can, independently or as a whole can, be responsible for blurring your face and elsewhere of your body.

Indian Ayurveda contemplates Pitta as the cause, and the elimination of toxins from the body will help prevent and cure Acne. Food indigestion and inadequate removal of toxins from blood and liver are related to Acne- Dr. Nigma Talib in her book “Younger Skin Starts in the Gut.”

Hormonal Acne starts around puberty between ages 10-13 and goes away around 20 years of age. Within this period, it can disappear and come back.

Consult your dermatologist if it persists.

Anusuya Choudhury


  1. Thank you very much for this great post, you must have put in a lot of energy in researching the causes and symptoms of Acne. I can’t agree less with that phrase that says “Treat the cause and not the symptoms”is there any way hormonal inbalance can be controlled? Thank you. 

    • Hey Clement,

      Thank you for taking the time to read the post. All I can say Vitamin-D is the controller of many hormones. If the Vitamin-D nutrient level in the body is right, you may see a happy hormone balance. That is my limited knowledge. Acne does not have one cause, we have to remember that as well.


  2. Well, in my quest to help my niece, who suffers terribly from acne, I learned a few new things.  I had never heard of Amalaki, which is a component of Triphala, nor had I ever heard of neem, but I’m always open to new things and learning.  I am a huge believer that everything in our bodies is related to what we eat.  I also believe stress definitely affects the body in bad ways and causes all kinds of disorders.

    You’ve given us lots of food for thought and some new things to try.  Thanks for a thoroughly researched article on the subject of acne.  So many people can benefit from this!

    • Hi Babsie,

      Thank you for taking the time to read the article and sharing your belief. I too am a great believer of what we eat have an impact on us. I also believe, stress has a profound effect on our body, mentally and physically.

      Thanks for your wishes. Anusuya

  3. I had terrible acne during high school and college, definitely from hormonal imbalances as I have a diagnosed adrenal disease that impacts my hormones. However, after I had my first child, my acne went away! It was amazing. When I got pregnant with my second child, I had some pregnancy acne, but since having him I seem to be a little more prone to it now again and it makes me sad. I typically get pimples under my bottom lip. Thank you for this article. It was helpful for me to learn more about acne since I’m struggling more with it lately. I think it’s likely hormonal again. I have an appointment with my endocrinologist soon so I’ll have labs run I’m sure. We will see.

    • Hi Holly,

      I am glad that you found this article helpful.

      Thank you for reading the article and sharing your information.

       I hope you will get some real help from your endocrinologist. Anusuya

  4. Hi Anusuya Choudhury,

    This is an excellent article with lot’s of specific information about the Cause of Acne from Biology Perspective. I believe this will help many people to understand this type of disease thoroughly. I have many relatives who are suffering this type of skin disease which is not permanently solved yet. It looks they are not aware of this skin disease reason and treatment. I am going to share it with them. Thanks for sharing this informative article.

    • Hi Mzakapon,

      Thank you for reading the article. Knowledge is the power and access to the right knowledge and information always help. 

      I hope the people you share with will be helped. Anusuya

  5. Hi,

    I have read the whole review about this information.This is really a necessary information about cause and symptoms of Acne.I learned to read your writing, why is the acne.This is really  very helpful information for us.I like this article very much.I believed most of the people will like this article.Thanka for sharing this informative article with us.

    • Hey Moinul,

      I am glad that you found this article informative. Thank you for taking the time to read. Anusuya

  6. This article is very informative. Personally, I have been struggling with acne from teenage years. Now I’m in my 30s and i’m still having flare ups from time to time. It’s like a roller coaster for me. Sometimes i’m Clear and then out of no where comes a flare, it’s so annoying. I have tried many products over the counter. They work initially, but after using them for some time, I have to change them. Lately, I have been trying to adjust my diet and excercise. I am not as discipline as I should be, so I’m yet to achieve the desired results.

    After reading this article, I’m definitely going to be implementing these suggestions. I think I tend to overuse the treatment and at times I experience excess drying and even peeling which looks so unattractive.

    I will be visiting your website for more information. I also think that finding out the cause of my acne would be helpful as well. I think it’s multiple causes for me though. 

    Where is the book by Dr Nigma Talib available? I would really like to ready it.

    Thanks for sharing.

    • Dear Brenda,

      I know how you feel with your breakouts. I hope it just disappears and never shows up again. 

      “Younger Skin Starts in the Gut” by Dr. Nigma Talib-I got it from Amazon. It is highly informative.

      I have been doing research on the problem. I can tell you,  there is no one size fits for all. Talk to your dermatologist for a diet change. Sometimes a particular diet works for someone and not for others.  I understand it is so easy to slip from a diet regimen.

      Vitamin-D deficiency has been attributed as a cause. So many of us around the world are suffering from this.  

      I will be publishing my next post on food. It seems to have a great bearing on acne. Choosing low GI, high fiber food and adding a lot of antioxidant help. Choosing the right ratio of omega-3: omega 6 is sometimes the key. 

      Thank you for taking the time to read and write your experience.

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