Acne is a frustrating and sometimes embarrassing skin disease that causes breakouts of pimples, zits, and cysts. Even though pimples disappear in time, untreated acne can leave scars that change how your skin looks for life.

When you have acne at any age, you may struggle to understand why and how it happened. If you’re among the many women and men over 20 who have acne, you may be extra perplexed.

At The Center for Dermatology Cosmetic & Laser Surgery in Mount Kisco, New York, our expert dermatologists diagnose and treat acne to reduce the appearance of an active breakout.

We also help you understand the reasons behind your acne so you can avoid or reduce the severity of the next breakout. 

What’s going on in your skin that causes pimples? Following are the main causes of acne.

Your hormones surge

You’re more likely to develop pimples during puberty, pregnancy, before your period, or when you’re going through menopause because those are times in which your hormones surge. In particular, increases in the hormone testosterone start the cascade that ends in a pimple.

When your body produces a lot of testosterone, your skin secretes more of a waxy, oily substance called sebum. Excessive sebum collects in your follicles (aka pores), the tubes where your hairs grow.

Your follicles clog

The excess sebum clogs your follicles, so they can’t easily shed old skin cells. Instead, the cells get clumped together in the sebum, along with other debris and dirt.

The clogs form comedones (i.e., whiteheads and blackheads). When you see a blackhead or whitehead, you’re looking at the end of a long plug of dead skin cells and waxy sebum. 

Your skin bacteria go wild

Bacteria live on your skin whether you have acne or not. The bacteria feed on sebum. Now that you’re excreting more sebum than ever, and much of it is clogged inside your follicles, the bacteria have a feast.

The feeding frenzy results in more bacteria. As the bacteria proliferate due to excess food, they cause inflammation in your clogged cells. Instead of a blackhead or whitehead, you now have an angry, red or pink, inflamed pimple.

Friction causes pimples too

Most cases of pimples result from hormonal surges, but hormones don’t account for all of them. Skin irritation and friction, combined with excess moisture, can cause a type of acne called acne mechanica. Common culprits for acne mechanica include:

  • Masks (i.e., “maskne”)
  • Sports equipment
  • Hats
  • Helmets
  • Bras
  • Collars

You can also develop acne mechanica in any area of your body that’s been stretched, rubbed, or exposed to pressure. You can even get it on your buttocks if you sit for long periods.

Other factors

The connection between diet and pimples isn’t as straightforward as it once seemed. 

Years ago, people believed the foods teenagers favored, such as french fries and chocolate, were causal. Then, the pendulum swung in the other direction, and researchers proclaimed that diet had no influence on acne.

These days, we may explore food sensitivities if we can find no other reason for your acne. Food sensitivities may cause inflammation that affects your pores and skin health too.

Another lifestyle-related cause of pimples may be stress. When your body is stressed, it’s likely inflamed; inflammation is key to developing pimples.

The severity of your acne may be influenced by your genes. You’re more likely to break out in pimples if one of your parents did too.

Finally, certain chemicals and medications increase the likelihood of a breakout. During your consultation, we take a complete medical history, including medications and supplements you take. 

We also explore whether your skin care products are clogging your pores or otherwise contributing to irritation that causes pimples.

Treatment depends on the cause

We have a myriad of treatments for pimples and acne, but our recommendations depend on the underlying cause. Most medications reduce breakouts by accomplishing one or more of the following:

  • Reducing sebum
  • Unclogging pores
  • Increasing skin cell turnover
  • Killing excess skin bacteria
  • Balancing hormones
  • Reducing inflammation
  • Improving skin health

We may recommend lifestyle changes such as minimizing stress and switching to a whole foods diet to subdue inflammation in your body. We also help you choose skin care products that are effective, safe, and gentle for your skin.

Discover what’s behind your pimples and how to treat them by contacting our knowledgeable team by phone or online form today. 

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