Skincare Tips

What Really Causes Acne? The 3 Main Culprits

If you suffer from acne, you’ve probably heard it all: It’s all that greasy food you eat! You’re too stressed! Your skin isn’t clean enough! Yup, there are a lot of theories out there about what’s really behind your breakouts, but a good deal of them are nothing more than fake news. Here, we’ll break down some of the most common misconceptions about acne and reveal the three real reasons you get pimples. Plus – we’ll teach you how to select the best acne treatment to get clearer, calmer skin.


The truth: Breakouts aren’t typically a hygiene problem. While washing your face a minimum of once a day is essential for healthy skin, you can’t scrub away your acne. Unfortunately, it’s just not that simple. In fact, over-washing your skin by cleansing too often or using harsh ingredients can dry it out and cause irritation, which then makes your oil glands go into overdrive. To compensate for all that dryness, your glands produce even more oil, which can cause more breakouts and make existing acne worse.


The truth: The oil from your French fries or greasy pizza doesn’t transfer onto your skin and cause pimples. The oil that causes breakouts comes from overactive sebaceous glands, not the foods you eat. Now there may be some link between diet and acne. There has been some limited research about foods with high glycemic index (think donuts, white bread, and other processed foods) as well as dairy contributing to breakouts, possibly by stimulating more pore-clogging oil. But more large-scale studies are needed before experts will confirm a definite link. One of Perricone MD’s pillars of good skin, the anti-inflammatory diet, is full of foods rich in omega 3’s like salmon, leafy greens, olive oil, nuts. It may be helpful in taming chronic inflammation, one of the known culprits of acne (read more about that below).


The truth: We know stress doesn’t do a body good, but for the most part, any link between stress and acne has been largely anecdotal. Stress alone doesn’t seem to cause a breakout; there needs to be other factors at play causing a zit to erupt. Keep reading to find out what those other factors are.


The causes of acne, even if you’re eating a poor diet and are stressed out to the max, still comes down to three main things: excess oil, acne-causing bacteria, and inflammation. It’s these factors combined together that create the perfect storm that is a pimple. Here’s an in-depth look at how each of these acne causes contribute to your breakouts:


We’re talking about sebum, the oily substance pumped out by your sebaceous glands. Some people just make more of it than others. If you have oily skin, you can probably thank your parents since it can be genetic. Some people experience an increase in sebum production when they experience a change or fluctuation in hormone levels—that’s one of the reasons teens get acne, why you may get a blemish along with your monthly cycle even as an adult, or see zits even when you’re post-menopausal. All that sebum can get trapped inside a pore, contributing to the formation of a pimple. Plus, sebum makes for a nice environment for pimple-causing bacteria to grow (see below). Many times, people try to combat oily skin with alcohol-based products, but those only dry out the skin, which as we mentioned earlier, can cause more sebum production (and acne) in the long run.


The bad bacteria that causes acne is called P.acnes (short for Propionibacterium acnes). It tends to grow on the inside of your pores and feeds off of the overproduction of sebum that’s also pooling in those same pores. You need sebum in order to have P.acnes. An overgrowth of P.acnes clogs the pores and triggers an inflammatory response, which brings us to the third component of acne.


When your pores are clogged with oil and bacteria, as well as dead skin cells and other debris,  an inflammatory response is set off within the pore in the form of swelling. This may bring white heads, blackheads, or red, angry cyst-like bumps to the surface.


We don’t have to tell you that there are a lot of options out there to treat acne. Drugstore shelves and department store counters are lined with acne treatments, and there are also prescription treatments such as topical Retin-a or Accutane, both drugs (with sometimes harsh side effects) that contain vitamin A. And while some of these treatments may do a good job at addressing oily skin, targeting acne-causing bacteria, or even (but rarely) reducing the appearance of redness, they don’t typically target all three factors.

That’s where Perricone MD Acne Relief Prebiotic Acne Therapy comes in. The simple, 2-step regimen (a cleanser for morning and evening followed by a hydrating lotion during the daytime and a retinol moisturizer for evening), effectively addresses the three root causes of acne at any age. Here’s how:


The Gentle & Soothing Cleanser helps reduce pore-clogging oil on skin’s surface without over-drying and triggering the production of more oil. It’s mild enough to be used day and night and includes moisture-replenishing ingredients such as glycerin, which also helps to calm and soothe cranky skin. The cleanser also contains two percent salicylic acid—enough to help slough off pore-clogging dead skin and absorb excess oil while you wash, without stripping skin. The formula is also infused with prebiotics, which encourage the good, acne-fighting bacteria and calms skin.


In the morning, the Calming Treatment & Hydrator will help soothe acne-prone skin without compromising skin’s moisture barrier (again, drying out your skin will only promote more oil production). It contains .5 percent of salicylic acid to help sop up excess oil, and also succinic and lactic acids—the combination of these non-drying acids can keep acne-causing bacteria at bay without destroying good bacteria, which we need to keep skin happy and balanced.

At night, there’s the Retinol Treatment & Moisturizer, which contains a gentle vitamin A-derivative to help encourage cell turnover and tame the overproduction of oil, which will make it harder for pores to clog and for that P.acnes bacteria to grow and cause acne. The PM treatment also contains .5 percent of salicylic acid. Both treatment products include Alpha-Lipoic acid, a potent antioxidant and anti-inflammatory, and prebiotics to help calm visible acne-induced inflammation and off-set any potential irritation from retinol.

Despite all the many theories out there, the causes of acne boil down to three main components: oil, bacteria, and inflammation. And the reason you have a drawer full of failed acne treatments may be because those products weren’t tackling all three culprits. The Perricone MD Acne Relief Prebiotic Acne Therapy line takes a unique, but effective, approach to clear, healthy skin.



Writer and expert