Acne, also known as “pimples”, is a chronic inflammatory skin disease of the sebaceous glands of the hair follicles. Many patients often ask me questions like, “I’m so old, but I still have acne?” It is possible for both adolescents and post-adolescents to develop acne. Acne can grow on the face, forehead, back, chest, etc. It can be a pimple, a pustule, or just a bulging red bag that hurts when pressed. They are all medically known as “acne”. Acne is an inflammation caused by the clogging of the sebaceous glands of the hair follicles. What are the factors that cause acne? Microbial infections: The most common is Propionibacterium acnes, which promotes skin inflammation through a series of cellular pathways that aggravate the inflammatory response within keratin-forming cells. There is also a correlation between Staphylococcus epidermidis and Helicobacter pylori infections and the occurrence of acne. Genetics: Domestic and international studies have shown that acne is a polygenic genetic skin disease and is closely related to genetic factors. One study found that over the past 20 years, individuals with a family history of acne developed acne at a younger age and with more severe disease. But some people will come forward and say, “My parents never had acne (pimples) before, so why should I? When we talk about genetic inheritance, we mean that the patient carries a gene that predisposes them to acne, and the disease (acne) is a combination of genes and the environment. Since we live in a much different environment than our parents’ generation, for example, we now eat a much greasier diet, air pollution, etc., these factors, combined with susceptible genes, make it easier to grow acne! Obesity: I often advise obese patients with acne to lose weight, because when blood lipids are high, oil formation may also increase and so does secretion. There have been research findings that confirm a correlation between obesity and acne. Diet: Dietary factors have been one of the most important predisposing factors for the development of acne. Therefore, reducing the intake of carbohydrates and dairy products can help improve acne. Endocrine: Women’s menstruation is often a high time of acne breakouts for women because of hormonal disruptions. In addition, middle-aged women with acne and hirsutism should go to a gynecologist to check if they are suffering from polycystic ovary syndrome. Emotional disorders also often lead to endocrine disorders, hormonal imbalance, and acne. So, keep an optimistic attitude from time to time! Medications: Hormonal medications (such as prednisone) can treat acne or cause acne. High doses of steroids are anti-inflammatory, and among the side effects they bring are reactive acne. Smaller doses have an anti-androgenic effect. Cosmetics: Cosmetics have more oily substances in order to make them last longer. Improper use of cosmetics and incomplete removal of makeup can lead to clogging of the hair follicles, or too much time with makeup every day, and acne will naturally find its way to your door. Smoking: Many domestic and international studies have shown that smoking and acne are correlated. This may be related to the fact that smoking leads to high oil secretion in the skin, or it may be because smoke particles block the pores and lead to acne.