The power of heredity is not to be ignored. The development of acne is similarly not free from its constraints. Clinically, it is common to see siblings in the same family with the same acne growth. When one twin has acne, the other often has acne without exception, as if to confirm that they are family. These phenomena suggest that acne is so closely related to genetics. Studies have shown that identical twins have the same rate of sebum production, which provides an important pathogenetic basis for the possibility of acne. Clinical experience has also demonstrated that the degree of their onset can again be different, suggesting that many other factors are involved in the development of acne, but in any case, the genetic hand can be clearly seen in action behind the shadow of acne. We should pay sufficient attention to people with this genetic background.