Hard acne on both sides of the cheeks can be caused by dietary factors, endocrine disorders and infections. 1. Dietary factors: if you often eat spicy and stimulating and too greasy food, it is easy to lead to sebaceous glands secretion, the skin will be too much oil, which may induce acne, so that hard pimples on both sides of the cheeks. 2. Endocrine disorders: If you often stay up late or are too nervous and anxious, which leads to endocrine disorders, androgen secretion increases, it is easy for sebaceous glands to secrete vigorously, blocking the pores, which leads to hard pimples on both sides of the cheeks. 3. Infection: hard pimples on both sides of the cheeks may also be related to infection factors, such as Propionibacterium acnes infection, making the hair follicles and sebaceous glands acute inflammation, which will be manifested as hard pimples on both sides of the cheeks. Hard pimples on both sides of the cheeks can also be caused by other factors, it is recommended to consult a doctor to clarify the cause of the disease, and actively follow the doctor’s instructions for treatment.