The causes of symmetrical acne on the face are complex and may be caused by a trigger or multiple triggers at the same time, while the main causes are endocrine disorders, hair follicle duct blockage and skin inflammation, which are now detailed in several common situations: 1. The sebaceous glands increase in size, and the sebaceous glands secrete excessive oil. The sebum provides the material basis for the growth of parasitic bacteria in the hair follicles, which can cause symmetrical acne on the face of patients, mostly in adolescents; 2. Skin inflammation: Patients’ immunity, overeating, lack of attention to personal hygiene, such as not regularly changing bed sheets and pillowcases, and often trying to touch the cheeks with both hands can provide favorable conditions for the growth and reproduction of Propionibacterium acnes in the hair follicles. Bacterial infection can cause skin inflammation, resulting in symmetrical acne growth on the patient’s face.