Acne on both sides of the cheeks may be caused by endocrine changes, inflammatory stimuli, follicle sebaceous gland duct keratinization abnormalities and other reasons. 1. Endocrine changes: androgen increase from puberty to middle age, endocrine disorders affect the balance of estrogen and androgen secretion, leading to exuberant secretion of sebum on the facial skin, and insufficient facial cleansing leads to pore clogging, resulting in acne on both sides of the cheeks. 2. Inflammatory stimulation: Propionibacterium acnes and other bacterial infections break down the sebaceous glands, forming some free triglycerides, fatty acids and other substances to block the follicular sebaceous glands, triggering inflammation and stimulation to form acne, resulting in acne on both sides of the cheeks. 3. Abnormal keratinization of follicular sebaceous gland ducts: causing sebaceous gland discharge obstruction, accumulation of sebaceous glands in the follicles to form closed pimples, appearing on both sides of the cheeks acne. There are many reasons for acne on both sides of the cheeks, you should consult a doctor in time, under the guidance of the doctor to carry out the correct treatment, and daily attention to avoid spicy and stimulating food, regular cleaning of the skin.