Acne: The Real Causes and What Makes It Worse

Four interlocking factors

Acne forms when four things coincide: excess sebum, dead cells accumulating inside the pore, C. acnes bacteria, and inflammation. Treating only one of them is rarely enough.

What actually makes it worse

• Stress and poor sleep raise cortisol, and sebum production with it.
• Heavy products and highly comedogenic oils.
• Touching the face and picking at blemishes, which leaves lasting marks and scars.
• Over-cleansing, which strips the skin so it compensates with more oil.

When to see a doctor

If breakouts are cystic, painful, and under the skin, if they scar, or if three months of home care has not helped, the condition needs a prescription.