Why Do I Still Get Acne and What Can I Do About It?

Sep 12, 2022
Why Do I Still Get Acne and What Can I Do About It?
Acne is often one of the rites of passage in adolescence. However, if zits and blemishes persist well beyond your teenage years, it could be a sign of an underlying condition. Find out why acne persists and what can be done about it.

Have you ever wondered how and why acne appears on your skin? For breakouts to appear, three conditions must be fulfilled: slower shedding of dead skin cells, increased sebum production, and the presence of the P. Acnes bacteria. 

You’re constantly shedding new dead skin cells through tiny openings in your skin called pores. These pores are connected to an oil gland found deep in your skin through a follicle. 

If the process of shedding dead skin cells is slowed down, the pore becomes clogged. The oil glands continue to produce sebum, creating a mix of dead skin and oil that forms a bump under the skin.

If the P. Acnes bacteria is around, the combination of dead skin cells and sebum attracts the bacteria, and this triggers an immune reaction that causes redness and inflammation. Often, acne treatments target either sebum production, skin cell shedding, or inflammation. 

If you’ve always dreamed of having a clearer complexion, read on. Below, we asked Dr. Andrea Volk, our expert at SafiraMD Medical Aesthetics and Wellness Center in Alpharetta, Georgia, to explain the causes of acne and the treatments that work against it. 

Acne causes 

In westernized societies, acne is the most common skin condition, while in traditional societies, acne is almost non-existent.

Pollution, diet, and exposure to endocrine disruptors found in food and water are all potential triggers for frequent breakouts. In the last 30 years, the incidence of acne increased by 50% worldwide. While researchers aren’t sure what causes acne, there are a few conditions and medications that are known triggers for breakouts. 

Hormone imbalances 

Hormone imbalances, namely excess androgens, can overstimulate the production of sebum, causing your pores to clog. 

In women, polycystic ovarian syndrome (PCOS) is one of the most common causes of acne. PCOS is a syndrome fueled by insulin resistance, which in turn causes the body to overproduce male hormones. 

In men, hormone fluctuations can cause breakouts as well, as androgens stimulate the oil glands. 

However, it’s often the combination of increased male hormones and inflammation that causes acne. Having more testosterone doesn’t always mean you’ll get acne. 


Medications that could be contributing to your breakouts include steroids, antidepressants, anticonvulsants, and B vitamins. 


Stress can’t cause acne on its own, but it can worsen your acne if you’re already predisposed to having pimples and blemishes. 

This may be due to cortisol, the body’s primary stress hormone. When cortisol increases, so does insulin, which causes more inflammation in the skin. 

Treating acne

Acne often has an internal cause, and the first line of treatments should focus on either treating inflammation due to an unhealthy lifestyle or balancing hormones. 

However, treating the cause of acne from the inside out takes time. In addition, treatments that fix the underlying issue alone won't help with acne scarring, pigmentation, and other problems caused by acne. 

A shortcut to clearer skin is treatments that focus on speeding up the healing of the skin and unclogging the pores.

If you’d like to improve the appearance of your skin, contact us to schedule an appointment. Dr. Volk offers chemical peels, laser treatments, and microneedling for the treatment of acne and acne-related concerns.