Is acne genetic?

What does family history tell you?

A parent or another close blood relative who had deep, painful pimples increases your risk of that type of acne. Severe acne that left relatives with scars is especially relevant, but family history cannot predict exactly how severe your acne will be. Tell your clinician about it, particularly if you are developing deep bumps yourself. Having no family history does not rule acne out.3

Genes are only part of what causes acne

Acne develops when hair follicles become clogged. Oil and dead skin cells collect inside the pore, and bacteria and inflammation contribute to pimples. Differences in the body's built in immune response help explain why acne is more severe in some people. Genetic, hormonal and lifestyle factors likely work together rather than acting as separate causes.1245

During puberty, hormones called androgens make oil glands enlarge and produce more oil. Acne can also occur when hormone levels are normal because the glands are particularly sensitive to them. Pregnancy and certain medicines can contribute, too. Acne is most common in teenagers, but it can continue into adulthood or start there for the first time.1235

What can you change?

Stress can worsen existing acne, but it does not cause acne by itself. Oily skincare and hair products, pressure from helmets or tight clothing, and hard scrubbing can also make breakouts worse. Food plays a less settled role: some foods appear to worsen acne in some people, but there is not enough evidence to recommend a specific diet as treatment.123

• Wash gently with a mild cleanser and lukewarm water in the morning, before bed and after sweating. Use your fingers rather than scrubbing with a cloth or sponge.
• Choose noncomedogenic products, meaning formulas designed not to clog pores; the skincare aisle is not a genetics department.
• Use an oil free moisturizer if your skin feels dry.
• Remove makeup before bed; its working day does not need overtime.
• Avoid picking or squeezing pimples, which can cause scarring, infection and slower healing.

Can treatment work if acne runs in your family?

Yes. Acne can be treated successfully even when family history increases your risk. Treatments can prevent new spots and reduce scarring, although there is no permanent cure. For milder acne, a pharmacist can help you choose an acne treatment such as benzoyl peroxide or azelaic acid. Apply topical treatments to the affected area, not just individual spots, and follow the product's directions. Frequency depends on the treatment.23

Improvement can take 6 to 8 weeks, with full effects often taking 2 to 4 months. Topical treatments can irritate skin, so gradual introduction can help. Reduce frequency if irritation develops and seek advice if it continues. If you are pregnant or planning pregnancy, discuss medicine choices with your clinician; isotretinoin must not be taken during pregnancy.27

Is cystic acne genetic?

Family history is a risk factor for cystic acne, too. Cysts are painful, pus filled bumps deep under the skin; nodules are deep bumps that are more solid. Both can scar. See a dermatologist for suspected cystic acne rather than relying on shop bought products. Clearing cysts can take three months or longer.6

Seek medical help if acne is worsening, leaving scars, causing emotional distress, or not improving after several months of treatment. Sudden worsening also deserves a discussion, especially if you take medicines that could contribute.27