Understanding the Causes of Acne: What We’ve Learned


We have laid out three common causes of acne (hormones, air pollution, digestion) and how your body uses the skin to rid the impurities from your body. Of course, there are a lot of potential causes of acne and the more we learn, the more questions we have.

After this investigative blog series, it remains complicated and it can still feel overwhelming to try to figure out what could be plaguing your skin. What we have found is that some of these themes we see with acne are reoccurring, which is a good place to start.

Acne: The Basics

It’s important to remember that the skin is an elimination system and that when it’s erupting, it’s pushing out impurities that would otherwise be swimming around your body, potentially wreaking havoc on you in other ways. I know it’s difficult to wake up and say, “Thank you, skin, for breaking out and pushing out those impurities,” but it’s actually performing its job exactly the way nature made it—so trust that it is doing the right thing for your health.

If you’re dealing with consistent acne, or even periodic acne, it’s good to start thinking about it as a cause and effect issue. There is a reason for its appearance and the best way to quell the acne pestilence is to work with your body to figure out what could be causing it, and then figuring out how to mitigate that issue.

Internal and External Causes of Acne

Blood is our internal transportation system. It’s the same blood that is oxygenated by the lungs, pumped by the heart, and filtered by the liver. Our blood carries hormones and nutrients to every part of our body, including the skin, and it picks up impurities and extra gunk while it’s circulating.

Sometimes there just isn’t anywhere else for the impurities to go, and since the skin is an elimination system and is the last organ to receive nutrients, the blood deposits extra impurities into the skin cells. They are then carried out with those cells and look like acne on the outside.

Whether you have extra hormones, toxic heavy metals from air pollution, extra lipids or other particles in your bloodstream that aren’t supposed to be there, the skin is a good place for your brilliant bloodstream to deliver them so that they aren’t floating around causing other problems.

External causes of acne are just as numerous. Things like smog, dirt, oil, sweat, chemicals, skin care products, dirty pillow cases, cell phones or any other environment that might cause bacteria to grow on your skin can all cause breakouts.

Some Other Common Acne Causes

This list is going to be similar to a lot of articles that you’ll find around the internet, but you can apply some of the principles we learned in the first 3 parts of this series to help you understand why these things can cause acne. You can also check out face mapping for breakouts to learn what your blemishes are trying to tell you.

Smoking–This goes along with air pollution and how that affects our lungs and puts toxic chemicals into our bloodstream. The smoke or secondhand smoke that you encounter can also settle on your skin and cause your breakouts.

Food Allergies–Everyone has a unique set of allergies, and it’s important to know what you may be sensitive to. Some of the most prevalent dietary causes of acne are hormones in dairy products, estrogenic-mimicking in high amounts of processed soy products, and the proteins in wheat products. It’s common that our bodies aren’t able to break down these sorts of nutrients and hormones, so it pushes them out through the skin. The best way to watch for this is to create a food and acne diary. Write down all of your food intake, what your skin is doing, and how you feel, then search your data for patterns.

Oil Balance—Most people think of oily skin when they think of acne but actually, if you’re over-producing or under-producing sebum you could be at risk for developing breakouts.

Overproduction of sebum from the follicle can cause congestion in your skin, both by itself and by holding bacteria in the follicle. Underproduction of sebum can allow dirt and grime to get into the follicle and get trapped in the cells, which will cause blackheads and breakouts.

Dehydration—Water and oil work together to keep the skin safe from bacteria. If your skin is dehydrated (most of us actually suffer from dehydration to some level) then the cells are unable to absorb the nutrients or protective oils.

Additionally, dehydration can have the effect of increasing impurities within the body. Our bodies use water in countless ways to break down impurities, mitigate and eliminate them. When we’re not getting enough water into our bodies, we run the risk of increasing the acne just because we don’t have any other means to get toxins out.

Liver Stagnation—We covered this more in depth in the article about digestion, but I’m listing it here again because it’s important to know that there are all sorts of toxins, nutrients, and hormones in the body that can cause acne when the liver is processing slowly or being overworked. If you’re drinking alcohol, eating high amounts of bad fats or processed foods, spending time in polluted areas, or letting your stressors get the better of you, you’re taxing your liver. Drinking water with lemon and eating a whole lot of green veggies can make all the difference.

Negative Emotions—Our emotional state directly affects our body chemistry. If you’re harboring long-term sadness, guilt, or anger and you’re finding that it’s affecting your personal life, it might be showing up on your face, too.

The science behind it is complicated but it has a pretty simple explanation. Your hypothalamus is sort of like a party planner. It knows when all the parties are, what everyone is bringing, and who will be there, and its job is to make sure that everyone has the information they need to make the party a success. If a planner were to feel sad, stressed or angry, he or she might not relay messages very clearly, or may tell you something twice and forget to tell someone else entirely, right?

It’s the same thing in your brain. When you’re feeling negative, the emotion can sort of override the typical function of the hypothalamus, sending messages around that disrupt the hormonal balance in the bloodstream—which can cause breakouts. Self-affirmations, a de-stressing ritual, and taking time for self-nurturing are all really great ways to deal with acne that could be caused by negativity.

Understanding The Causes of Acne: What We've Learned

Acne is a difficult beast to conquer. Often times, the skin is more of a map for internal strife rather than an individual organ malfunctioning. It’s important to notice patterns in your skin and take notes as often as you can. If you’re at a loss for what could be going on, see a holistic doctor who can help point you in the right direction.

It can take a while to find the reasons for your breakouts and then to incorporate changes into your daily routine. Cutting down on the ice cream and reducing stress at the same time may seem impossible right now, but you can do it. For those who deal with breakouts from uncontrollable environmental issues like smog or heavy metals, it can be a little bit more difficult to work through. The best thing you can do is take care of your skin and your body, and they will take care of you.

Understanding Acne: The Series

Acne is really complicated. This is the last part in our four part series, here's where you can read more:

Click Here to Read Part 1: Hormones
Click Here to Read Part 2: Pollution
Click Here to Read Part 3: Digestion

Have more suggestions on causes of acne? Let us know in the comments. We love to investigate!

comments (10 and counting)


Reader Interactions


  1. Lucy says

    What an incredible 4 part article! Thank you for all this information, I’ve been scouring the internet for a while and luckily ended up here!
    I am a beauty therapist and have always wanted to know WHY for so many things. One less thing to wonder now!

  2. aditya says

    I am a teenager 16 year old since last three year I’m suffering from black scars of pimple and now from acne plz plz plz plz tell me how to treat it I tried so many things..

    • Annmarie Skin Care says

      Hi Aditya,

      Thanks for writing in. It sounds like you’ve been working with oily skin for a while. Clogged pores are very complicated and can be caused by a lot of different things including your diet, stress level, hormonal shifts, the environment that you live in, the products that you’re using, and a lot of other things. I would suggest working to find the cause and working with your skin the way that it needs. Start by looking at the kind of clogged pores you have. Then try to notice a pattern of when they show up and when they’re subsiding. Hopefully from there and maybe with a bit of extra research, you’ll have a good idea of where to start.

  3. Melanie says

    What is a natural sun screen that doesn’t cause acne and is a product you’d want to put on your face? Most of the ‘natural’ sun screens have been heavily influenced by zinc oxide and it feels weird and my face becomes white from it.

    • Annmarie Skin Care says

      Hi Melanie,

      Natural sun protection is what is considered physical protection so it is thick because it’s physically blocking the harmful UVA and UVB sun rays. That means you probably won’t be able to get away from the way it feels.
      However, our Sun Love is slightly tinted so that it won’t completely white-out your face.

  4. Mel says

    Hi Maria,

    The oils have begun the proper hydration of your skin on the surface.

    The industry wants you to think you have large pores but I call it pore scarring. It is collagen damage from years of clogged pores from most likely past chemical filled products ( petroleum, silicones, liquid plastic, etc). I am a skin expert and organic esthetician and skin care educator of many years. Without PROPER ingredients and steps your skin is unable to correct itself as you have probably noticed.

    I recommend against mud and scrubbing with your particular skin condition. These will further the inflammation response. I can explain why if you or anyone is interested.

  5. Maria Smith says

    Thanks so much for this.

    One of the issues I started having when switching to Essential Oil based skin care, is that my nose and cheeks (which have developed larger pores as I’ve aged – I’m 50 now), tend to hold the oils and create blackheads in the pores. I dislike the look of my nose very much when this happens…and it happens so much that every other day I try to removed the accumulation in the pores…which is probably causing a vicious cycle since my pores look more inflamed.

    Do you have something in your skin care line that will dissolve these oils in the pores more naturally. Again, it’s been happening more often with the use of the essential oil skin care lines.

    Thanks so much!

  6. Erin says

    One thing I’ve been dealing with is Lyme disease plus bartonella and babesia coinfections. Lyme likes to attack collagen, and bartonella can cause some really nasty skin issues. I get large blood & pus filled ‘pimples’ on my face and neck that are caused by bartonella. When I started treatment, my cheeks were full of them. Now they’ve mostly gone away on my face. Just have some on my neck and jawline now.

    Babesia specifically can cause issues with the liver. Its a blood parasite. The other infections can cause liver issues too, but more so with detoxing from die off in my experience.

    • Amanda says

      Thank you for sharing this comment! Lyme disease can make everything more difficult, including skin care.

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