Acne is one of the most common skin concerns seen in dermatology, affecting people of all ages and skin types. While it is often associated with adolescence, acne can persist into adulthood or appear for the first time later in life. Breakouts can be frustrating, uncomfortable, embarrassing, and sometimes painful. Understanding what acne is and why it develops is the first step toward achieving clearer, healthier skin. Our team at Beacon Dermatology helps patients identify the underlying causes of acne and creates personalized treatment plans that address both active breakouts and long-term skin health.

What is acne?

Acne forms when hair follicles become clogged with oil, dead skin cells, and bacteria. The skin naturally produces oil to keep it soft and protected, but when oil production increases or the shedding of dead skin slows down, pores can become blocked. Once a pore becomes clogged, inflammation can develop, leading to visible bumps on the skin. While acne most commonly appears on the face, it can also affect the chest, back, shoulders, and neck, where oil glands are more abundant and prone to buildup.

What are the types of acne?

There are several types of acne, and many people experience more than one type at the same time. Comedonal acne includes blackheads and whiteheads, which form when pores become blocked with oil and debris. Blackheads remain open to the surface of the skin and appear dark due to oxidation, while whiteheads remain closed beneath a thin layer of skin. These forms of acne are often less inflamed but can still cause congestion and uneven skin texture.

Inflammatory acne includes papules, pustules, nodules, and cysts. Papules are small, tender red bumps, while pustules contain a visible white or yellow center. These lesions develop when bacteria and inflammation are involved. Nodules and cysts are deeper, more severe forms of acne that develop beneath the skin’s surface. They can be painful and often require medical treatment to help prevent permanent scarring. Cystic acne in particular may leave lasting scars if left untreated, which is why early evaluation by a dermatologist is important.

What causes acne?

Acne has many causes, and most cases result from a combination of internal and external factors. Hormones play a major role by increasing oil production and sensitivity within the skin. This is why acne often begins during puberty and may flare during menstrual cycles, pregnancy, or hormonal changes, including perimenopause. Genetics also influence how much oil the skin produces, how quickly pores become clogged, and how strongly the skin responds with inflammation, which is why acne often runs in families.

Bacteria naturally live on everyone’s skin, but when pores become blocked, these bacteria can multiply and trigger inflammation. This may lead to red, tender bumps or deeper cystic breakouts. Stress does not directly cause acne, but it can worsen breakouts by increasing hormone levels that influence oil production. Certain skincare or hair products may also contribute to clogged pores, especially products that are heavy, oily, or not labeled non-comedogenic. Environmental factors such as heat, humidity, and sweating can create conditions that make acne more likely to develop or worsen.

Diet may also play a role for some individuals, particularly foods that create rapid changes in blood sugar or contain high levels of dairy. However, every person’s skin responds differently, and identifying triggers often requires a personalized approach. Medications, friction from helmets or straps, and frequent touching of the face may also contribute to breakouts. Because the causes of acne vary from person to person, a one-size-fits-all approach rarely works. Dermatologic evaluation helps identify contributing factors and guide appropriate treatment.

Who is at risk for acne?

Acne can affect anyone, and while it is extremely common in teenagers, adults make up a large portion of patients seeking treatment today. Adult acne may affect individuals in their 20s, 30s, 40s, and beyond. Hormonal fluctuations, stress, and genetics are leading contributors to adult acne, although skincare habits and lifestyle factors may also play a role. Men and women often experience acne differently. Women frequently develop cyclical breakouts related to hormonal changes, while men may experience more persistent acne associated with increased oil production.

Acne can also affect emotional well-being. Even mild breakouts may impact confidence, social interactions, and overall quality of life. More severe acne may lead to permanent scarring, creating long-term cosmetic concerns. Early and consistent treatment can significantly reduce the risk of scarring while helping restore clearer, smoother skin over time.

If you are struggling with acne, schedule a medical dermatology appointment at Beacon Dermatology today. From diagnosis to treatment, our team can help reduce acne and restore healthier-looking skin. Beacon Dermatology is located in Asheville and serves patients from Arden, Black Mountain, and Hendersonville.