"Why me of all the people in this world?"

There have been numerous explanations cited as to why acne occurs in some people and not in others. Innumerable debates have taken place as to what is related and what is not related to the development of these eruptions. However, the actual and precise cause of acne still remains a mystery.

The process by which a pimple is formed is very intricate and occurs as described here:

"The pores (hair follicles) in our skin are closely associated with oil glands called 'sebaceous glands' which produce Sebum. Sebum is an oily substance that lubricates our hair and skin. When Sebum is being secreted, the dead skin cells are also being expelled from the lining of the pore at the same time. Sometimes, when too much Sebum is produced, it accumulates, thus clogging the pore. When the pore gets blocked, the Sebum or dead skin cells cannot leave the pore. This leads to swelling around the pore and the result is acne. At times, bacteria can also build up inside leading to the formation of pus."

1. Hormones – Acne is precipitated by Androgens, the male hormones that are present in both males as well as females. The oil surplus created by these hormones has been thought to be instrumental in clogging Hair Follicles. Hormonal changes occur with puberty, menstrual periods, pregnancy, use of birth control pills, menopause and each of these is a potential state for developing acne.

2. Genetics – Heredity plays a significant role in the development and persistence of acne.

3. Medications – Certain medications such as Steroids, Testosterone injections and pills, Danazol, Lithium, Dilentin, Marijuana, etc. can lead to severe outbreaks of acne in some individuals.

4. Stress – The changes induced by stress have been extensively studied over many decades and hormonal change is one of the chief results of stress which can lead to acne.

5. Bacteria - Propionibacterium acnes is a normal inhabitant of the skin and thrives on Sebum. People with acne have more of these bacteria as compared to people without acne.

6. Diet – This area largely remains grey due to a wide disparity in opinions of dermatologists as well as patients. There are two groups herein – one which believes diet has no role to play in acne and the other one which strongly believes in the role of diet.

The latter group holds that following types of foods worsen acne and may lead to outbreaks: Spicy foods, caffeine, excessive sweets, alcohol, chocolates, red meat, corn, gluten, etc.