Key Points

• Acne develops when hair follicles become clogged with oil, dead skin cells, and bacteria. 
• Hormones, stress, diet, skincare products, and genetics all play a role in how often and how severely you break out. 
• Acne is not just a teenage problem -- adult acne is extremely common, particularly in women. 
• Over-the-counter products work for mild acne, but moderate to severe acne almost always needs professional treatment. 
• Legacy Dermatology in Algonquin, IL offers personalized acne treatment plans for teens and adults of all skin types. 

If you feel like you are doing everything right and still breaking out constantly, you are not imagining it -- and you are definitely not alone. Acne is one of the most common skin conditions in the United States, affecting up to 50 million Americans every year. It shows up in teenagers, adults in their 30s and 40s, and sometimes even older. And for a lot of people, no matter how many cleansers, toners, or spot treatments they try, the breakouts keep coming back. 

The reason most at-home attempts fall short is that they treat the surface without addressing what is actually driving the acne underneath. Once you understand what is really going on beneath your skin, you can start making decisions that actually move the needle. 

Here is a straightforward breakdown of what causes acne, what makes it worse, and what you can do about it -- including when it is time to stop doing it alone and bring in a professional. 

What Actually Causes Acne?

Acne starts inside the hair follicle. Every pore on your skin is connected to a follicle that contains a sebaceous gland. That gland produces sebum, an oily substance that helps keep your skin moisturized. When everything is working normally, sebum travels up through the follicle and out to the surface of your skin. 

The problem starts when that process gets disrupted. When excess oil, dead skin cells, or bacteria build up inside the follicle, it becomes clogged. That clog can turn into a blackhead, a whitehead, a pimple, a cyst, or a nodule depending on how deep the blockage is and how much inflammation is involved. 

There are a few key drivers that make this more likely to happen. 

Excess Oil Production 

Some people naturally produce more sebum than others, and excess oil is one of the primary ingredients in an acne breakout. Oil production is largely driven by hormones, which is why acne tends to peak during puberty, pregnancy, and other times of significant hormonal change. 

Clogged Pores 

Dead skin cells are supposed to shed naturally, but when they do not shed properly they mix with oil inside the follicle and create a blockage. This is the starting point for almost every type of acne lesion. Treatments like chemical peels work specifically by accelerating cell turnover and clearing out that buildup before it has a chance to cause problems. 

Bacteria 

A specific type of bacteria called Cutibacterium acnes lives naturally on the skin. In normal amounts it is harmless, but when it gets trapped inside a clogged follicle it multiplies rapidly and triggers an inflammatory response -- which is what causes the redness, swelling, and pain associated with inflamed pimples. 

Inflammation 

Inflammation is what separates a simple blackhead from a painful, swollen cyst. When the immune system responds to bacteria inside a clogged follicle, the surrounding tissue becomes inflamed. The more inflammation involved, the more severe the breakout -- and the higher the risk of scarring. Untreated inflammatory acne is also one of the leading causes of hyperpigmented spots, which are the dark marks left behind after a breakout clears. 

What Makes Acne Worse?

Understanding the root cause is one thing. Understanding what is actively making your acne worse is another -- and this is often where people find the most actionable answers. 

Hormonal Fluctuations 

Hormones are the number one driver of acne for most people. Androgens, a group of hormones that includes testosterone, stimulate the sebaceous glands to produce more oil. During puberty, androgen levels spike -- which is why teenage acne is so common. But hormonal acne does not stop at 18. 

Adult hormonal acne is particularly common in women and tends to flare around the menstrual cycle, during pregnancy, postpartum, and around menopause. It typically shows up along the jawline, chin, and lower cheeks. If this pattern sounds familiar, it is worth mentioning to Dr. Bradley at your appointment so a hormonal treatment approach can be considered. Learn more about the practice and Dr. Bradley's background on the about us page. 

Stress 

When you are stressed, your body produces cortisol, which signals the sebaceous glands to ramp up oil production. This is why a big exam, a work deadline, or a difficult personal situation often results in a wave of new breakouts. Stress does not cause acne on its own, but it is a reliable amplifier for people who are already prone to it. 

Certain Skincare and Makeup Products 

This one catches a lot of people off guard. Some moisturizers, foundations, sunscreens, and hair products contain ingredients that are comedogenic -- meaning they clog pores. Even products marketed as good for acne-prone skin can contain problematic ingredients for certain skin types. 

Look for products labeled non-comedogenic and fragrance-free. If you started using a new product and noticed more breakouts shortly after, that product is worth eliminating. It is also worth noting that conditions like rosacea can sometimes be mistaken for acne, particularly on the face -- another reason a professional evaluation matters when breakouts are persistent and do not respond to standard acne products. 

Diet 

The relationship between diet and acne is more established than it used to be. Research increasingly links high-glycemic foods -- think white bread, sugary drinks, chips, and processed snacks -- with increased acne severity. Dairy, particularly skim milk, has also been associated with breakouts in some people, though the connection varies significantly from person to person. 

Keeping a food diary and noting when breakouts occur can help you identify whether diet is a factor for your skin specifically. 

Touching Your Face and Picking at Breakouts 

Every time you touch your face, you transfer bacteria and oil from your hands to your skin. Picking at or popping pimples forces bacteria deeper into the skin, worsens inflammation, and significantly increases the risk of permanent acne scarring. It is one of the hardest habits to break and one of the most damaging things you can do to acne-prone skin. 

Certain Medications 

Some prescription medications, including certain corticosteroids, lithium, and some hormonal contraceptives, can trigger or worsen acne as a side effect. If your breakouts started or got significantly worse after beginning a new medication, that is worth discussing with both your prescribing doctor and your dermatologist. 

Types of Acne: What Are You Actually Dealing With?

Not all acne is the same, and the type you have influences which treatments will work best. 

Non-inflammatory acne includes blackheads and whiteheads. These are clogged pores without significant inflammation. They tend to respond reasonably well to consistent topical treatments and professional options like chemical peels. 

Inflammatory acne includes papules (small, red, tender bumps) and pustules (pimples with a visible white or yellow center). These involve bacterial activity and immune response and usually need more targeted treatment. 

Severe acne includes nodules and cysts -- large, painful, deep lesions that develop when inflammation spreads beneath the skin. Cystic acne is the most likely type to cause permanent scarring and almost always requires professional treatment. For deep, painful cysts, intralesional injections are one effective in-office option that can dramatically reduce swelling and pain quickly. 

What Can You Do About It?

For Mild Acne 

If you are dealing with occasional blackheads, whiteheads, or a few small pimples, a consistent at-home routine can make a real difference. Key ingredients to look for include salicylic acid, which helps unclog pores, benzoyl peroxide, which kills acne-causing bacteria, and adapalene, an over-the-counter retinoid that promotes healthy cell turnover. 

Consistency matters more than the specific product. Give any new routine at least six to eight weeks before evaluating whether it is working. 

For Moderate to Severe Acne 

If your acne is painful, widespread, cystic, or leaving marks behind, over-the-counter products are unlikely to be enough. This is where a dermatologist becomes essential. Prescription-strength treatments are significantly more effective for moderate to severe acne than anything available without a prescription. 

The sooner you seek professional help for serious acne, the lower your risk of permanent scarring. Treatments like microneedling, the Aerolase laser, and chemical peels are all available at Legacy Dermatology and can be highly effective for both active acne and the marks it leaves behind. Early intervention is one of the smartest investments you can make for your skin. 

When to See a Dermatologist for Acne

You should book an appointment with a board-certified dermatologist if: 

• Your acne is painful, cystic, or nodular 
• You have been dealing with breakouts for more than a few months without improvement 
• Over-the-counter products have not made a meaningful difference after six to eight weeks 
• Your acne is leaving acne scars or dark marks behind 
• Breakouts are affecting your confidence or mental health 
• You have adult acne that does not respond to typical skincare 

At Legacy Dermatology, Dr. Bradley offers personalized acne treatment plans built around your skin type, your acne type, and your lifestyle. Whether you need prescription topicals, oral medication, or a combination approach, the practice has the tools and expertise to help. You can also schedule a routine skin check at the same time to make sure everything else on your skin is looking healthy. 

New patients are always welcome -- visit the new patients page to get started or explore the full range of dermatology services available at Legacy Dermatology. 

FAQs About Acne Causes and Treatment

Does washing your face more often help with acne? Not necessarily. Over-washing can strip the skin of its natural oils, which triggers the sebaceous glands to produce even more oil in response. Washing twice a day with a gentle, non-comedogenic cleanser is generally the right approach. 

Can adults get acne even if they never had it as a teenager? Yes. Adult-onset acne is more common than most people realize, particularly in women. Hormonal shifts, stress, new medications, and changes in skincare products can all trigger acne in adults who had clear skin for years. 

Does sunscreen cause acne? Some sunscreens can clog pores, but many are formulated specifically for acne-prone skin. Look for sunscreens labeled non-comedogenic, oil-free, or designed for acne-prone skin. Daily SPF is still important even if you have acne -- sun exposure can worsen hyperpigmented spots left behind by breakouts significantly. 

How long does it take for acne treatments to work? Most topical treatments take six to eight weeks to show meaningful results. Prescription treatments may work faster or more dramatically depending on the type. Patience and consistency are essential -- switching products too frequently is one of the most common reasons acne does not improve. 

Is acne genetic? There is a significant genetic component to acne. If your parents dealt with moderate to severe acne, you are more likely to as well. That does not mean it cannot be treated effectively, but it does mean your skin may need more than basic over-the-counter care. 

FAQs About Legacy Dermatology 

Does Legacy Dermatology treat acne in both teens and adults? Yes. Dr. Bradley treats acne across all age groups and skin types, including adult hormonal acne and acne in patients with skin of color. Learn more on the about us page. 

What acne treatments does Legacy Dermatology offer? Legacy Dermatology offers a full range of acne treatments including prescription topicals, oral medications, chemical peels, microneedling, Aerolase laser, and intralesional injections for cystic breakouts. Browse the full dermatology services page for more. 

Where is Legacy Dermatology located? 2230 Huntington Drive N, Unit C-1, Algonquin, IL 60102. 

How do I schedule an appointment? Call (847) 603-4146 or book online. The office is open Monday through Friday, 8:00 AM to 5:00 PM. 

Is Legacy Dermatology accepting new patients? Yes! Visit the new patients page to get started. 

Ready to Stop Breaking Out?

Acne is incredibly common but it is also very treatable -- especially when you have the right help. Do not spend another six months trying products that are not working. A single appointment with Dr. Bradley at Legacy Dermatology can give you a real diagnosis and a real plan built specifically for your skin. 

Call (847) 603-4146 or schedule your appointment online today. 

Disclaimer: The information provided on this blog is for general informational purposes only and is not intended as, and should not be considered, medical advice. All information, content, and material available on this blog are for general informational purposes only. Readers are advised to consult with a qualified healthcare professional for medical advice, diagnosis, or treatment. The author and the blog disclaim any liability for the decisions you make based on the information provided. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.