What Causes a Pimple?

What Causes a Pimple and Acne?

To control blemishes effectively, it’s important to understand how spots form and what causes it. The most important thing to remember about pimples is: It’s not your fault. Contrary to popular belief, zits are not caused by external factors such as what you eat, how often you wash your face or exercise. They’re caused by a combination of physiological factors at work far beneath the skin’s surface that are beyond our control.

The Secret Life of a Pimple

The life of a pimple begins around 2-3 weeks before it appears on the surface of the skin. It starts in your sebaceous hair follicles, or pores.
Deep within each follicle, your sebaceous glands work to produce sebum, the oil that keeps your skin moist and supple.

As your skin renews itself, old skin cells die and shed. Normally, these cells shed gradually, making room for fresh new skin cells. But if cells are shed unevenly, they clump together with the skin’s natural oil to form a plug What Causes a Pimple? Blackhead?within the pore – like a cork in a bottle.

This plug, or comedo, traps oil and bacteria inside the follicle and begins to swell as your skin continues its normal oil production process.

That’s when your body’s immune system kicks in, producing white blood cells to attack the bacteria – the end result is a pimple.

Causes of Pimples

When it comes to zits, there is no one “cause” but many factors at play which are beyond our control, such as:

  • How often you shed skin cells which can change throughout your life.
  • The amount of sebum that your skin produces which is affected by your hormone balance, which is often in flux — especially for women.
  • Genetics can play a big part in the development and persistence of spots, so family history can give you a good idea of how likely it is that you will develop pimples.

The Five Main Causes of Pimples

Each of these factors can vary dramatically between individuals and while you can’t control them, understanding these factors can help you find the most effective solution.

Hormones Cause Acne

For most blemish sufferers, skin problems start at puberty, when the body begins to produce hormones called androgens. These hormones cause the sebaceous glands to enlarge, which is a natural part of the body’s development. In blemish sufferers, however, the sebaceous glands are overstimulated by androgens, which can sometimes persist well into adulthood. Androgens are also responsible for flare-ups during the menstrual cycle and, for some people during pregnancy.

Extra sebum

When the sebaceous gland is stimulated by androgens, it produces extra sebum (oil). As the sebum makes its way up the follicle towards the skin’s surface, it mixes with common skin bacteria and dead skin cells that have been shed from the lining of the follicle. While this process is normal, the presence of extra sebum in the follicle increases the chances of clogging which can cause pimples.

Follicle fallout

Dead skin cells within the follicle usually shed gradually and are dislodged onto the skin’s surface. In people with overactive sebaceous glands — (including almost everyone during puberty) — these cells are shed more rapidly. When this happens, the dead skin cells mix with the excess sebum and form a plug in the follicle, preventing the skin from finishing its natural process of renewal.


The bacteria exists in all skin types; it’s part of the skin’s natural sebum maintenance system. Once a follicle is plugged, however, acne bacteria multiply rapidly, creating the chemical reaction that results in inflammation in the follicle and surrounding skin.


When your body comes in contact with unwanted bacteria, it sends an army of white blood cells to attack the intruders. This process is called chemotaxis; or, the inflammatory response. This response is what makes pimples red, swollen and painful. The inflammatory response is different for everyone

Dr. Lawrence Jaeger is a board certified dermatologist in New York City and Medical Director of Advanced Dermatology Associates, a state of the art medical practice with multiple locations in Manhattan and the Bronx. Dr Larry Jaeger and his group of board certified dermatologists and medical providers are expert in the diagnosis and treatment of all skin, hair and nail disorders and specialize in the practice of medical, cosmetic and surgical dermatology. They accept all Insurance Plans, HMOs, PPOs as well as Medicare and Medicaid.

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