So acne can have a great impact on patient's lives, often independent of severity. Severe acne is associated with increased depression, anxiety, poor self-image and poor self-esteem. Psychiatric symptoms are more common in more severe acne and in the later stages of puberty.

• Hormones. When androgens rise in both boys and girls during puberty, the sebaceous glands under the skin enlarge and produce more sebum or oil.
• Heredity.
• Oil-based beauty products.
• Stress and Anxiety.
• Medications.
• Diet.
• Your partner's beard.
• Pimple popping.