How much of acne is genetic? And how much of it is under your control? In this post we’ll try to answer these questions. I’ll also explain how genes contribute to acne, and what you can do to mitigate the damage.
Studies: Acne is strongly genetic
The relative contribution of genes and environment on acne has been studied a number of times. Let’s look at some of these studies.
- A massive study of 458 pairs of identical twins and 1099 pairs of fraternal twins found that genes explained 81% of the difference in acne prevalence. Only 19% was explained by non-shared environmental factors (such as diet and stress).
- One study looked at the influence of genes on sebum production. This study had 20 pairs of each identical and fraternal twins. Identical twins had almost identical sebum excretion rates but different rates of acne severity. Fraternal twins had different rates of sebum production and acne severity. They concluded that sebum production, but not acne severity, is under genetic control (a conclusion I disagree somewhat with).
- One study compared 204 acne patients with 144 non-acne controls. The researchers compared the difference in rates of acne in first-degree relatives (parent, sibling, and offspring) between patients and controls. They found that having a first-degree relative with acne increases your risk of getting it by 4 times.
From these studies it’s clear that genes have a prominent role in acne. I know that these studies paint a grim picture, and I hope you don’t take a fatalistic view of this. Because these studies don’t give you the whole picture. There’s another side to the coin also.
- Dr. Cordain found no evidence for acne in the more tribal societies he studied. Similarly acne is less prevalent in nonwestern countries, but when people from those countries migrate to West they often develop acne.
- Similarly studies on diet and acne have found that low sugar and low GI diets reduce or even completely acne.
What these (and countless other) studies show that genes are not destiny. Having ‘acne genes’ doesn’t mean you automatically get it, or that there’s nothing you can do about it. What genes do is make it more likely that you get acne, given certain environmental influences (more on that later).
I believe the studies on the heredity of acne overemphasize the importance of genes. Why? Simply because family members often eat and do similar things. So if you have similar genes and eat similar foods, it’s no wonder you find similar rates of acne. And these studies can’t capture the kind of dietary changes that help acne.
The point is that, yes, genes contribute to acne, but they aren’t the whole story and having acne genes doesn’t doom you.
What ‘acne genes’ do?
What genes do is they increase your propensity to develop acne. They modify the physiology of your skin to be more sensitive to hormones and other factors. For example:
- Genes influence how sensitive your skin is to hormones. So that similar levels of androgen hormones have different effects on acne-prone and healthy skin. And because of this acne-prone skin produces more sebum and has faster rate of skin cell growth.
- Genes influence the strength of inflammatory response to bacteria. It’s known that acne patients have far stronger inflammatory response to P. Acnes bacteria and other minor injuries.
- Genes also influence the production of anti-inflammatory chemicals in the skin.
And because of factors like those you get acne and some other people don’t, even if you have identical diets, lifestyle and other environmental factors.
We can mitigate the damage
Now because of advances in medical research we now know many natural ways of mitigating the damage genes do to your skin. Consider these examples:
- Green tea can block the androgen receptors in the skin and reduce the damage those hormones do to the skin. That’s why studies show dramatic reduction in sebum production after using green tea cream.
- Similarly caffeine can dampen the pro-inflammatory effect androgen hormones have on the acne-prone skin.
Are these enough to completely mitigate the effect of ‘acne genes’? Probably not, but every little bit helps. And those little bits start adding up when you really know what you are doing.
Importance of acceptance
Meet Elizabeth. She’s a fictional character that illustrates something I’ve seen over and over in my years of working with acne patients.
Elizabeth is in her 30s and has suffered from acne since her teen years. Understandably she’s frustrated. Nothing has really worked for her. She has tried all the creams and lotions. She has tried many diets. She has cleansed and detoxed. She’s been to homeopath and other natural doctors. She feels like she’s at the end of the road and desperate because nothing seems to help.
She’s stressed. She reads everything about acne she can get her hands on. And the frustration piles up with every failure. She has lost count on how much money she has spent on different remedies and treatments.
Can you identify with Elizabeth?
If so, we should face a somber truth. Because acne is a strong genetic factor it may be possible you won’t get over it completely. I’m not saying you shouldn’t do anything about it, but I think it’s important to face that as a possibility.
And it’s even more important to accept what can’t be changed.
Here’s why I think it’s one of the best things you can do for your skin and life. Humans are emotional creatures. I don’t claim to know your situation, but in general we humans do things for emotional reasons. And the vast majority of acne patients want to get clear because of the emotional pain acne causes.
So it’s not acne as such that’s the problem, it’s the emotional pain that it causes. You may think you can’t separate them, but you can. I believe there are two reasons why acne is so painful for some people:
- They believe it means something negative about them (like they are dirty or somehow broken).
- Stress and frustration caused by repeated failures. They want to get over it, but they can’t.
But those two things are not set in stone. And they are not tied to acne. You can work on yourself, and figure out what having acne means to you. And with some work you can come to realize that it doesn’t have to mean anything negative about you.
Similarly, practicing acceptance can cut out lot of the stress acne and trying to get over it causes.
Learn to accept what is. Deal with it. And suddenly it’s not such a big deal anymore.
Very rarely acne limits your life in any real way. You can find examples of people acne succeeding in any endeavor. Even celebrities and high-profile actors have acne.
Again, I’m not advocating a fatalistic view. And I’m not saying you shouldn’t try to cure your acne. What I’m saying is that, I believe, it’s far better to work on acceptance than mindlessly going down the path that leads to more frustration and wasted time and money. The stress alone can perpetuate acne.
Summary and take-home messages
Acne is strongly influenced by genes, and having a first-degree relative with acne increases your risk of getting acne by 4 times. While genes as such don’t cause acne they change the physiology of your skin in a way that makes you more likely to develop acne. They make you far more sensitive to dietary and other environmental influences.
With combination of internal and external treatments you can mitigate the effect of genes and in many cases completely clear your acne. So while you can’t change the hand you were dealt with, it’s important you play that hand well.
But there exists a real possibility that you may not completely get over your acne. And that’s why it’s importance to practice acceptance, and you to identify and work on the reasons that make acne so painful. This work alone can make a profound difference not only in the quality of your life but also on your skin.
I think the post Tracy made ”You can be overwhelming beautiful even with acne” Fits nicely here. Most of my friends rarely notices my pimpels and well.. In a way I understand when people who doesn’t have acne doesn’t get the ”pain” we go through when it’s some bumps on our skin… Which it actually is. But we make it seem worse!
Besides, I’ve seen plenty of hot guys who have acne but I rarely notice it because of their personalities! 🙂 I think people should focus on that idea as well other than trying to cure their acne! 😀
Good point. You are almost always your worst enemy. So it’s good to keep in mind that others rarely see your acne as ‘as horrible as’ you see it.
But then again, it’s understandable to feel the stuff that we go through..
But I guess you just have to try and not make it a huge deal.
Thanks for sharing your wonderful posts . You are doing great work! I just want to share my success story (bad acne genes). I’ve been using Retin-A (Tretinoin). Very happy I found ‘QACNE365’ in google and got retin-a ❤️. It is hands down the most effective anti-acne, anti-blackheads, anti-whatever skin flaw you may have. It is the only thing that has actually helped with my acne.
I agree that genes play a role in acne but I’m not sure how straightforward the relationship is. Neither of my parents had acne, although one of the sisters on my father’s side did. So, if the acne gene was passed to me by one or both of my parents, it is possible it can be “dormant” in one generation. But I don’t recall any of my grandparents having acne either.
I suppose the genetic combination passed to me by my parents could have been the “first generation to mutate”. After all, evolution relies on gene pools mutating or adapting, without that there can be no change.
At the end of the day, it doesn’t really matter to the acne sufferer how their genetic make up came to be, they just have to deal with the consequences. But from a research point of view, it is important to understand exactly how genes affect acne and how those genes came into being
All very good points. I wrote this post mainly to help people realize it’s not all their fault. Many alt-med and natural health blogs and books do a fantastic job of making people feel guilty for their health problems, when in many cases it comes down to genetics.
This is partially true in acne. Genes play a big part, but one can mitigate the situation with smart diet, lifestyle and topical treatments.
Hard to say about your case. I do know that there’s probably no one acne gene. The science is anything but settled on this, but the studies that have been done show abnormalities in genes regulating immune response in the skin as well as in genes dealing with hormones and how they affect the skin.
Perhaps your parents just weren’t exposed to the same environmental influences than you are, and that’s why, despite having ‘acne genes’, didn’t develop much acne.
Sometimes I’m actually afraid that I will never get clear, back a few months ago when I was following the alt-med path I felt like I would never get clear even though I ate a pretty good diet, but.. Then I realised that diet is just one part of the puzzle, when I was out traveling with my dad this summer, my acne DID get better because I wasn’t so stressed anymore…
Then I made the connection that I was still not done regarding clearing my face. I still have stress/emotional issues and.. I need to fix my gut health a bit more + I need to take antioxidant supplements.
I’m trying to fix the above now, and I feel like my face is getting better and better every day that comes and go and therefor I think I may not end up in Elizabeth’s situation but… I’ll probably have to accept it if I don’t get a clear face though!
You don’t necessarily have to do all that. I just write about them as possible causes for acne, but it doesn’t mean everyone with acne has gut problems or struggles with stress. You already said that your acne got better when you stressed less, so there you already know something that works for you.
But still.. Living an optimal life would include not having any gut problems or stress.. I actually don’t know exactly how much acne is caused by emotional issues as I still get that occasional pimple here and there but I dunno.. Is it caused by a lack of antioxidants? Too high levels of inflammation? Maybe I stressed too much without noticing or was it something I ate? I dunno.
But I still want to fix the above in any case.
Crazy man I was randomly researching genetic skin considerations. Because I’m down with altering my own genetics… Figured I’d look into the comments scrolled down saw your picture. It’s like looking in a mirror you look almost exactly like me except I have tattoos and cooler hair Oh yeah my secret alpha lipoic acid and conjugated lineolic acid mix together and apply on area. It burns a bit but cleans out the bacteria 5min and wash it off. Instant results pores reduced and skin looks refined. Vitamin A palmitate will actually change your skin for good. But if you use it say with fractional coconut oil measure it according to standard it’s toxic accumulation in the liver in high doses. I figure if it works on your doppelganger it should work on you.
I should probably post the reason why vitamin A palmitate works is because of the retinoid compounds. It’s the same reason why isotretinoin (Accutane) and tretinoin work. Which interestingly are also being studied for normalization of lesions and skin cancers. As far as is known how it eliminates acne is it upregulates lipid transfer in basal cells reducing the binding sebaceous glands over production of sebum. Although peoples reversion after discontinuing use is likely because the gene controlling the sebum production is down regulated again or died from apoptotic means. Which might lead one to think some liver transcription failure of vitamin A and or dietary deficiency of it. Also zinc is required to activate vitamin A in the liver. Anyway that’s all I have to say.
Conventional wisdom says vitamin A compounds work because they normalize keratinization in the skin. But it’s possible they also affect other acne pathways. Things get kinda complicated at the cellular level and I’m not sure anyone really knows why they work.
Thanks for sharing this! I have to take your word for the hair, but I’m pretty sure my wife agrees! She always calls me a nerd 😀 A comment about your tip. Have you tried using only linoleic acid? Acne prone skin tends to be short on LA, and applying LA on the skin has been shown to reduce acne.
My name is Thulasi and i’m 24 years old unmarried guy. Acne problem started when i was 14 and still i couldn’t find out any permanent cure. I never had a girl friend because everyone felt that i’m having a skin disease. Every girls who crossed my life looked at my face and not my character. But that’s also resulted good because i concentrated more in my studies rather than spending time with a girl. Now i’m working as an Aircraft Maintenance Engineer in India. Even though i never gave up the confidence, sometimes i was crying in night by hugging the pillow. My pillow is my best girl friend because she won’t hates me even if i have acne.
After reading this article, i could understand that DNA or Genes is responsible for chronic acne problems. So i decided not to marry till the end of my life because i don’t want to give birth to someone because if i get married, my acne genes will spread to that child itself. The reason behind why i made such a decision is that i don’t want to give this extreme acne pain( Appearance and Psychological pain) to anybody.
NO MARRIAGE… NO CHILDREN… NO MORE ACNE occurrence to anybody due to me.
My kind request to every one:
Please don’t avoid peoples those who have acne problems. At least don’t show them that you are avoiding them because if you break a bulb you can replace with another one. But if you break a heart it will cry lonely…
Thanks for posting such a great article. This article afford me a solution… Really thank you so much for the article.
Well, Thulasi, I can emphasise with what you are going through. I know that acne can be a huge pain in the ass. Especially if you are one of the unlucky ones that are susceptible to it beyond the teen years. That said, I think you are being overtly dramatic here.
There are a lot worse things than acne. I know it can make you feel bad about yourself, but one has to remember that feelings are subjective and to a large degree a matter of perception. I’m not saying you can be perfectly happy and confident while having a horrible acne, but at the same time you are not a mere passenger. You do have a certain degree of control over your feelings and how you see yourself, difficult as it may be to exercise that control.
Genes make you susceptible to acne, but they don’t doom you to live with horrible acne for the rest of your life. I would bet that most people with adult acne can make a huge difference to their skin by making proper diet and lifestyle changes and taking good care of their skin. I’ve written about all of those things on this blog.
It’s just really discouraging when you get acne even though you’re still doing all the right things.. I dunno, I cut out the food sensitivities out of my diet and my skin seemed better but then I got 2 new pimples.. It’s rare that I get it but I feel so discouraged when I do.
To be honest, for me I don’t know what else there is to ”fix” I mean.. The only thing I can imagine there is left for me to fix is how I perceive myself emotionally and probably also stress.. Since I’ve never really taken those seriously.. I’m going to have a skype session with Ted Grossbart because I’m at the ends road here.
Regarding my diet, I dunno. I started eating white rice after I sent you that study that protein & fat mixed with white rice lower the GI of it.. Maybe I should change back though?
Perhaps that’s your problem. Making a big fuss of a few small pimples. Most acne-prone people get a few pimples here and there. I do, and so do most of the so-called ‘acne gurus’.
The point of this article was that having some acne doesn’t mean there’s anything wrong with your body or that you need to fix anything.
Yeah but.. I don’t know if this is all I can do. what I would like to is just achieve a clear complexion. Even if it’s only a short while. But getting a new pimple just tells me that.. There’s something I still can do to fix up my problem but I don’t know what now. :S
And what makes you believe that there is some problem you can still fix?
Perhaps there is, but we are now at the limits of scientific knowledge. So you are shooting blind in searching for that elusive problem.
My suggestion would be to focus on why you need to have perfect skin. Nobody will think less of you if you occasionally have a pimple or two.
I dunno, my stress and emotional health is a wrack. Being around my parents and just at home stresses me out highly.. I actually said it over at Tracy’s blog too.
And why I want to have perfect skin. Because even though nobody might not think less of me.. There might be someone who will.. And I really don’t want to end up alone because people find my skin to be all disgusting and all.
Well, I have hormonal acne, and I just don’t get few pimples now and then. My acne is so bad that I have open wounds that bleed. I have been under different treatments, and by this I mean antibiotics, creams, lotions, pills, vitamins, etc. I have tried different diets but nothing seems to help. I agree that it is not the worst disease you can get but it can definitely affect you emotionally and physically. I can’t even get out of your house because I have pimples that are bleeding in my face or chest… I say this to make other people understand that there are different levels of acne. Anyone who sees symptoms like mine should get a hormonal panel and see how your hormones are acting up. In my case, my body releases an immense amount of androgen that in combination with my acne genes make things worse. Once you see if maybe your hormones are the cause, you can try options like hormone regulators. Acne has different causes and making sure that your body is acting correctly will help you learn what you can do about it.
Sorry to hear you have to go through all that. I do agree that in cases like yours there’s more than just genes involved. My main point with this post was to argue against the silliness found in natural health. Many people believe that they can get perfect skin if they could just be more strict with their diet or fix some elusive health problem that causes their minor acne.
I loved every single word of this article, super motivational and informative for a sufferer of genetic acne like myself! Thank you 🙂
Glad to hear you liked it, Gisel. The point I wanted to make was that genes DO matter, and that while there often is a lot you can do about your acne, don’t get too upset if you can’t get rid of it completely.
Hey. .I’ve had acne since age 14. It started as 1 or 2 but now (18yrs) it just covers my face..I have it on my neck, arms, chest and back too.I tried everything..all treatments and creams and lotions what not…no home remidies work..its more liKe they make my acne worse. Im not fussing over my looks but I cant touch my face even when im washing the acne really hurt and they dont have heads so it doesnt even die out ..dies in?(lol) leaves a mark for sure.And I found out today that dad had the worst case oily skin with acne from teenage and he easily gets pimples even now. Please tell me this won’t be the case for me too…I just want healthy skin…acne on my body really is so troublesome when all I want is a healthy body and not a prettier one.It really hurts when I touch or wash and I don’t want that…Am I also gonna face problems like my dad till im 40-50yrs old? This sucks.. Is there no way to cure this?
Aside from Accutane, there’s nothing you can do to get rid of the genetic tendency to get acne, and even Accutane is not that reliable. This doesn’t mean you have to live with horrible acne for the rest of your life. There’s a lot you can do to reduce what I call the distal causes of acne (hormones, inflammation, gut problems, etc.), and doing that will often get rid of acne or at least significantly reduce it.
Accutane huh ? Never gave it a try so gonna see if that helps. Im glad i read this article because i was actually stressing out about the sudden increase in acne for no reason. Atleast now i know that iam not doing anything wrong to cause it. Finally gonna put a stop to my experiments, tried too many products already. And can you please tell me ways to reduce my Inflammation and hormones ? I have no idea what iam supposed to do. As for gut problems, i think i don’t have any since i almost always stick to healthy eating everyday ( more fruits than junk food). Thanks alot for the guidance 🙂 ^^ Im not stressed anymore. But iam not gonna give up and try abit more. If nothing works then iam ready to accept it.
Dear Taka,
I could feel your pain that you are now carrying with you. There may be some situations in which you find yourself amid your female friends whom have clearer skin. Lots of situations like this might make you feel despair. But please keep in mind that, what others tell to you is not important instead what you tell to yourself is more important. Since i too battled like you, i have psychological method to control acne problems in the long run. Herewith i’m explaining it. Stand in front of a mirror and start counsel yourself like a 3rd person “taka, your face has been improved comparing to yesterday. The remaining residues are losing their immunity so that it loses it strength so that your face is glowing from this moment. Taka, lets smile.. Oh how cute isn’t it…? ” Like wise talk to yourself as a third person and believe it. In due course, your subconscious mind will regulate the underlying hormones which in turn you’ll surely reduce 20% of your acne problem. Then, adopt a vegan diet so that it cuts up to another 20% of your acne problem. Then, do “Pranayama” breathing exercise daily, which in turn regulates your hormone 30%. So if you follow all the 3 techniques, surely you can solve your acne problem 70%.
Then, finally have a friend like me who always gives your positive talks.
Ok, shall we be friends…?
Oh no I’am not depressed or anything. I do think Iam pretty ^^ Its just that acne makes me feel unhealthy rather than not pretty. And thank you for your advices 🙂 i made a note of them ^^ i’ll be sure to try them starting from now.
And sure 😀 lets be friends ^-^ Thanks a lot Thulasi 🙂
Hi, thank you so much for posting this article for acne sufferers. If you are in school, I would suggest buying a large thermos and carry it around with hot green tea. I would keep the thermos in my backpack and pour the tea into a disposable coffee cup.
I had persistent acne everyday from 4th grade until now (28 years old). I have noticed that when I worked at a Japanese restaurant eating very strong, high quality, hot green tea for 12 hours straight everyday while working, then my skin started acting normal. A couple months after I started drinking the green tea my skin stayed calmer. It is so good to hear someone else has has the same experience. I will admit: I had to drink A WHOLE LOT of the green tea at least 6 days a week and didn’t add any sugar in order to maintain the effects, but hey, green tea is good for you anyway.
Thanks for sharing your experience!
Acne is the problem. If it weren’t, this article wouldn’t exist. Western society tends to have high incidence of acne and honestly cutting out cows milk(which is popular in western society) and lessening my sugar intake helped the situation. I suggest following the acne face map, an eastern invention. Once dairy was out of my diet, my cystic acne was nearly non-existent. It’s all the crap that the US puts in food. Easterns Asians don’t usually have acne but I’ve seen Americans of East Asian descent with acne and it’s most likely because of the diet.
It’s true that dairy and sugar can cause acne. But I can’t agree with you on the acne face map. Diagnosing your acne with face map is like predicting your future with horoscope. It may be fun but ultimately useless. I wrote a post about acne face map here.
…Odds are quite good that the genes to be concerned with are not YOURS, but those belonging to the bacterial strains which inhabit your skin. I suspect some variants of our standard human skin bacteria have evolved to incidentally produce more inflammatory fatty acids – resulting in acne. And since we acquire our personal bacterial biome during our first year of life, we are very likely to acquire them from those we’re most exposed to…namely, family. Want to get rid of your acne? Figure out a way to breed that trait out of them. Sounds improbable, but consider the following facts and a possible solution:
1. You cannot simply swap out your bacterial colonies… since your immune system is wired to recognized them and only them as ‘part’ of your body/organism.
2. It’s nearly impossible to wipe out indigenous bacterial populations on/in your body due to their sheer numbers, and endless other advantages they have in their repopulation efforts.
3. Wiping out such colonies would likely prove very problematic and create a variety of hard to predict secondary effects anyways.
Solution: modify the genetic traits of your personal bacteria by simple eugenics.
How: find someone with fantastically healthy and radiant skin… then, have them wipe their face with a cloth or sponge in the morning upon waking. Then take this oily cloth and rub it all over your face before sleeping. Did this every day if possible or as frequently as you can. Objective would be to gradually diversify the genetic traits of your current bacterial strain, with those of a strain which seems to function without the acne result, by slowly cross breeding them over time. Anyways, thought I’d share this… waste of my time though, since no one will find this agreeable.
Acne scars one them, which bothers every girls. These can happen due to genes, I didn’t know yet. But, you have gave us a good information. I had acne, which make me hate my self and my friends also make fun of me. But, after getting treatment for this, I am so happy.
Hey,actually am impressed by this i have alot of Acne (BLACKHEAD SPOTS) due to genetics my mum and my grandma have them i think as for me i have learnt accepyong them,and living with as well..i have tried almost everything untill i gave up..actually as for now am contented.
Yes awhile back I read an article about vitamin A normalization of kerotinocytes. That’s initially what set me into learning more about why it works. I read alot of nih studies involving certain genes that affect skin growth and potential avenues for correcting skin disorders. Sadly I know more sometimes than my dermatologist about concurrent efforts. I have tried just lineolic acid however I feel like I do with many remedies. Most work but don’t penetrate the skin deep enough to cause any lasting residual effect. I think after such things as light chemical peels and exfoliating the skin is weakened enough allowing for better absorption. Nanoparticle delivery options are another interesting option as they get better and better such as liposomal compounds and such. So I feel like more delivery options are becoming readily available it’s just knowing what is lasting and safe to deliver at that deeper level.