Most of us will experience pimples or skin irritation in our lifetime but for people with chronic acne symptoms, it can be difficult to live with and confusing to treat. It's normal to look for answers to the root cause of acne to help guide treatment. Is it genetic? Environmental? Or a bit of both?

While acne used to be a common but vaguely mysterious skin condition, we now know more about the role genetics plays. Thanks to research studies examining family history as well as lifestyle factors, we have more of an understanding of gene variants associated with acne.

We've taken the time to do the hard yards of reading the literature so you can feel informed and confident when looking after your skin, find an acne treatment that's right for you, and start to reduce breakouts.

What is acne?

Let's start with the basics.

Acne vulgaris is a super common skin condition that typically begins during adolescence [1]. It occurs when the hair follicles and their associated oil glands (sebaceous glands) become blocked and inflamed.

Whiteheads and blackheads are usually the first lesions to develop and inflamed pus-filled spots form on the face, neck, back and chest. These areas are where our body's oil glands are the largest and most active, so acne symptoms are more likely to appear there.

If acne becomes more inflamed, that's when larger, redder and more tender nodules or cysts can form and sometimes lead to acne scarring (if you've experienced a hard and painful pimple, you'll know just how unpleasant this type of acne can be).

If you've experienced severe acne you'll know it is a very painful condition and not the same as getting the occasional pimple, which is why acne is classified as a chronic inflammatory skin disease [2].

While some of us associate acne with adolescence, it's not uncommon for it to persist into the 30s and 40s [3]. It is no surprise that acne can affect self-esteem and confidence, regardless of what age you are, especially inflammatory acne that is painful and chronic.

Thankfully, these day,s there are specialist treatment plan options for people suffering from acne, but it can still help to be aware of the underlying causes that lead to this skin condition.

Every person has different genetics, lifestyles and environmental factors, all of which can help broaden our understanding of acne.

Is acne genetic?

The long and the short of it is yes — genetic factors do play a role in developing acne.

Anecdotally, if you live with acne you might already know that a sibling or parent of yours suffered from it too (or still does). The evidence backs this up. Researchers have found strong links within biological families which confirmed a genetic basis for acne.

One large-scale literature review found that heredity plays a large role in the occurrence of acne (so much so they called it a 'dominant' role) especially in people with severe forms of acne who experience nodules, cysts and scarring [2].

Much of the well-regarded research that studied the connection between acne and genetic predisposition used a twin study model. One such study in the UK found that 81% of acne variants were caused by genetics and family history, proving there is a significant genetic component [2].

How is acne genetic?

Interestingly, many clinical studies from just 10 or 15 years ago state that they aren't sure of the exact mechanism of how genetics plays a role in making someone more acne prone, and just acknowledge that there is a familial connection.

In recent years, there have been major advances in understanding acne-causing bacteria and genetic risk, which not only helps specialists further develop acne treatments, but help acne patients understand the factors that influence acne.

A meta-analysis from 2021 found specific genetic subvariants that may play a role (more on that further down!) and conducted a systematic review with the aim of understanding the disease pathogenesis to provide more information than a vague 'yes, there's a genetic factor, but we don't know how'.

Their research investigated 60 genes and 100 variants. Here are some of the key findings and the genes identified as contributing to acne [4]:

• While there is no single gene that can be determined as the sole cause of acne, a species of bacteria known as 'C. acne' (Cutibacterium acnes) is thought to promote the development of acne lesions
• The most commonly studied gene is the pro-inflammatory factor, tumor necrosis factor (TNF), which was found to be a potential risk factor for Caucasian populations specifically
• With sebaceous glands, variations in genes such as IGF1 and TGFB are suggested to increase acne risk by influencing the production of oil in the glands

How much of acne is genetic?

It's now generally accepted that genetics play a role in around 80-90% of acne [5].

One major study involved in these findings was an Australian study that estimated the heritability of acne severity in an unselected sample of Australian teenage twins and their siblings.

The researchers then searched for molecular variants that contribute to this genetic variance to determine the genetic risk.  These findings backed up previous studies indicating a high genetic component, confirming some people are at higher risk.

For anyone who's been shamed about their skin, this proves it has way more to do with your genetic make-up and immune cells than hygiene or other factors.

That doesn't mean all hope is lost just because a lot of it is inherited! Acne genetics teach us the cause of the condition, but there are effective acne treatments available.

One such treatment option is Software's Acne Kit, which is designed to target acne at all stages. The 4-step kit includes our Salicylic Acid Foaming Wash, Ceramide Repair Balm, Acne Supplement and AHA/BHA Pimple Patches and helps to reduce acne, balance oil production, control emerging breakouts and repair the skin barrier.

How do I know if my acne is genetic?

Anecdotally, if both of your parents had severe acne, either as teenagers or in adulthood, your risk for having acne breakouts may be higher.

Both parents may possess the same genetic components for acne or varying ones. For example, one parent may pass on a hormonal condition that makes you acne-prone, while the other passes on a stronger inflammatory response to bacteria or other genetic factors that clog pores [6].

If just one parent had acne, that may lower your risk. But at the end of the day, unless you and your family undergo rigorous genetic testing (which isn't necessary to access effective acne treatments), it’s fair to assume acne is caused by a lot of genetic factors, as well as lifestyle and environmental ones.

Can you treat genetic acne?

No matter the underlying cause, acne vulgaris is a treatable condition.

We recommend using specialist products designed by dermatologists, like Software's prescription acne treatments. Personalised for you, these products in your treatment plan have the scientific backing to help treat acne symptoms and skin irritation.

As well as using evidence-backed products, it's recommended to complement this by looking after your skin to prevent breakouts in the following ways [7]:

• Make sure to wash your face twice a day with warm (not hot) water and use a soft washcloth instead of a hard scrubber
• Use sun protection, like Software's Daily Sun Defence SPF50+, every single day
• Always remove your makeup before going to bed
• Wash your hair regularly, especially if it's oily — sleeping on oily hair can irritate inflammatory acne and clog pores
• Aim for a healthy, well-balanced diet; greasy foods and foods with refined sugar are fine in moderation, just be mindful of how diet affects your skin

There is also a range of environmental factors that can irritate mild to moderate acne and severe acne to keep an eye on:

• Avoid oil-based makeup or sunscreen that feels greasy
• Acne patients sometimes use harsh soaps or cleansers that 'burn' because it feels like something is working, but you might just be feeling inflamed skin — gentle is best
• Avoid physical exfoliants like scrubs
• A common symptom of acne is experiencing it on places like the chest or back. Try to wear natural fabrics and avoid tight-fitting clothes to reduce body acne
• It's tempting, but avoid touching, squeezing or picking at pimples. This can lead to scarring or further inflammation
• Avoid smoking (this is just a general overall great health tip!)

How to prevent acne genetics?

Unfortunately, genes can’t be prevented or treated — they are formed before we are born.

But a good treatment plan in consultation with experts, like our Australian health practitioners at Software, can make a huge difference in treating acne symptoms now and preventing future outbreaks.

What's the main takeaway?

The findings from the studies and literature we've mentioned above help us gain insights into acne risk factors, which can hopefully lead to even more effective acne treatments.

At the end of the day, we can't change our genes, but we can access effective treatments. Like a lot of hormonal conditions or illnesses that affect the immune system, it can help to know the genetic factors at play.

Knowing that acne has such a significant genetic cause can help people living with acne feel validated: if you suffer from acne, there's nothing wrong with you. It's a very common condition that with a bit of time and care, can be treated and managed.

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