Diagram of acne: bold “ACNE 101” text next to a skin cross-section with an inflamed pore.

Acne 101: What’s Happening Under Your Skin

When a breakout decides to show up, it’s usually at the worst time–like during a frigid Minnesota cold snap or right before college finals week. Sound familiar? Whether you’re a stressed-out student or an adult in the Twin Cities juggling work and winter weather, acne has a knack for popping up when you least need it. Yes—even in our dry Minnesota winters and beautiful summers (and yes, acne in adults is common too), breakouts still show up when you least want them.

Let’s dig into what’s really going on with acne and how you can get the upper hand on it.

Why We Still Don’t Have a Single “Root Cause”

If you’ve been searching for the one thing to blame for your breakouts, you’re not alone – but the truth is, there isn’t a simple answer. Dermatologists don’t have a single “root cause” for acne because it’s a complex, multifactorial condition. In plain English, that means acne is usually a mix of factors: genetics, hormones, skin oil production, and even your environment. What triggers breakouts in one person might not affect another at all. The reassuring news? You didn’t do anything wrong to “cause” your acne – and understanding its many facets is the first step toward managing it.

What’s Happening Inside an Acne Lesion

To tackle acne, it helps to know what’s unfolding beneath your skin’s surface. Here’s a quick peek at the four-step drama happening inside that pimple on your chin:

Clogged Pore (Follicular Plug): Dead skin cells and grime stick together and block the opening of a hair follicle. This plug is the starter point for all types of acne, from blackheads to cysts.
Excess Oil Build-Up: Your skin’s oil glands (sebaceous glands) go into overdrive and produce too much sebum (oil). Since the pore is plugged, all that oil gets trapped behind the clog, creating a cozy little environment.
Bacteria Multiplying: Acne-causing bacteria (called Cutibacterium acnes, the usual culprit) love the oil-filled, airless pore and start to multiply. These bacteria feed on the trapped oil, and their presence triggers your body’s defenses.
Inflammation: Your immune system responds to the bacterial growth and clogged pore with an inflammatory reaction. This leads to redness, swelling, and that tender, angry bump we recognize as a pimple (sometimes filled with pus, which is just your white blood cells doing their job).

Evidence-Based Triggers (Only a Few!)

There are endless myths about what causes zits (chocolate, anyone?), but science shows only a few real acne triggers. And importantly, not everyone’s skin reacts to each of these. Here are the known troublemakers for some people:

Hormonal Flux: Surges in hormones (especially androgens) can kick oil production into high gear. That’s why teenagers sprout pimples during puberty and why many women notice breakouts around menstrual cycles or during pregnancy. (Stress can play a part here too, since stress hormones may trigger flare-ups.)
Pore-Clogging Products: Heavy, oily cosmetics or skincare products can block your pores. Certain cosmetics (like thick foundations, creams, or pomades for hair) are labeled comedogenic for this reason – they can breed comedones (clogs). Not everyone breaks out from makeup or lotions, but if you’re prone to acne, look for “non-comedogenic” on your products to be safe.
High-Glycemic Diet: Diets loaded with sugar and simple carbs (think sugary drinks, white bread, candy) spike your blood sugar, which can contribute to acne in some people. High-glycemic foods may fuel hormonal fluctuations and inflammation that worsen acne, though this varies person to person. (So that chocolate bar might not directly cause acne, but constant high sugar intake could set the stage for some.)
Chronic Stress: Ever notice breakouts when you’re under pressure? Stress does not cause acne outright, but it can aggravate it. Ongoing stress prompts hormonal changes (like a rise in cortisol) that might lead to more oil production and slower skin healing. In short, stress can throw fuel on the fire if you’re already acne-prone.

(Remember: You might react strongly to one trigger and not at all to another. Acne is highly individual, so part of the journey is figuring out which factors your skin cares about.)

Over-the-Counter Options That Actually Help

You don’t need a prescription to start, but remember: getting a dermatologist on your side from the outset speeds everything up. These OTC actives can help keep breakouts in check while you line up expert care:

Benzoyl Peroxide (2.5–5%) Kills acne bacteria and clears pores. Start once nightly; bump to twice if you tolerate it. Tip: Watch for bleaching—use an old pillowcase and follow with moisturizer.
Salicylic Acid (1–2%) Gently exfoliates inside pores to prevent clogs. Use once daily—if it’s too drying, switch to every other day or rinse-off cleansers.
Adapalene (0.1% Retinoid Gel) Normalizes cell turnover and calms inflammation. Apply a pea-sized amount nightly. Expect mild flaking early on—moisturizer and morning SPF are musts.
Sulfur (3–10%) Dries and soothes individual pimples. Spot-treat as needed—best at bedtime, since it has a distinctive smell.
Gentle, Non-Comedogenic Cleanser Twice-daily wash to remove oil and grime without stripping your skin. Use lukewarm water and pat dry to protect your skin barrier.

While these treatments can make a difference, teaming up with a board-certified dermatologist ensures you’re using the right mix of therapies—and getting prescription-strength tools when you need them.

When (and Why) to See Your Dermatologist ASAP

Don’t wait until you’ve “tried everything.” If OTC options aren’t giving you clear skin in 8–12 weeks, or if you’re facing painful cysts, loop in a dermatologist immediately. A board-certified Minnesota dermatologist will:

Confirm it’s really acne (and not a look-alike condition)
Prescribe faster, more powerful treatments
Help you avoid permanent scars and dark spots

Getting expert guidance early means less downtime, fewer scars, and a quicker return to clear, confident skin.

Scenic Dermatology: Your Clear-Skin Ally in Chaska, MN

At Scenic Dermatology, we believe every acne journey goes smoother with a dermatologist in your corner. Our team offers personalized plans—and often same-day or same-week appointments—so you can get expert care as soon as possible. We proudly serve the southwest Twin Cities metro area, including Minnetonka, Excelsior, Chanhassen, Eden Prairie, Victoria, Waconia, Carver, Cologne, and Shakopee.

Ready to partner with a Minnesota dermatologist who moves quickly? Call (952) 520-5000 today and let’s tackle your acne together, or visit ScenicDermatology.com for more information.

Remember: Acne is a real medical condition—and the sooner you team up with a dermatologist, the better your skin’s outcome.

Acne FAQ

Q: Is acne just a teenage problem?
A: Not at all. Adult acne is very common, especially among women in their 20s, 30s, and even beyond.

Q: How long should I try over-the-counter products before seeing a dermatologist?
A: If you’re not seeing improvement after 8–12 weeks—or if breakouts are painful, deep, or leaving marks—it’s a good time to get a dermatologist involved.

Q: Can my diet affect my acne?
A: Possibly. High-glycemic foods and dairy may trigger breakouts in some people, but not everyone. It’s very individual.

Q: Do I need to wash my face more often if I have acne?
A: No—twice a day is plenty. Over-washing or scrubbing can actually make things worse by irritating your skin.

Q: What’s the best treatment for acne?
A: There’s no one-size-fits-all answer. Retinoids are a great foundation, but the best plan depends on your skin type, acne type, and goals—which is where we come in.