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What Are the Causes of Facial Blemishes?

By Holly McGurgan ; Updated July 18, 2017

Facial blemishes are not only unsightly, but may also be painful if they become red and inflamed. Also called acne, these blemishes affect approximately 17 million people in the United States, according to KidsHealth from Nemours. Understanding the causes of blemishes will help you devise a skin care regimen to addresses the source of your break outs.


Facial blemishes occur when pores clog with dead skin cells and sebum, a natural skin oil. When the clog occurs near the top layers of the skin, whiteheads or blackheads form. Deeper clogs cause pimples and acne cysts. Pimples and cysts look red because P. acnes bacteria found on your skin mixes with sebum and skin cells in your pores, causing an inflammation in the blemish.

Excess Oil Production

Excess oil production can increase your chance of developing a clogged pore. Excess oil production often occurs during adolescence when oil glands ramp up production of sebum, due to the influence of hormones called androgens. Because there is so much extra oil produced, some of it backs up in the pores and blemishes form. The American Academy of Dermatology reports that 85 percent of teenagers will have acne each year.

Controlling Oil

Removing excess oil from your face can help reduce facial blemishes. Washing the face twice each day with a mild antibacterial cleanser will remove both oil and bacteria on the skin. Avoid scrubbing too hard or washing your face too frequently, as these practices can irritate the skin and worsen your blemishes. Sebum is produced by all of your pores, including the ones on your head. If you have oily hair, oil can migrate to your face from your hair. Shampooing daily can help alleviate this problem. Extra oil can also collect on your face after you eat greasy or oily foods. Cleaning your face after eating those foods may help prevent blemishes.

The Role of Hormones

Hormones can also play a role in acne, even if you aren’t a teenager. Hormonal fluctuations caused by pregnancy, menopause, menstruation and the use hormonal types of birth control can cause or worsen acne. Hormones influence both oil gland production and the maturation of skin cells, contributing to the formation of acne lesions, according to the American Academy of Dermatology.

Treating Blemishes

Over-the-counter topical medications can be effective in drying out pimples and causing more rapid turnover of skin cells. Look for medications that contain salicylic acid, lactic acid or benzoyl peroxide. Although use of these medications may initially cause flaking, skin irritation or dryness, these symptoms often improve after the first month of treatment, according to If your blemishes don’t improve after using over-the-counter medication, your doctor may prescribe stronger topical medication or oral antibiotics.

Although hormonal birth control can cause blemishes in some women, others may find that taking birth control pills helps control acne. The oral medication isotretinoin can be helpful in treating painful acne cysts, although the medication can cause severe birth defects if taken by pregnant women. Doctors may recommend microdermabrasion or chemical peels to control severe acne or laser treatment to reduce production of sebum.

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