Acne is caused by enlargement of the oil gland (which is stimulated by genes, stress, diet & hormones), which leads to oil gland overproduction. When oil is overproduced, the channel that delivers the oil, the skin pore, becomes enlarged. This leads to natural bacteria on our skin to “fall” into the open pore and cause an inflammation/infection. The excessive oil overproduction also causes the top epidermal cells to get clogged, leading to the skin pore to trap dead skin and bacteria in the oil gland. When the pressure is too much, the oil gland and pore can rupture, leading to big cystic acne and lead to severe scarring. So the treatment should be directed at the cause of the acne: 1. Enlarged oil gland (with topical tretinoin aka “retinol”) 2. Sterilizing the natural bacteria on the skin (with topical antibacterial ie: benzoyl peroxide or topical antibiotic), and 3. Exfoliating off the top layer of clogged skin cells (with monthly peels/microdermabrasion & at home “peel pads”).