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Why Do Some People Suffer From Severe Acne? Large Genetic Study Reveals Hair Follicle Formation May Be Key


Some 85 percent of people experience acne breakouts. Ocskay Bence/Shutterstock

Acne is one of those conditions that seemingly has no perfect treatment, with expensive creams, ointments, and pills providing some benefit but not often complete resolution. Now, a large genetic study raises the possibility that we’ve overlooked a major factor in the development of acne.

“Applying these genetic approaches to acne has never been done before, and it’s a significant leap forward,” said Professor Jonathan Barker, lead author of the study, in a statement.


The study, published in Nature Communications, looked at 26,722 individuals, of which 5,602 had severe acne. The team identified 15 regions of the genome linked to its development, with 12 not previously implicated in the condition. Many of these variants were found to influence hair follicle formation – an as-yet unknown risk factor for the disorder. 

“It was surprising that so many of the variants appear to influence the structure and function of the hair follicle,” said Michael Simpson, head of the Genomic Medicine Group at King’s College London. “It may be that the genetic variation influences the shape of these hair follicles and makes them more prone to bacteria and inflammation, which are a characteristic of acne."

One of the genetic variants, called WNT10A, is linked to ectodermal dysplasia, a condition that causes sparse, thin hair as well as other physical abnormalities of the nails, teeth, skin, and glands. Around 22 percent of the phenotypic variance (observable characteristics) in acne patients were explained by the genetic variants examined in the study, with the 15 significant loci accounting for around 3 percent of that. This suggests there are likely other regions contributing to the condition that remain undiscovered.

“A number of the genetic variants point to interesting mechanisms that could be really good targets for new drugs or treatments that would really help patients," added Simpson.


Around 85 percent of people experience acne breakouts at some point in their lives. These red lumps and bumps can pop up for decades and leave scars in up to 20 percent of patients. Although the condition may seem trivial at times, for sufferers of inflammatory papules, pustules, and nodules, the results provide added hope for new treatment possibilities. 

"Acne can have severe emotional and psychological consequences and has been associated with depression, unemployment, suicidal ideation and suicide itself,” wrote the authors.

The team hopes the new discovery leads to novel treatments with fewer side effects than current drugs. One of the top drugs on the market today is isotretinoin (also known as Accutane), but there are unwanted symptoms that accompany the medication and women who are pregnant cannot take it.

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