Why do some teenagers get more blemishes than others? Genetics, hormone sensitivity, sebum production, follicular behaviour.

Two teenagers. Same age. Same school. Similar skincare routine.

One gets the occasional blackhead, while the other seems to battle one stubborn breakout after another.

Why? Because puberty does not affect every teenager’s skin in exactly the same way.

Genetics and teenage blemishes

Genetics plays a major role in who develops acne.

A comprehensive systematic review found that teenagers with a parental history of acne were far more likely to develop it themselves. Across the analyzed data, parental acne was associated with almost three times the odds of a teenager developing breakouts (Heng and Chew, 2020).

Recent genetic research supports this. Scientists have identified multiple genetic regions linked directly to acne susceptibility and to the specific ways cells grow and behave inside the hair follicle (Petridis et al., 2025).

If a parent struggled with acne as a teenager, their child has a statistically higher chance of experiencing it too. Genetics can load the biological dice.

Why hormones affect teenage skin differently

During puberty, androgen hormones become highly active in both boys and girls. These hormones stimulate the sebaceous glands to expand and produce more sebum, which is a foundational driver of acne biology (Del Rosso et al., 2024).

However, teenagers do not all respond to those hormonal spikes the same way:

• Some produce significantly more sebum than others.

• Some follicles are structurally more prone to developing blockages.

• Some immune systems mount a much harsher inflammatory response to everyday skin bacteria.

This explains why one teen gets a slightly shiny forehead while another develops deep, repeating blemishes.

It is not just about oily skin

Excess oil matters, but acne biology is more complicated than a simple "more oil equals more pimples" equation.

Breakouts involve localized changes inside the pilosebaceous unit — the tiny structure containing the hair follicle and its oil gland. Changes in how cells shed inside that follicle create the initial physical blockage. From there, trapped sebum, Cutibacterium acnes activity, and inflammation alter the local environment (Zha and Usatine, 2024).

This is why two teenagers with the exact same level of oily skin can have completely different faces. Their skin is simply not behaving identically beneath the surface.

Does skincare still matter?

Yes. Genes and hormones dictate the internal starting point, but daily skincare directly manages what happens at the surface.

For blemish-prone teenage skin, a streamlined routine keeps the skin environment balanced. At Upenya, that means starting with our Exfoliating Cleanser, hydrating with the Moisturising Gel, and managing pore build-up with our Blemish Care.

The goal of a skincare routine is not to alter a teenager's genes or hormones. It is to gently care for the skin they currently have and help them achieve healthy skin in the long term.

A message for parents

It can be incredibly frustrating when one sibling sails through puberty with clear skin while another struggles constantly.

It does not mean one child is cleaner. It does not mean they are doing their skincare wrong, and they certainly did not cause their own blemishes. Their underlying skin biology is simply different.

Reminding them of this matters, especially when teenagers are constantly comparing themselves to the peers around them.

The bottom line

Some teenagers are more prone to blemishes due to an intersection of genetics, hormones, sebum production, follicular cell behavior, and inflammation.

Puberty initiates these internal changes, and genes dictate how intensely the skin responds. When two teens get completely different results from the same habits, look to biology for the answer.

Frequently asked questions

Is teenage acne hereditary?

Yes, there is a clear genetic link. Having a parent with a documented history of acne significantly increases a teenager's likelihood of experiencing breakouts (Heng and Chew, 2020).

If both parents had acne, will their teen definitely get it?

No. Genetics influence the baseline risk, but they do not guarantee the final outcome. Daily skin biology, environmental factors, and routine management also play a role.

Why does one sibling break out more than another?

Unless they are identical twins, siblings do not share identical genetics. Their specific hormone levels and cellular skin responses vary, meaning one sibling may produce more sebum or experience higher inflammation.

Do boys get worse teenage acne than girls?

Both sexes develop acne as androgens drive sebum production in both boys and girls. Because severity varies drastically by individual genetics, sex alone cannot predict how severe a teen's breakouts will be (Del Rosso et al., 2024).

Can good skincare overcome genetics?

Skincare cannot alter a teen's genetic makeup, but a consistent routine cares for blemish-prone skin and prevents unnecessary surface irritation. Severe, painful, or scarring acne requires a medical evaluation.

References

Del Rosso, J.Q., Kircik, L.H., Stein Gold, L. and Thiboutot, D. (2024) ‘The cutaneous effects of androgens and androgen-mediated sebum production and their pathophysiologic and therapeutic importance in acne vulgaris’, Journal of Dermatological Treatment, 35(1), 2298878. doi: 10.1080/09546634.2023.2298878.

Heng, A.H.S. and Chew, F.T. (2020) ‘Systematic review of the epidemiology of acne vulgaris’, Scientific Reports, 10, 5754. doi: 10.1038/s41598-020-62715-3.

Petridis, C. et al. (2025) ‘The genetics of acne’, Annals of Human Genetics. doi: 10.1111/ahg.70014.

Zha, M. and Usatine, R. (2024) ‘Common skin conditions in children and adolescents: Acne’, FP Essentials, 541, pp. 7–13.