Factors affecting the formation of acne commonly occurs in people who are genetically predisposed. Use of cosmetics such as creams, oil based moisturizers, oil based foundations, etc. can cause acne. Application of heavy oil or gel on the scalp leads to pimples on the back and forehead. People who work in chemical or oil industries and come in contact with hydrocarbons, heavy oils, cutting oil, wax, grease and coal tar derivatives can develop acne.People working in hot and humid climate can develop acne. Drugs such as oral contraceptives, steroids, isoniazid, lithium, phenytoin, iodides etc. can cause pimples. Squeezing or picking at a pre-existing lesion will lead to secondary infection and increased pigmentation. Stress will exacerbate acne. Finally, if acne persists in spite of medical treatment or if the patient has other features such as or hair loss, an endocrine disorder must be considered and investigations carried out accordingly.
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