The Genetics of Acne

July 2025 in “ Annals of Human Genetics ”

Maurice A. M. Van Steensel

acne genetic basis antimicrobial resistance retinoid comedo switch hypothesis sebaceous progenitor cell GWAS androgen signaling leucocyte migration WNT signaling epigenetic modifications DNA methylation genetic acne antibiotic resistance retinoid side effects genome-wide association studies

TLDR Genetics play a major role in acne, but environmental factors and epigenetics also contribute.

The review examines the genetic basis of acne, affecting over 80% of adolescents in developed countries, and emphasizes the need for non-antibiotic treatments due to antimicrobial resistance and retinoid side effects. It introduces the "comedo switch hypothesis," where genetic and environmental factors influence sebaceous progenitor cell identity, potentially leading to acne. Family and twin studies indicate genetics account for 80% of acne variance, with GWAS identifying loci related to androgen signaling, leucocyte migration, and WNT signaling. However, genetic associations vary across ethnic groups. The review also highlights the role of epigenetic modifications, such as DNA methylation, in acne risk, suggesting that while genetics support the comedo switch hypothesis, they don't fully explain acne inflammation. Larger-scale studies and advanced -omics techniques are recommended for further insights and novel treatments.

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Research cited in this study

14 / 14 results

research Lrig1-Expressing Epidermal Progenitors Require SCD1 to Maintain the Dermal Papilla Niche

March 2023 in “Scientific reports”

Hair growth-related cells need the enzyme SCD1 to help maintain the area that supports hair growth.

research TREM2 Macrophages Induced by Human Lipids Drive Inflammation in Acne Lesions

62 citations , July 2022 in “Science Immunology”

TREM2 macrophages and unsaturated lipids contribute to acne inflammation.

research Aberrant Wnt Signaling Induces Comedo-Like Changes in the Murine Upper Hair Follicle

4 citations , December 2021 in “The journal of investigative dermatology/Journal of investigative dermatology”

Overactive Wnt signaling in mouse skin stem cells causes acne-like cysts and shrinking oil glands, which some treatments can partially fix.

research Androgens and Acne: Perspectives on Clascoterone, the First Topical Androgen Receptor Antagonist

9 citations , April 2021 in “Expert opinion on pharmacotherapy”

Clascoterone is a new, effective, and safe acne treatment without systemic side effects.

research Homeostasis of the Sebaceous Gland and Mechanisms of Acne Pathogenesis

82 citations , May 2019 in “British Journal of Dermatology”

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research What Does Acne Genetics Teach Us About Disease Pathogenesis?

29 citations , March 2019 in “British Journal of Dermatology”

Acne is significantly influenced by genetics, and understanding its genetic basis could lead to better, targeted treatments.

research Genome-Wide Meta-Analysis Implicates Mediators of Hair Follicle Development and Morphogenesis in Risk for Severe Acne

43 citations , November 2018 in “Nature Communications”

Genetic variations affecting skin structure play a key role in severe acne.

research Genome-Wide Association Study in Japanese Females Identifies Fifteen Novel Skin-Related Trait Associations

58 citations , June 2018 in “Scientific reports”

Researchers found 15 new genetic links to skin traits in Japanese women.

research Sebaceous Lipids Are Essential for Water Repulsion, Protection Against UVB-Induced Apoptosis, and Ocular Integrity in Mice

32 citations , January 2016 in “Development”

Sebaceous lipids are crucial for keeping skin and eyes healthy in mice.

Strategic Targets in Acne: The Comedone Switch in Question

The Genetics of Acne

Research cited in this study

research Lrig1-Expressing Epidermal Progenitors Require SCD1 to Maintain the Dermal Papilla Niche

research TREM2 Macrophages Induced by Human Lipids Drive Inflammation in Acne Lesions

research Aberrant Wnt Signaling Induces Comedo-Like Changes in the Murine Upper Hair Follicle

research Androgens and Acne: Perspectives on Clascoterone, the First Topical Androgen Receptor Antagonist

research Homeostasis of the Sebaceous Gland and Mechanisms of Acne Pathogenesis

research What Does Acne Genetics Teach Us About Disease Pathogenesis?

research Genome-Wide Meta-Analysis Implicates Mediators of Hair Follicle Development and Morphogenesis in Risk for Severe Acne

research Genome-Wide Association Study in Japanese Females Identifies Fifteen Novel Skin-Related Trait Associations

research Sebaceous Lipids Are Essential for Water Repulsion, Protection Against UVB-Induced Apoptosis, and Ocular Integrity in Mice

research Strategic Targets in Acne: The Comedone Switch in Question

research Involvement of Wnt, Eda, and Shh at Defined Stages of Sweat Gland Development

research C-MYC-Induced Sebaceous Gland Differentiation Is Controlled by an Androgen Receptor/p53 Axis

research Leucine-Rich Repeat-Containing G-Protein-Coupled Receptors as Markers of Adult Stem Cells

research The Role of Fibroblast Growth Factor Receptor 2b in Skin Homeostasis and Cancer Development