There are many theories on what causes acne vulgaris but no one knows for sure what causes it. The NIAMS says, "The exact cause of acne is unknown, but doctors believe it results from several related factors. One important factor is an increase in hormones called androgens (male sex hormones). These increase in both boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormonal changes related to pregnancy or starting or stopping birth control pills can also cause acne.
Another factor is heredity or genetics. Researchers believe that the tendency to develop acne can be inherited from parents. For example, studies have shown that many school-age boys with acne have a family history of the disorder. Certain drugs, including androgens and lithium, are known to cause acne. Greasy cosmetics may alter the cells of the follicles and make them stick together, producing a plug."
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Wikipedia says, "Exactly why some people get acne and some do not is not fully known. It is known to be partly hereditary. Several factors are known to be linked to acne:
• Stress
• Hormonal activity
• Hyperactive sebaceous glands
• Accumulation of dead skin cells
• Bacteria in the pores
• Skin irritation or scratching of any sort
• Anabolic steroids
• Any medication containing halogens (iodides, chlorides, bromides), lithium, barbiturates, or androgens
• Exposure to high levels of chlorine compounds, particularly chlorinated dioxins, can cause severe, long-lasting acne, known as Chloracne
Traditionally, attention has focused mostly on over-production of sebum as the main contributing factor of acne. More recently, more attention has been given to narrowing of the follicle channel as a second main contributing factor. Abnormal shedding of the cells lining the follicle, abnormal cell binding ("hyperkeratinization") within the follicle, and water retention in the skin (swelling the skin and so pressing the follicles shut) have all been put forward as mechanisms involved, but there does not appear to be much conclusive medical research on the subject." [source]
Does diet have anything to do with acne? Answer
