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Acne is caused by a combination of factors, including genetics, hormones, and environmental factors. When the sebaceous glands in the skin produce too much oil, it can clog hair follicles, leading to the formation of pimples. Hormonal changes can also cause the sebaceous glands to produce more oil, which is why acne is common during puberty. Other factors that can contribute to acne include stress, diet, and certain medications.