1. Hormonal Changes: Hormonal fluctuations, especially during puberty, menstruation, pregnancy, and when starting or stopping birth control, can increase oil production, leading to acne and blackheads.
2. Excess Oil Production: Sebaceous glands produce sebum (oil) to keep the skin lubricated. Overproduction of sebum can clog pores, creating an environment for acne and blackheads.
3. Dead Skin Cells: When dead skin cells are not properly shed, they can mix with sebum and block hair follicles, resulting in acne and blackheads.
4. Bacteria: The presence of bacteria, particularly Propionibacterium acnes (P. acnes), can lead to inflammation and infection in clogged pores, causing acne.
5. Certain Medications: Some medications, such as corticosteroids, androgens, and lithium, can contribute to the development of acne.
6. Diet: Certain foods, particularly those high in refined sugars and dairy products, may exacerbate acne in some individuals.
7. Stress: Stress can increase the production of hormones like cortisol, which can stimulate oil glands and worsen acne.
8. Cosmetics: Some makeup, skin, and hair products can clog pores, leading to acne and blackheads. Non-comedogenic products are less likely to cause these issues.
9. Environmental Factors: High humidity and pollution can contribute to clogged pores and acne.
10. Genetics: A family history of acne can increase the likelihood of developing it.

Maintaining a consistent skincare routine, using non-comedogenic products, and addressing underlying hormonal or health issues can help manage and prevent acne and blackheads. If over-the-counter treatments are not effective, consulting a dermatologist may be necessary.

1. Reduces Severe Acne: Isotretinoin is highly effective in treating severe, cystic, or nodular acne. It works when other treatments, such as topical therapies and antibiotics, have failed.
2. Long-Term Remission: Many patients experience long-term remission of acne after completing a course of isotretinoin. Some may see permanent improvement, while others may need additional courses, but the severity of acne usually decreases significantly.
3. Decreases Sebum Production: Isotretinoin reduces the size and activity of sebaceous (oil) glands, leading to less oily skin. This helps to prevent the formation of new acne lesions.
4. Prevents Future Scarring: By effectively controlling severe acne, isotretinoin can help prevent the scarring that often accompanies severe outbreaks.
5. Anti-Inflammatory Effects: Isotretinoin has anti-inflammatory properties, which help reduce the redness and swelling associated with severe acne.
6. Reduces Bacterial Growth: It helps decrease the population of Propionibacterium acnes (P. acnes), the bacteria linked to acne, reducing the risk of infection and inflammation in clogged pores.
7. Improves Skin Texture: Over time, isotretinoin can improve the overall texture of the skin by reducing acne lesions and oiliness.

While isotretinoin can be highly effective, it is also associated with significant side effects and risks, including dry skin, lips, and eyes, potential birth defects if taken during pregnancy, and possible mood changes or other mental health effects. It requires careful monitoring by a healthcare provider.