Acne is caused by over productive sebaceous glands that clog up the hair follicle causing bacteria to breed. Sebaceous gland activity is trigger by androgen hormones that become active during puberty. Genetics play a role in how large and productive sebaceous glands become. Acne does tend to run in families though there is not a clear pattern of inheritance. Meaning just because your parents had it does not always mean that you will and you could be the first in your family to get it. Diet has no influence in sebaceous gland activity or acne and medical studies have proved this. Sebaceous glands and hair follicles lie beneath the surface of your skin so how clean or how dirty the surface of skin is does not influence acne. Acne begins beneath the surface of the skin. I have had acne and have 100 percent cleared it for many years using prescription medication.