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What causes the initial breakout?

What exactly causes the initial breakout? The derm said it forces everything out of your system, but I thought acne was formed by the improper shedding of dead skin that clog the pores?

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Acne is formed by a lot of factors, the initial breakout is caused by a new wash or a new antibioic forcing all the zits out faster, I'm not to bright on the subject I just wanted to reply

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