The Genetics of Acne

    July 2025 in “ Annals of Human Genetics ”
    Maurice A. M. Van Steensel
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    TLDR Genetics play a major role in acne, but environmental factors and epigenetics also contribute.
    The review examines the genetic basis of acne, affecting over 80% of adolescents in developed countries, and emphasizes the need for non-antibiotic treatments due to antimicrobial resistance and retinoid side effects. It introduces the "comedo switch hypothesis," where genetic and environmental factors influence sebaceous progenitor cell identity, potentially leading to acne. Family and twin studies indicate genetics account for 80% of acne variance, with GWAS identifying loci related to androgen signaling, leucocyte migration, and WNT signaling. However, genetic associations vary across ethnic groups. The review also highlights the role of epigenetic modifications, such as DNA methylation, in acne risk, suggesting that while genetics support the comedo switch hypothesis, they don't fully explain acne inflammation. Larger-scale studies and advanced -omics techniques are recommended for further insights and novel treatments.
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