Acne is caused by blocked hair follicles and over production of sebum, causing blackheads, pimples, cysts, nodules, and inflammation. Acne is usually triggered by hormonal changes or imbalances in the body. With acne, very often the breakouts get worse before they get better, this is totally normal, please be patient with your skin. This skin condition requires a combination of Niacinamide, Sodium Ascorbyl Phosphate, Retinoids, and either an Alpha Hydroxy Acid (AHA), Beta Hydroxy Acid (BHA) or Poly Hydroxy Acid (PHA) exfoliator. Results / improvement can take up to a minimum of 12 weeks.