Acne vulgaris affects as much as 80% of the adolescent population and persists in approximately 3% of middle-aged adults. Only a percentage of these persons seek medical help, however, acne can cause levels of anxiety and depression akin to a chronic illness. A recurring question from patients who seek help from various healthcare professionals - their pharmacist, family doctor or dermatologist, is "why?" They also ask questions about a possible familial link, the impact of their diet and the association with their hormones. The following review aims to link these factors with the end result - inflammation.