Acne not only has physical manifestations of papules, pustules and comedones but this skin disease can also have emotional and psychological effects on the sufferer. Early and intensive treatment is therefore advocated. Acne generally affects areas of the skin densely populated with sebaceous follicles; including the face, upper part of the chest and back. There are many causes of acne with the predominant cause being hormonal fluctuations where excess sebum is produced and when mixed with redundant skin cells, hair follicles will block and form comedones (pimples). Other aggravating factors include using incorrect skin care products (especially those containing emulsifiers), poor quality makeup and primers, diet, some medications, UV exposure and digestive disorders. Acne can also be genetic and the severity of acne can be increased with a rise in stress levels.