Exactly why some people get acne and some do not is not fully known. It is known to be partly hereditary. Several factors are known to be linked to acne:
Acne that is close to skin surface are what we know as whiteheads and blackhead, non-inflammatory type of acne. Acne that is painful to the touch and swell up, on the other hand, is the inflammatory type of acne. These are the pimples or zits and they can leave scars since they go beyond the top layer of the skin.
I know how you feel, trust me. I wouldn't take my shirt off for years to show off the healthy body I worked on because the acne made me feel worse on my arms and back.
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