It is both, because they are under the skin, it is probably better to go to a Salon (beauty therapist) and get them to treat them professionally, dont touch them yourself asyou could end up scarring.
Sometimes is could be eating to much dairy food, not drinking enough fluid to flush your system out (and I dont mean drinking coke either, its bad for the skin as it has too much sugar in it and can do all sorts of things to the skin, especially if you have skin problems already, lucky for those who dont) hormones ect ect
You would have to go have a profile/assessment done at the salon and get them to determine the solution.
It is a bit hard not actually looking at your skin.(myself)