For the past several decades, doctors have been prescribing topical and oral medications for acne and telling people to patiently “wait” for results.  ”I’ll see you again in 3 months”,  is usually the last thing you’ll hear when leaving the doctors office.  While some mild cases will clear up with a single prescription and a smile,  more stubborn cases do not always go as planned.  It is often told to patients coming in, “Your acne will take 6 months to one year to clear up.”   This prognosis is dangerous for many patients because they find themselves in a “Hoping and Waiting” pattern like when they eagerly waited to get their driver’s license.  Unlike other milestones though, real psychological damage can be done when a year has passed and, despite perfect compliance, they are the same or even worse.

        As you can see from several of our case studies,  moderate acne can be cleared in weeks and severe acne can be cleared in a few months when treated properly.  Why then, do many doctors still tell patients 6-12 months??    It is simply the passing forward of the “standard of medicine” from generation to generation.  As you can see from the videos, the standard isn’t always the most effective.  Commonly used topicals like prescription retinoids, benzoyl peroxide,  and antibiotics have ruled this field for decades.   When and more importantly, if at all successful, this treatment concept can take several months to a year.

     How do you know if you should patiently “wait” or change up doctors??   This really becomes a critical question because, on the other end,  many people also make the mistake of switching up before giving their treatment a chance at all.     How can you decide what to do???

Here’s how:   Rather than asking random people what they think you should do,  simply ask your doctor if he or she thinks you are on the right track.  If you can’t get in touch with your doctor after several attempts or feel like he or she really doesn’t care whether you get better or not,  then it’s time to switch.  

©2008 Acne Misconception #5 (”It takes 6 months to 1 year to clear up Moderate or Severe Acne”)    by Dr. Neal Schwartz

    The biggest misconception about acne is the idea that it is a simple problem. Decades of acne marketing with a smile have mislead the public to believe that acne is something you can “just” fix with a small tweak in your washing or nutritional routine. I always encourage my patients to try any simple acne program sold on the market, only to get an idea of how this condition is not as simple as it seems.

    I often get worried when I hear people give others acne advice with a breezy tone that sounds like this:   “All you have to do is just………”            With persistent acne, there is no “just” do this or that.  It can be very stubborn and very complicated.

    We created this program to handle the complexity of persistent Acne.  All possible scenarios can be handled in a new tone that sounds more like this: “Pay attention, this is not a simple problem to defeat. However, although it is powerful, it can ALWAYS be beaten.”  I give online support with all our programs to specifically address the stubborness of this chronic condition.

©2008 “Acne Misconception #4 (”For Acne, all you need is to just…..”)”   by Dr. Neal Schwartz

“Hormonal Acne”

The idea of “Hormonal Acne”  is a newer misconception that has spread quickly among physicians and female patients alike. 

When encountering severe acne, there is always the thought of hormonal alterations causing such a breakout.  The differential diagnosis includes increased androgen secretion from benign growths, malignant tumors, and hyperactive glands.  Fortunately, there are accurate blood tests and imaging studies that can detect such hormone imbalances. If still questioned, the tests can be repeated at a later time.

Real hormone issues combined with the widespread knowledge that oil glands respond to androgens in general, has many patients and doctors believing they are treating a “newly discovered” variant of acne called “Hormonal Acne”,  which has normal bloodwork but distict acne characteristics and locations.  This line of reasoning has since been solidified by the fact that hormone altering medications have been shown to help some cases of acne in varying degrees.

**Before I make a point about this emotional subject, I’d like to refer to the video gallery and note that the vast majority of the female patients in the gallery had worsening symptoms with menstrual periods.  Afterwards, they completely cleared up and stayed clear without any direct or indirect hormonal treatments.

Question:

If all women have SIGNIFICANT hormone fluctuations before and during their menstral periods,  why do only some women have monthly breakouts….???

The answer is because some people are in a State of Acne Proneness while others are not.  The hormones are better viewed as  “gasoline” poured on a “fire”     The acne prone skin itself is the fire and should remain the focus of treatment if all hormone levels prove normal in a simple blood test.

Bottom line:     While Hormonal treatments have been used with varying success in this battle,  Acne is still simply just “Acne”   (Just like it was in the 60’s……)   

This post may be off-putting to some people……  Here’s why:

I’ve observed that women over 25 with chronic acne find it easier to accept their condition under the veil of “Hormonal Acne”.   Maybe it sounds better than “plain old acne”,  Maybe it just doesn’t make sense to have a “teenage” condition throughout adulthood.  Maybe they are sure they have hormonal acne because all other treatments failed except hormonal therapy.  Maybe they locked into this “diagnosis” simply because their physician told them, “You have hormonal Acne”   

The stubborn nature of acne has many people desperately searching for a new diagnosis.  If you look hard enough, you’ll find something else besides “plain old acne” to pin this problem on.  The truth is that the diagnosis of acne is far easier than the successful treatment of it.  

Here’s the story as I see it…..,     All acne prone skin responds poorly to hormone changes.  Acne prone skin is the problem, not the hormones.  Any successful hormonal treatment that works is simply minimizing a major aggravating factor.  This is a fine treatment option for those who don’t mind taking long term hormonal therapy for their skin.  

What about the Acne prone skin?? ……you may ask….

It’s always changeable over time…..  We’ll discuss the misconception of Acne-prone skin as an affliction vs. the temporary state of acne proneness in a separate post.

This topic may be confusing to those who are strongly convinced they have “hormonal acne.”  When all the videos are watched closely, you can see that the women on here are completely transformed without any hormonal treatment whatsoever.

©2008  ”Hormonal Acne” by Dr. Neal Schwartz

       You’re a special person.  With all your quirks, your strengths, your history, and your troubles.  Your skin however, is not special.  Regardless of how intolerant of products, or how  heavily oily or reactive it gets…,  it’s still not special.  Your skin’s current state of unwellness is not unique in any way whatsoever.  Millions of people all over the world have suffered from juicy acne bumps, oil slicked faces, red faces, post-oral isotretinon sensitivity, dry irritation, and oily irritation.  The moment you think your skin is “special”, is the moment you stop looking for answers and stop asking for assistance.  This mistake can potentially cause a lifetime of needless suffering.  

©2008 “My Skin is Special”  by Dr. Neal Schwartz

      Genetics does indeed have a large influence on one’s capacity to fall into a State of Acne Proneness.   The oil gland’s behavior pattern and distribution can vary greatly between and within all ethnic groups.  However, the idea of Genetics being the “cause”  of acne bears great potential repercussions because at this time, our genetics are not changeable.  So it would  stand that if acne is primarily cased by genetics, and genetics are not changeable, then acne is also not changeable!?   The video gallery has already proven otherwise demonstrating that the conversation of genetics and acne is one of mistaken pessimism and is unimportant in the treatment of this condition.

©2008 “Genetics and Acne”  by Dr. Neal Schwartz