Since the inception of the video gallery in 2007, people have asked me the seemingly simple question, “What is the cause of Acne?”

I will answer this age old question today in such a crystal clear manner that this question will forever be put to rest. Once this inquiry is fully resolved, people will then be able to grieve properly over their current situation and move forward in their pursuit of total inactivation and satisfaction.


So without further delay, I present to you:


Dr Neal’s Clinically Derived, Non-Theoretical, Firm Stance on the “Cause” of Acne:


1) Understanding Humanity:

To understand the “cause” of acne, you will first have to understand that there is no cause, no cure, and no magical source of your acne. The “cause” of your acne is your humanity itself. Every single person is prone to acne in some degree on a bell shaped curve. The condition you are suffering from is the same condition that people were emotionally reacting to in the 1950’s. It was battled throughout our history and has forever been mentioned in association with humans walking on this planet.





The degree of proneness is originally set up by both your inherited skin type and your development, both in-utero and as a child.
The people on the left side of this curve are less acne prone and the people on the right are more acne prone. The bell curve is made to show how poplulations have averages and extremes. Notice there are less people who are at both extremes. There are very few people on the far left who have never noticed a pimple in their life and there are few people on the right that had to come to this practice after failing accutane more than 4 times. The middle of the curve represents those with mild pimples occasionally who are more easily satisfied with any age-old topical preparations. It is this average majority that is responsible for minimizing the emotional effects and difficulties of acne. The reality is that, regardless of motivation, nutrition, fitness, and hygiene, it is easier for some people to beat than others. Period.


Grieve and deal with this reality and do whatever is needed to fix your specific situation. As proven by the video gallery, there is no location on the bell curve that is not treatable to total inactivation and satisfaction. (See the post-accutane playlist on the home page for examples of very resistant cases)




2) Aggravating Factors:

Now that you understand your own humanity and understand that acne has been around since the dawn of mankind, we can unemotionally discuss all the aggravating factors of acne that are often times misconceived as “causes”.


Stress:



What is stress?? I like to use plain language so I’ll just define it for you from the top of my head. To further your investigation, you can look up other people’s poetic interpretations as well. In my mind’s eye, Stress represents a true biochemical/physiological reaction that can’t be properly contained or harnessed by someone’s physical or emotional coping skills or resilience. This chemical reaction can come from physical trauma, fear, loss, anger, work, medical illness, or anything that is distressing emotionally. The reaction can also occur with over-excitement or manic reactions that can’t be fully contained.


The subtle buzz of stress is the most powerful aggravator of acne in my experience. It has the power to take someone on the far left side of the curve and blaze them open with a huge breakout. A stress induced flare of someone from the left side of the curve usually sounds like this clinically, ” I never had acne my entire life until I got divorced at 34. Since then, my face and my life have been a mess.” Although stress in this example is the main aggravator, the cause is still the person’s humanity. It just got flared up by stress.

When someone further to the right side of the bell curve is stressed, it usually sounds like this clinically, “I have always had acne to some degree but since I’ve been cramming for finals this week, my acne is much worse than ever!!”

To make matters worse, the emotional stress of dealing with acne also directly aggravates the situation and thus we have one of the toughest, downward spiraling conditions known to mankind.


Nutrition:



For many good reasons, there is much talk and passion in the world of Nutrition these days. Rather than get everyone manic on the magic food or food restriction that will “cure” you, I like to place this aggravating factor within the conversation of stress above. Think of it this way, having great nutrients decreases the workload and stress of the body’s maintenance and eating unconsciously and recklessly causes more stress on the functioning of the body. When you think of the art of nutrition in terms of stress inducing and stress relieving, you will start to understand how the body works. There is no one magic food and there is no one demon food. Think like an artist and consciously paint every detail of your life under manual control rather than by habit.

Avoiding foods you know aggravate your skin is a good idea for now, but always know that a person in real control of the activity can eat anything they want without consequence or fear. The only dietary recommendation I made for every patient in the video gallery was, “do the best you can to make good lifestyle choices.” Many people continued to eat unconsciously and still became completely inactivated here. Furthermore, many ultra-conscious healthfood enthusiasts have come into the office with full faces of active acne. (and expectedly, they were baffled by the situation)

Go figure, food is not the “cause” of acne. This is further proven by studying the eating habits of people with healthy skin. You’ll find countless individuals with beautiful skin that have very poor nutrition. (check out the skin of the homeless population. I observed these individuals for years when I worked in the Hospitals of New York City)

Food is simply a potential aggravator for those who are not in total control of the overall situation. Those who desire a great life full of energy, a balanced mood, and disease prevention are cleverly making good food decisions every single day. I feel much more energetic when I eat nutritiously.


Fitness:



Think of fitness or lack thereof in the same context as the stress topic above. Those who are in great cardiovascular shape are more resilient to every stressor of life. Those who are sedentary are vulnerable to every common stressor of life. I can’t emphasize this enough. if you are not breaking a sweat every single day of your life, prepare yourself emotionally for all the predictable chronic conditions that are headed your way sooner than later. Type 2 diabetes, high cholesterol, high blood pressure, depression, anxiety, insomnia, joint pain, and impotence will come to all who are sedentary. That is a promise. It’s so painfully predictable.

If sweating and cardiovascular exercise is currently aggravating your acne, know that you are at risk of making a bad decision. If you mistakenly choose to give up sports for any reason, you have just condemned yourself to a lifetime of depression and furthermore, your acne will still not be in total control just by avoiding this activity. The solution is knowing that once in total control, you will be able to participate in any physical activity, even with sunscreen slathered all over you face. (see my surf videos in the blog)


Skincare Routines:



An inappropriate or poorly managed skin care routine can aggravate a current acne condition. Many people are making their acne worse every day while trying to fix their skin by themselves. Asking for assistance from a real expert can be critically important.


Unending List of Aggravators: Hormonal changes, the sun, the cold, the humidity, makeup, dirty air, dirty sheets, phones on the face, rubbing your face, and countless other activities are all aggravators only for skin that is already not in great control. Know that when your skin is in total control, you can have a massage therapist rub your face for hours, and you can mash your face into an old pillow case without fear or consequence.

Know also that women who are in total control of their skin can have menstrual periods without a breakout. Those who are only in partial control going into their monthly cycle are at risk of a “hormonal” breakout. It’s all just aggravation of plain old acne. (Learn more about the misconception of “Hormonal Acne”)




3) Improper or Delayed Treatment:



(The longer the skin remains out of control, the more stubborn the condition becomes)
After genetics and aggravating factors, the third main component that determines the stubborness of an acne situation is the amount of time spent active. Similar to all chronic situations like obesity and bowel trouble, the persistence of imbalance or active inflammation on the face can create a new setpoint for the skin that makes it more resistant to change. When your skin remains undertreated or mistreated for many years in a row, expect the skin to behave a little differently than it did 5 years prior. Not permanently, but for awhile until a new, more balanced, setpoint can set in. (i.e. it has to be inactive for awhile before behaving normally again)

I have witnessed this phenomenon of chronic conditions for many years. The Dermatology community has also observed this patten and I recall many other doctors saying, “For acne, treat swiftly and start treatment at the earliest stage possible”

See the post on “Troubled Skin” to see what years of both active inflammation and improper medical treatment can do to skin in general. The take home point of this third component is that skin that is left untreated or improperly treated will become a more stubborn case in the future. This is a time-senstive condition.






The Bottom Line:

1) There is no cause nor cure for any chronic condition of the human body. The goal is to achieve total inactivation, emotionally heal from the ordeal, and efficiently maintain the balance.

2) The 3 main components that make up an acne situation are: Hereditary, Aggravating Factors, and Duration of ongoing activity.

3) Now that you understand the “cause” of acne, you can focus all your energy on the battle towards inactivation without fear or distraction.

©2011 “What is the “CAUSE” of Acne??” by Dr. Neal Schwartz

You may notice as you browse this site that I always place quotes around the term “Rosacea” whenever I speak of it. The reason is because, in my opinion, there is no other inflammatory facial condition that has been misdiagnosed and mismanaged as frequently. Not surprising is the global pessimism, retirement, and depression surrounding a condition that is fumbled with as the standard of care.


The scary part is that most of these diagnoses and treatment attempts are coming from the most credentialed board certified dermatologists around. When a consensus of real experts are seen as off-point so often, it has to be considered that there is not only a diagnostic inconsistency, but maybe one of a semantic discrepancy…? (i.e. doctors are calling anything that is red rosacea as a “working diagnosis” to introduce treatment attempts. This idea would be reasonable except…, the diagnosis itself often times creates a self-victimizating mindset which can then perpetuate the spiral of hopelessness.)


When I make an adamant stance on this blog, I’d like it to be understood that these expert opinions are being made within the reality that there is no right and wrong in the world of art, and that medicine is certainly not a hard science. The “standards” of westernized medicine have accidentally mislead many people to believe they are speaking in fact rather than outcome statistics. Given that I’ve spoken to thousands of people who are needlessly suffering from “Rosacea” despite treatment at this time, it seems appropriate to both challenge the standard algorithm and to give insight into the treatment of skin that is inflamed, red, flushing, and uncomfortable. As always, these opinions have not been generated from any form of solitary imaginative thinking. Rather, they have been derived from paying extremely close attention, succeeding in the most hopeless clinical situations, and of course, video taping the results.




I will break this important post into two main categories. Those who have been misdiagnosed with “Rosacea” and those who have been accurately diagnosed yet still have failed the standard of care.

1) The Epidemic Misdiagnosis of Rosacea:

If your skin is red, raw, irritated, has broken blood vessels, has sensitivity to light, spicy foods, alcohol, and heat…., you will probably get a diagnosis of Rosacea from many primary care physicians and dermatologist alike. As mentioned above, they may be using this diagnosis as a quick “working diagnosis” to initiate attempts at treatment.
Here’s what physicians and patients are not taking into consideration when making this diagnosis:


-Oily skin alone can cause all these symptoms also.
-Acne prone and inflamed skin from acne can also cause these symptoms.
-Seborrheic Dermatitis causes all these symptoms as well as eye irritation. (there is also an epidemic misdiagnosis of ocular rosacea)

Read this part closely:
-Oily skin causes Seborrheic Dermatitis. (a chronic skin thickening and sensitivity due to oiliness or what is called “seborrhea”)
In a high maintenance patient, Seborrheic Dermatitis will not have the classic scaled and thickened appearance because this patient is constantly removing the flakes every day. Instead, they will present with only red, sensitive, flushed, uncomfortable skin. This presentation is not easy distinguishable on physical exam from rosacea and the misdiagnosis and lifetime treatment failure are driving millions of people crazy.


Here’s a very important sidenote to prevent any new self-vicitimation after hearing the diagnosis of Seborrheic Dermatitis:

All oily-prone and acne-prone patients are also prone to a bit of thickening and seborrheic dermatitis. This diagnosis is simply descriptive and in no way dooms people. It’s tricky, but like acne, is always treatable as proven in the redness videos on the home page. I refer to this type skin as “troubled skin” to avoid the emotional pitfalls of hopelessness that are generated from labels and diagnoses.

2) Those with Classic Rosacea who are still suffering:
If the diagnosis of Rosacea has led you and your doctor to a victory over your facial inflammatory ailment, I’m very glad to hear it. This section of the post is for those who have the classic and obvious diagnosis of rosacea yet still have not achieved inactivation despite going deep into the 20 year old algorithm of topicals like metronidazole, antibiotics like tetracycline, and finally isotretinoin. What is important for this group of sufferers to know is that all inflammatory conditions of the face and body are treatable. Inflammation only propagates for years when improperly treated. Let it be known worldwide that the classic rosacea treatment algorithm has helped millions and failed millions. Do not be baffled or depressed if your rosacea is not responding. It happens all the time. This condition is also completely treatable in this practice. Feel free to send your story and focused photos if you’ve tried “everything” and still need some help with it.




This post is intended to be read by both confused patients and practitioners themselves.


To the passionate doctors of the world,

“Please hesitate before dooming someone with the misdiagnosis of Rosacea. All that is red, sensitive and irritated is not “Rosacea”. Here’s some tips that will prevent the misdiagnosis:

-Tip #1: If a patient has a history of acne, oily skin, blackheads, and sensitivity issues, consider you are working with an acne-prone skin manifestation we call seborrheic dermatitis.

-Tip #2: Many patients with Seborrheic Dermatitis won’t present will scales because they are diligently removing them in a desperate effort to get clean.


Furthermore, when confronted with a real case of classic non-oily rosacea, think twice before ending the management of it after the basic cookbook algorithm is exhausted. These chronic conditions sometimes take more touch than knowledge. We know they don’t really teach the art of medicine in medical school. It’s something that needs to be indulged and cultivated by each and every passionate practitioner.”




The Acne Practice video project represents much more than just an acne solution for those who have become hopeless.

In a world where Acne, Rosacea, Seborrheic Dermatitis, Low Back Pain, and Heartburn are not curable, I’m introducing and illustrating, in high definition, a completely new medical treatment paradigm that is a step forward from the approaches of both traditional Western Medicine and ancient Eastern healing. I will be detailing this new medical paradigm for all chronic ailments in a future post which will break down the history, strengths, weaknesses, and fundamentals of all medicine that is commonly practiced at this time.

I’ll be here,
-Dr. Neal







©2011 “The Epidemic Misconception of “Rosacea” by Dr. Neal Schwartz

hello everyone,

I’ve been getting this question since the inception of The Acne Practice and I thought this post would help clear up some of the global confusion about acne and chronic conditions of the human body in general.

Here’s the reality:

There is no magical cause of acne. (read that twice)

There is no magical cure for acne. (read that twice)

There will never be. If I’m wrong about this, I’ll happily move on to another passionate chronic condition that ruins people’s lives.

With this understanding, one will also realize there are no magic single ingredients.
There are also no demon ingredients. None of the current FDA acne ingredients are the magical cause of cancer on our planet.


If you find yourself angelifying or demonizing single ingredients, consider you have become victim to the trauma of acne, prior failure, and the marketing machine of the 21st century.

The more a company convinces you that the ingredients are the magical secret, the more they can hype up the magic fruit they found on the far off reaches of the volcanic islands.

I’ll break down the marketing logic for you in full detail:

inaccurate premise #1 There is a magic cure for acne somewhere on the planet, we have just yet to find the secret source.

inaccurate premise #2 The fruit of the magical islands of _______ , (fill in Figi, Tahiti, Hawaii, or any other beautiful remote place), has a fruit that has magical healing powers. When applied to the skin, magic will happen.

Therefore: Since we have harnessed the power of this magical fruit in our acne line, we have found the CURE for acne!!?!!

Perfect logic! …and totally inaccurate based on the inaccurate premises. (Reminder that logic is based on consistency, not accuracy)

Here’s another mistaken road people take with ingredient focus:

Premise #1: Acne Ingredient “A” makes me red and irritated

Inaccurate premise #2 Redness and irritation are the signs of a real skin “Allergy”

Therefore: I am allergic to Ingredient “A” for life.

Perfect logic, and completely inaccurate.

Here’s another:

Premise #1: All acne ingredients make me red and irritated.

inaccurate premise #2: Skin that can’t handle any acne ingredients must be special and different from all other people.

Therefore: Since I can’t use acne medications, I am doomed to have acne forever. My case is special and untreatable.

perfect logic! … and completely inaccurate. (see 135 videos including those with skin allergies)

Here’s another:

premise #1 I know everything there is to know about skincare ingredients.

premise #2 I still have active acne.

inaccurate premise #3 Ingredient knowledge is the key to healing

Therefore: Since I know everything and still have acne, my acne must be untreatable!!?!!!

perfect logic!! ….and classically inaccurate.

Here’s a question for you:

If ingredient focus is the key to clearing acne, why are there so many biochemists, skin care formulators, and self-proclaimed experts with active acne??
How is this possible??
They know everything there is to know about the science of skincare??

Maybe science has limitations in the world of chronic human conditions?? Think about it…

FAQ: then what is the cause, and how do I fix it??

Answer: The reason there is no single source is because the cause of acne is our own humanity. There are different degrees of family predisposition, but everyone can break if pushed hard enough.
Some families have a ton of it, others have less. Some people with no family history stress themselves out enough to be the first in the family to suffer. Some people have had it since puberty while other lose control for the first time in their 30’s. Its a combination of 3 main factors we will discuss in detail in a later post.

This same idea is true for all chronic conditions.

Rather than magic single causes and cures, try to keep in mind the idea of aggravating and alleviating factors for the following human conditions:

Acne
Gastritis
IBS
Chronic Fatigue
Depression
Obesity
Anxiety
Panic Attacks
Hemorrhoids
All Chronic GI Ailments
Eczema
Hives
Tension Headaches
Low Back Pain
Acid Reflux
etc. (anything you see remedies for over the counter)

can you start to see what a human chronic condition is verses an acute affliction??

Chronic Conditions have no single magical cause and no single magical cure. The ailment companies of the world would rather you believe otherwise. How else would they hype up the special “juice” (see photo below)

(from 2003 to about 2007, countless patients of mine would go nuts over the healing power of this magic juice. Then somewhere along the line, I stopped hearing about it from patients…?
do you think they ran out of fruit on the magic island??


or maybe hype is what it is: A way of marketing to an unsuspecting audience who does not understand the nature of chronic human conditions.

In this practice, people like the products not because what they think they can do based on magical ideas, but rather how it feels on the skin. Creating base formulations is much more of an art than a science.
Also.., this practice was created specifically for those like myself with skin allergies and sensitivities and requires zero active acne ingredients for those who are extremely sensitive. Each kit comes with over 1000 possible combinations.

When you can break down this next sentence, you will undertstand why ingredient shopping is a classic mistake and you will understand the mission of this expansive medical project.

“Although there is no cure for acne, any chronic condition, or even death…., when one’s ailment becomes completely inactivated and time allows the mind to heal from the ordeal, one can truly become “cured”

This type of dramatic transformation has been captured countless times in HD to allow hopeless people to see what is possible. If still hopeless, I recommend watching them all.

Bottom Line:



Angelifying or Demonizing any ingredient for any chronic health condition is a simplistic and failure-prone perspective on both medicine and wellness. The single source/single cure mentality creates mistaken hopelessness and a powerful hype that companies love to harness for marketing.

when something becomes Angelic, “Yes!…, we have this special ingredient in our formulation!!”

and when something becomes demonized by unproven fear, “Oh no!!.., We never use that horrifying ingredient!!”

It’s classic. Hopefully this project will help clear things up.

take care,

-Dr. Neal










©2010 “What is the Magical Active Ingredient??” by Dr. Neal Schwartz

While some misconceived thoughts about acne have been generated by public hype and mysticism, the idea of “cystic acne” is purely to blame on western medicine’s diagnostic language accidentally spilling into the public arena.

These arbitrary terms make more sense if you know how western medicine operates and evolves.


With the advent of more invasive and risky acne medications, doctors needed a cut-off of acne severity to justify when to take the risk of heavy treatment. This cut-off helped physicians weigh benefits of scar prevention and emotional preservation verses the risks of powerful systemic treatments of all kinds.

The cut-off made sense using the idea that someone with “cystic acne” had a serious health risk while those without cystic acne were more safe and maybe shouldn’t risk messing with a livable situation.

The classic western algorithm of topicals, oral antibiotics, hormonal treatment, and accutane has since grown and branched itself off this special cut-off we call cystic acne.

Here’s the problem:

When you categorize levels of a common chronic condition, you create special cases and victimization. In this case, it’s the doctors’ misunderstanding of acne as a whole that allows them to tell a patient, “I have bad news for you.., you have cystic acne”.

After hearing such a unique diagnosis, a patient can easily give in to hopelessness knowing that they have a special, rare, “internal”, and unbeatable disease.

It’s classic medicalization or what I call induced victimization. (a term I use to describe self-victimization that is generated by an authority figure)

In an effort to fix what has been broken for decades, allow me to correct the language of acne.
From now on, we will call all cases of acne “Plain Old Acne”, and understand that when it comes to all chronic conditions, there are no special cut-offs. Only shades of gray that have differing levels of inflammation. This new way of speaking about acne will not allow for any victimization as this project has already proven that all cases of acne are completely treatable without oral medications.

To further this line of thinking, here’s yet another severe case of acne that was treated without any oral medications, lasers, or dietary restrictions.

(the full screen button is in the lower right corner)

Bottom Line:

There is really no such thing as “cystic acne”. It is simply an arbitrary term used to help physicians make tough treatment decisions. There is, however, a chronic condition called plain old acne which can manifest in a variety of magnitudes.

Plain old acne is the same acne that was relentlessly battled in the 1950’s….
It has always been difficult and has hurt millions of people.
This reality combined with the video gallery will help create the optimal mindset for victory.

be well,
-Dr. Neal

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©2010 “Classic Acne Misconception: “Cystic Acne”" by Dr. Neal Schwartz

In the Post entitled “Vegetarians with Acne”, I discussed the basic feeling of being baffled with acne while maintaining an ultra-healthy lifestyle.

In this post, we can revisit this emotional issue and continue to illustrate how hopelessness is created from doing “Everything Right”

Lets breakdown how logic can create hopelessness for a motivated, health conscious individual:

Misconceived Premise #1: Diet is the cure for all normal acne.

Premise #2: I eat a masterful diet.
(ex: raw food, vegan, vegetarian, organic, grass fed, paleo, etc…)

Premise #3: I still have acne.

Therefore: My acne must be abnormal and untreatable.

That’s perfect logic.

(Remember that the power of logic is not based in accuracy but rather in consistency. Premise #1 is inaccurate and therefore the perfectly logical conclusion is also inacurate.

If you are making great dietary efforts and this internal thought has crossed your mind, you have just become victim to what I call “needless suffering”. A powerful breed of hopelessness that is generated from the power of logic regardless of how inaccurate the premise.

If needed, here’s some logical arguments that will get your mind back on the right track:

Premise #1: Diet restriction is well known to have failed millions of acne sufferers.

Premise #2: You are an acne sufferer.

Therefore: Diet restriction may fail for you as well.
(Do not be surprised by this common outcome)

If still hopeless, try this one…

Premise #1: All Acne is treatable. (a well known reality that has been proven in over 130 videos)

Premise #2: You still have acne.

Therefore: Your Acne is treatable.
(There is no amount of hopelessness that can refute this reality.)

Bottom Line:
Eat well. It will help your mood, your energy, and possibly your skin. Do not be surprised if you still have active acne on a perfect diet. Diet has never been and will never be the ultimate “cure” for acne.
The power of logical conclusions can create hopelessness for those who suffer from treatable conditions. This type of needless suffering hurts us all.

Here’s a video of another health conscious vegetarian who still suffered from chronic acne despite her great lifestyle.
(The high resolution may need a moment to load up)

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©2010 “Vegetarians with Acne?? (part II)” by Dr. Neal Schwartz