There is major conflict going on in the world of acne treatment that is driving patients more crazy than the condition itself. I’m referring to the repeated lack of confidence a patient has for their chosen practitioner.
The real problem is that this lack of confidence is often times justified and makes sense when you consider the amount of failure currently going on in the world.

In order to preserve the minds of the many continuing sufferers, I want to do another pro and con list specifically regarding Board Certified Dermatologists. I will make a new blog category today organizing these pro and con lists to help people get their heads around what is going on in the world of acne treatment. My intention with these lists is to prevent patients from being baffled by what is going on in the offices they choose. I want everyone to understand the reality of the medical world we live in and work wisely from within the confines of this reality.

Pros of seeing a Board Certified Dermatologist:

1) They are legally and ethically held accountable:
This aspect immediately makes going to see a real doctor completely different than taking irresponsible advice on a blog site. Doctors have an accountability that is monitored by the state government, their specialty associations, and their peers. They are held to a high standard of “First doing no harm”
For this reason, seeing a real doctor is a relatively safer move.

2) Powerful Remedy Options: A good dermatologist has the ability to quickly blast old bumps with injections, lasers, aestheticians, antibiotics, and creams. With this extended arsenal, a dermatologist is the best place to go if you have one large rogue bump that needs to be fixed fast.

3) Credentials: There is no doubt that your dermatologist is more knowledgeable regarding the anatomy, physiology, statistics, and science of skin than any other practitioner you will ever run across. The amount of hours, meetings, competitive testing, and speaking on the topic is far more extensive than any patient can ever imagine.
For this reason, doctors who have been in practice for many years are true experts in the field, having spent tens of thousands of hours at their craft.

4) Some really do care: Although they get a bad rap, some dermatologists are still very passionate about helping acne sufferers. It may take a few tries before you find one you can connect with on an emotional level.

Let’s look at the other side to break down why so many patients are losing their minds in this system.

——————————-> (more…)

One of the earliest posts on this blog was called, “My skin is Special”

It talks about the emotional phenomenon of categorizing oneself in a hopeless situation based in prior heartache and failure.

After seeing this next unbelievable case, I will ask you whether you still think your case is special and untreatable.

Pay close attention to every detail of a case that seemed unbeatable for years.

History:

Acne for 18 years!
Flares mostly with Menstrual Periods
Never had a clear month (”no vacation”)
emotionally affected
life choices and dreams affected
compensatory life skills were developed to overcome the challenges.

Prior Failures:

Multiple Dermatologists
Accutane
Oral Antibiotics
Rx Topicals (multiple)
OTC Topicals (multiple)
Lifestyle Modification
Food Changes
Home Remedies
“Everything”

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©2010 “My Skin is Special (Part 2)” by Dr. Neal Schwartz

(Continued from “Are you still Hoping and Waiting”)

I keep meeting people who are hoping and waiting for their acne to get better.

They are either trying to grow out of it or wish it away. It’s tough to witness as this condition can stick around unnecessarily for a lifetime if not properly taken care of.

My mom turned 60 the other day and mentioned to me that her face didn’t feel oily anymore like it always had. (she had bad acne when she was younger and never had asked me for any treatment for the oiliness. I think she just noticed it more when it was no longer present.)

I thought to myself, “ok, now I know what to expect as far as really growing out of this thing”

I met a 54 year old lifetime acne sufferer the other day in the office and we had a chat about the confusion that exists regarding outgrowing acne or oily skin. I told him the story of my mom and then told him…, “Only 6 more years and you’re golden…”

we laughed and spoke more about his life with the struggle of a heavy face full of oil and occasional bumps.

I meet with acne patients in their 30’s, 40’s and 50’s every month and invariably the misconceived idea of growing out of it comes up in some conversation.

To minimize underestimation, frustration, and further emotional trauma..,
I think its important to be very clear with young patients who are struggling with this chronic condition.

Here’s the reality of the chronic human condition we call acne:

1) If you have a family history of acne, it started young, you are oily, and you have had it for years:
Expect to battle it for a long, long time.

Your mission is to completely win the battle. Thats what this program is about. Victory over a very powerful beast.
Here’s what a true victory looks like:

-you are not scared of food
-you are not scared of any activity
-your skin feels great
-your skin looks calm and healthy
-you can touch your skin, others can touch your skin
-you are no longer neurotic or fixated on your skin and have moved on to more interesting passions in life.

2) No amount of wishing, hoping, begging, or negotiating will ever magically fix this stubborn condition for you.
Rather, you’ll need to beat it and keep it good so you don’t create further wear and tear. If avoiding things in life because of your skin, you haven’t yet found a full victory.

3) There is neither a Cure nor Root Cause for any chronic condition of life:
-Chronic conditions of the human body never have a cure. They need to be inactivated and maintained for people to move on and heal physically and emotionally.
-Chronic conditions of the human body do not have a root cause. The root cause is the humanity itself. We are all predisposed to chronic conditions in differing degrees. (more on this topic later)

4) Are you “hoping and waiting” while on Dr. Neal’s Acne Bootcamp™??
yikes.., read this post many times and email as instructed when concerned.

5) And lastly as always, It’s important to know that Time = Scarring.

(watching people hope and wait with treatable conditions is a painful experience…)

Hope this helps people get their head around this thing.

I teach people that true power in life comes from working within the confines of reality.

Although magical thinking is fun and soothing, it creates weakness through frustration, disappointment, anxiety, and Fear.

To attain any goal in this lifetime whether it be acne, fitness, success, relationships, or any dream…,
you will find the most power working creatively from the confines of reality.

Bravely confront the truth and what is real, and you will find the step by step pathway to achieve your goals.

-Dr. Neal

©2010 “Hoping and Waiting (Part II)” by Dr. Neal Schwartz

If you’ve been reading my blog for awhile, you may have picked up some of the new language I use to describe issues of the skin.

Here’s another term I like to use to describe one of the trickiest skin situations that is commonly encountered.

Dr. Neal’s definition of “Troubled Skin”:

acne-prone skin that is oily, sensitive, thickened, prone to flushing, prone to redness and flaking, prone to premature aging, prone to discomfort and often times intolerant to all types of topical preparations. (Although often times seen in post-accutane patients, this situation can occur in any chronically oily patient)

If left inflamed for decades, the uncomfortable sensation and premature aging can dramatically effect a patient’s emotional stability and wellness.

Anxiety is the norm in patients caught in this chronic situation.

Case Presentation:

This highly intelligent and likable guy suffered for 10 years despite the greatest of efforts to get past the beast of troubled skin.

He had tried and failed:

Accutane
Benzamycin
Epiduo
Sulfacetamide
minocycline
Alkaline Diet
multiple other food restrictions
All OTC combinations

When he arrived at The Acne Practice, he was very anxious and complained of acne, oily skin, uncomfortable skin, flushing, and redness.

Watch very closely as the most difficult type of Post-Accutane skin situation can also be completely transformed.

This case, and others like it to come, represent both the stuggle I myself went through for years and what is possible for ALL chronic inflammatory conditions of the human body.

If you listen to my bio, pay close attention to the time in my life where my skin could not even tolerate exposure to water. During this time, my skin was very “troubled” and it took some time to get out of that highly inflamed situation.

Patients who have already taken Accutane often times run into the situation of Troubled Skin because they are unable to remove the ever-present oil due to issues of extreme skin sensitivity. Any product they use to cleanse the skin can turn them bright red and flushed. It’s a very tricky situation to navigate as too little cleansing leaves them an oily mess and too much leaves them flushed, inflamed, and often times incapacitated by facial discomfort.

My hope is that this blog, these videos, and this practice will bring awareness to this real health issue.
(I call it “Troubled Skin”)

For awareness sake, I think its fair to say that most dermatologists, primary care doctors, and skin care experts fumble around with this type of ultra-sensitive, troubled skin. You may be handed a diagnosis of “Rosacea”, “Seborrheic Dermatitis”, or “Eczema”. And then may be handed guesswork from topical anti-inflamatories, metrodnidozole, tetracycline, tar, zinc, selenium, special diets, and the list of guesswork goes on and on.

The real diagnosis in this situation is usually Acne combined with Seborrheic Dermatitis, but this doom and gloom diagnosis will not help anyone whose face turns bright red with the immediate application of any topical preparation.

The new term “Troubled Skin” has a much more clear and optimistic plan as a patient can imagine that what gets troubled, can eventually get Well in time with the proper assistance.

The diagnosis Seb Derm or the common misdiagnosis of “Rosacea” for this situation will only enhance the self-victimization of those who will inevitably focus on the misconceived idea of “no cure”
(we’ll talk more about “no cure” for all chronic conditions in future posts)

I hope this video and blog will create global awareness and optimism for this relentless situation.

-Dr. Neal

©2010 “Troubled Skin” by Dr. Neal Schwartz

This is likely a long-awaited post.

I will share with you my firm stance on the issue of food and acne as an innovator in the field and a lifetime sufferer.

Let’s review first why there is such a controversy to begin with:

-For several decades, Board Certified Tenured Dermatologists have held an adamant stance that “diet is not related to acne” based on multiple studies that have failed to prove any correlation.

Aside from possibly Milk and Iodine, you will very rarely hear from a dermatologist or Family Practitioner that food and acne are related.

On the other side,

-you will hear from a huge group of acne patients that some foods trigger worse episodes than others. You will also hear from some sufferers that mild or extreme dietary changes lessoned or even stopped their breakouts.

So it seems we have a problem here??

Either the most credentialed skin care specialists on the planet are completely incorrect or patients are completely deluding themselves??

Dermatologists, who mostly have not had decades of active acne are saying “No” and lifetime sufferers are saying “Yes”

FAQ:

“So Dr. Neal, what’s the real story with Diet and Acne??”

Many people have asked me this question and I believe now is a good time to end this confusion once and for all.

As an innovator of this field, I present to you:

Dr. Neal’s Clinically Derived, Non-Theoretical, Firm Stance on Diet and Acne:

Before getting into this very emotional topic, allow me to first preface by saying I always try to eat very well and recommend conscious eating and living to everyone around me.
Today we are going to be talking about the common mistake of living life with “fears of certain foods”

Here’s the situation:
Many people come into my office scared of eating pizza, chocolate, caffeine, salt, citrus, breads, chinese food, gluten, soy, greasy food, french fries, hamburgers, and many more specific foods. When I ask, they tell me that these foods make them breakout worse than when they avoid them.

(should I believe them??)

Since female acne patients can accurately describe worsening of their condition before menstruation, why wouldn’t they be able to accurately describe worsening with other changes in life???
This is one reason i trust the story of my patients who speak of breakouts with specific foods.

The other reason is because I already know that when my own skin is already out of control, dietary changes affect my oiliness and skin activity as well.

Note** the key detail in the above statement is “when already out of control”

To understand chronic conditions on the next level, It’s important to first teach the difference between an “Aggravating Factor” and a “Cause”

This is a very important distinction:

“Aggravating factors” aggravate existing conditions.
“Causes” bring on a afflicton that would not have occurred otherwise.

If an aggravating factor is strong enough, it can bring an asymptomatic person to a state of symptoms. However, these factors are still not considered “causes” when dealing with common chronic conditions of life. All Chronic conditions have no real root cause as they are a part of a spectrum of humanity. We are all predisposed to them at varying levels on the bell curve of predisposition.

(i.e. aggravating factors can only be the straw that breaks the camel’s back in the case of chronic human conditions)

I’ll use an example to illustrate an “Aggravating Factor”:

” Billy usually has no problem eating spicy foods. However, since his stomach has been acting up lately…, he decided to skip on the hot sauce today.”

In this example, the hot sauce is a known aggravating factor that only plays a significant role when there is already an irritation or inflammation present.

The same is true for Acne:

If there are foods in your life that you are avoiding because you know they will worsen your acne, you may be making a wise decision to avoid this loaded aggravating factor. However, here’s the part of the story you have yet to experience….

If you were to “Totally Inactivate” the skin at a much higher level, you would be able to eat any individual food without fear or consequence to your skin.

How am I so sure of this??

Because the majority of patients you see in the videos let me know they were scared of certain foods before entering the program. When completed, I ask them if they are still scared of “greasy foods” for example, and they tell me, “I can eat whatever I want without fear.”

(similar to the upset stomach conversation. When Billy’s stomach feels resilient and strong again, he can eat spicy foods without fear or consequence.)

I’ll bullet point some facts from the office to help summarize the reality here:

–Food can act as an “Aggravating Factor” of any active inflammatory situation including acne.

–Doctors who say Food has absolutely nothing to do with acne most likely have never had 10 years of acne. (they are quoting studies)

–Holistic practitioners and enthusiasts who hype up dietary changes as the “Cure” for acne are hurting many people by creating confusion, false hope, and needless scarring from wasted Time.
(improper focus on aggravating factors alone)

–Eating consciously does affect every system of the body including the skin.
(think aggravation and allieveiation rather than “Cause” and “Cure”)

–In contrast, eating unconsciously can have a cumulative negative effect on the look and behavior of the skin.

–When “Totally Inactivated”, you can eat whatever you want without immediate fear or consequence to your skin.

–If food still “breaks you out”, your skin is not in great control at this moment.

–All cases can be totally inactivated and freed up from fears of living and eating.

–And of course, no case is special. (acne is clearly a self-victimizing condition)

Bottom Line:

**Although foods may aggravate your current skin situation, they are neither the cause nor the cure regarding the chronic human condition of acne.

**Healthy eating is always recommended for countless reasons. (primary being energy, mood, and wellness consciousness)
However, when the skin is “Totally Inactivated”, you can eat any individual food without immediate fear or consequence.

**If you are still scared of foods, your overall chronic condition is not in great control.

hope this helps,
-Dr. Neal

©2010 “Food and Acne: (the biggest controversy since sliced bread…)”
by Dr. Neal Schwartz