There is nothing tougher than trying to plan the perfect wedding with skin that is completely unpredictable. Fear of being the center of attention during a very romantic celebration is often times too much for an acne sufferer to bear.


The lesson of this blog post is that skin that feels unpredictable is not really in good control.


Real control comes with it a sense of confidence and a lowered level of anxiety, allowing one to focus on other aspects of life. (like the flowers and catering for the reception…)

When you watch this video, you can really feel how her anxiety vanishes once her skin is in total control.

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©2010 “Wedding Day Anxiety?” by Dr. Neal Schwartz

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

This recent interview was about acne relating to Polycystic Ovarian Syndrome.

(PCOS Interview)

Many of our patients in this practice have PCOS.

“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