Archive for the ‘The Cause of Acne’ Category

What is the “CAUSE” of Acne??

Saturday, June 18th, 2011

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”.


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.


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.


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

13 Responses to “What is the “CAUSE” of Acne??”

  1. annemarie Says:

    Thanks for the understanding of what and why my 17 yr. old has been battling acne for 3 yrs. Under the car of a dermo, family practice physician and Len and Joe online Dr.s all making suggestions and offering products that don’t make much of a difference. Every now and then his face may look like it’s improving but a day or two later it looks worse then it was. We would be willing to try your bootcamp product if you really have one. Thanks again for your wisdon and insight in this horrific disease. My son said he’s rather have a disease than have acne. Little does he know. You are the 1st person that has referred to acne as such.

  2. annemarie Says:

    meant “care” not car in line 2 and ‘He’d’ not ‘he’s’ towards the end Sorry

  3. Anonymous Says:

    I am an African American male and have been battlining acne since the 10 grade, I am now 50 yrs old. It seems that my issue is with ingrown hair and not just acne. I only get the breakouts on by face where my hair grows. It seems because of my African American curley hair; the hair curles under the skin before it break through the skin pores which causes the hair to press against the skin internally and cause acne to accure.

  4. admin Says:

    search up “razorbump bootcamp” on the blog to see what is possible for any acne or razorbump situation.

    I’ll be here,
    -Dr. Neal

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