acne expert

Hello – I’m so glad you found this page “Ask Brea”.  Please feel free to ask me any questions regarding your skin.

Just so you’ll know, I do not always give you the standard answer. I do my own thinking! I study the body, how the body works and relate my knowledge and experience as I know and see it.

My opinion will differ from what the doctors tell you. I often disagree with their treatment plans, their use of antibiotics and topical antibiotic treatments. If you find that you’ve been using antibiotics and topical treatments for 6 months or more and still have acne, perhaps you should seek a different solution. 90% of the time, acne is not that hard to clear.

In my opinion, antibiotics and topical antibiotic treatments only mask the problem and never seem to clear the skin. Just because you are not having a breakout when using the antibiotic treatments does not mean the problem is gone. Do you have a dependency on the use? When you stop using the antibiotic treatment does your skin break out?  If you answer YES to these two questions – call me for a consultation.



Is acne pimples?

Yes, acne is one pimple or many pimples. Acne occurs when one or more hair follicles (pores) become plugged. Or, you have a systemic imbalance of some type.

There are basically two types of acne – follicular and systemic.

FOLLICULAR ACNE is when the follicle becomes plugged with dead skin cells and sebum (oil) – a blackhead.

SYSTEMIC ACNE is when inflammation occurs in the tissue creating nodules unrelated to the follicle. This is what I like to call a tissue blemish.

Why do I have to keep using antibiotics?

It is MY OPINION that you don’t need to keep using antibiotics to keep your skin clear. Since you are asking me, I want you to understand that follicular acne is because your follicles have become blocked with dead skin cells and and sebum (oil).

Your follicle (pore) is an indentation of the surface of the skin. Dead skin cells start off at the basal layer of the skin and as they move to the surface, they become dryer and flatter.  Once on the surface, they slough off or you may exfoliate them. This same process happens in the follicle. Dead skin cells arrive in the follicle and mix with the sebum – a blackhead. Typically, this process works fine with the follicle emptying and staying free of a plug.

Many circumstances may cause the follicle to not empty, but instead the dead skin cells and sebum stay in the follicle and the plug forms.  Imagine a balloon being filled with water.  When you continue to add water to the balloon, the “skin” of the balloon continues to stretch. It will finally reach a point where it has stretched as much as it can and will burst.  Same thing happens to the follicle. When it continues to fill with dead skin cells and sebum, it will eventually reach the point where the follicle wall will break and the debris in the follicle is NOW “inside” the body.  Until that point, the debris was “outside” the body. Consider this: Picture a pocket in my pants. The pocket is like the follicle – an indentation of the surface of my pants. I can put sand in the pocket and it is just being held there. But, if I get a hole in my pocket, the sand NOW is “inside” my pants.

When the follicular debris gets “inside” your body, you have a natural alarm system that signals the white blood cells to rush in the start digesting the bacteria and debris.  This is when you actually “see” the pimple. This is what antibiotics do – they stop this process of infection, but do nothing to rid the skin of the blackhead plug.

If you want to know more, please call me – I can help.

What kind of disease is acne?

In my opinion, acne is not a disease. If you consider the breakdown of the word dis-ease, then YES it is a dis-ease. “Dis” means negative or reversing force and “Ease” meaning content.

Acne is a symptom, not a disease. I like to compare it to constipation (I know – weird), but constipation is not a disease, but a symptom that the colon is plugged. If a persons changes their diet, the colon (most usually) will function properly. Constipation, a symptom of not eating properly.

Acne is a symptom of (here are a few):

  1. Follicle becoming plugged by constant pressure on the skin (ie, placing hands or phone on face constantly).
  2. Improper cleansing products not able to reach into the follicle and “clean” the pore.
  3. Hairspray/hair products or environmental/airborne oils covering the follicle opening and preventing the normal expulsion of debri.
  4. Relying on topical antibiotics to clear skin when, in fact, they sometimes cause the problem (ingredient in medicinal carrier causes acne).

More information during your consultation.

Do some acne products cause acne?

Yes – Retin A is a good example.  The carrier cream that holds the medicine Retin A has an ingredient in it that causes comedones – Isopropyl Myristate. What a shame! (Johnson & Johnson).

The list below are comedogenic. This is not a complete list, but get this:  some common ingredients that are known pore cloggers, but still tend to appear in products that are being sold as non-comedogenic are:

  • acetylated lanolin (not to be confused with regular pure lanolin)
  • acetylated lanolin alcohol
  • PEG 16 lanolin (Solulan 16)
  • coconut butter
  • cocoa butter
  • coconut oil (it is highly comedogenic – only to be used on dry skin and skin not prone to congestion)
  • myristic acid
  • lauric acid
  • laureth-4
  • laureth-23
  • oleth-3
  • isopropyl myristate
  • isopropyl isosterate
  • myristal myristate
  • myristyl lactate
  • isocetyl stearate
  • isostearyl neopentanoate
  • hexadecyl alcohol
  • stearyl heptanoate
  • decyl oleate
  • anything ending in laureth or oleth
  • evening primrose oil (even though it’s great for anti-aging, but not for clog-prone or acne-prone skin)
  • mink oil
  • soybean oil
  • buytl stearate
  • shark liver oil
  • acetylated lanolin

If any of these are within the first seven ingredients on the ingredient list of a product you are choosing, you may want to reconsider. If, however, any of these ingredients are far down on the list, this means the manufacturer may have included it in a very small amount and the product may still be safe to use.

Can what I eat cause acne breakouts?

Generally, no. But I’ve seen evidence that high consumption of dairy products, alcohol or any type of carb, sugar or fermented product interacts with the overgrowth of yeast in the body and produces acne blemishes. See my article on yeast related acne.

Should I stop wearing makeup if I have acne?

You don’t have to stop wearing makeup altogether, but you might try switching brands or going with a different type. If you’re noticing breakouts along the sides of your temples, hair creams, oils or gels might be exacerbating your acne. I like to recommend mineral makeup/powders. Look for makeup with the label “non-comedogenic,” meaning that they don’t clog pores. Read my answers about “Do some acne products cause acne?”

Does having acne mean that I'm not keeping my face clean?

Not necessarily. But, you could be using all the wrong products if you have follicular acne. If you dry out your skin with harsh products, you could be creating a hard surface at the follicle opening and blocking the elimination of the comedone plug.

If your acne is systemic, cleaning has nothing to do with your acne.

What is a blackhead?

It is thousands of dead skin cells which have sloughed off in the follicle (pore) along with the skin’s own sebum (oil) and other natural debris to create a small mass (impaction).  When this mass pushes to the surface, it turns black on exposure to the oxygen in the air and also darkens from the buildup of skin pigment in the dead cells. The blackhead is NOT dirt, but an actual anatomical impaction that may extend 1/16th of an inch below the surface of the skin.

Do blackheads turn into pimples?

Not all blackheads (comedones) turn into pimples.  Some just sit there and do nothing in your skin (open comedo). Others become more impacted and the follicle continues to expand and the small opening at the top, but for all practical purposes , is closed – a closed comedo (comm-ee-doe). Typically, these are non-inflammed acne.

Pimples occur when the follicle becomes so filled with the debris of dead skin cells, sebum and bacteria that the follicle wall erupts and all the debris is dumped into the tissue (now it’s inside the body). White blood cells stream into the area to engulf the invading debris. You get a red, sore bump called a papule.

As it becomes further inflamed, you will notice pus forming near the surface – this is a pustule.  If the break in the follicular wall is deep down, at the very bottom of the follicle, then a sore, red lump forms. This is a nodule which is similar to a papule but larger, deeper and feels very firm to the touch.  It will fester as a deep, inflamed bump until the lesion finally drains or the break spontaneously heals and goes into remission. Unresolved nodules often flare up again and again.


Click drawing to enlarge.


5 + 2 =