My guess is that the United States has a lot more toxins in the food and environment than Thailand does, due to the Western diet which loads food with genetically modified organisms, pesticides, herbicides, food attitives, preservatives and a bunch of other man made chemicals. I suggest eating organic food as much as possible. Go to health food stores and stay away from the huge publicly traded stores such as Ralph's, Safeway, Albertsons, Von's, etc. Also, you must do a Colon Cleanse first to get rid of all the toxins in your body. Then do a liver cleanse. Acne is an internal problem caused by too many toxins in your body. Your skin is trying to get rid of the toxins, thus it creates acne. Address the cause of your acne. The cause is the toxins in your body. So, stop putting toxins in your body, and cleanse the toxins that are in your body now.