For most of my adult life, I’ve struggled with severe acne. If you met me today, however, you would probably never know it. Having adult acne was embarrassing for me, because many people believe that it’s due to a lack or hygiene or proper nutrition. I had always felt judged because of this issue, as its something that often plagues teenagers. Many people who never had skin problems offered advice, as though having clear skin somehow made them experts on why they never had breakouts but I did. I heard so many solutions that were old news to me. What most people don’t know is that adult acne is typically caused by stress or changes in hormone levels. The problem can be mostly internal, rather than external, as many people believe.
One of the worst parts of severe acne is that I often had 1-2 cystic pimples on each cheek and on my chin. Cystic acne consists of large red bumps that are often hard and painful. These cysts would scar, regardless of whether or not I tried to pop them. Without foundation and concealer, my cheeks looked like I had at least 15 pimples per cheek, even though most were simply scars. It looked so awful that I had to wear “noncomedogenic” foundation every single day (this means makeup won’t clog pores). At the time, my Cover Girl concealer and foundation was a Godsend for evening out my skin tone and covering up my blemishes and scars.
This blog post is my chance to share my decade-long struggle with adult acne, and also celebrate a solution that finally worked for me. You probably have heard of “Accutane.” Everything I had heard about Accutane before taking it was all negative and pretty scary. I learned that Accutane caused suicidal thoughts and depression, and could make the user mentally unstable. When it was brought up by my dermatologist many years ago, my mom strongly vetoed this option. We never knew at the time that it would work so well for me! (I am not being paid in any way to promote Accutane. The following blog post is my personal opinion and experience using this product.)
Trial and Error at the Dermatologist
My battle with acne had lasted from my late teen years into my late twenties. I was in high school when we first visited the dermatologist. I had been using the typical over-the-counter acne products consistently, and my acne was not improving. In fact, some products made it flare up even more. Remember the original Neutrogena commericals with Kristen Kreuk and Jennifer Love Hewitt? I tried that face wash, I tried the Stridex pads, I tried Tea Tree Oil toner, and Clearasil with the “microscrubbers.” None of it worked for me.
The dermatologist had first prescribed 2 oral medications and 1 topical medication as well. One was a pill called doxycycline that was meant to combat one aspect of acne, bacterial infection. The topical cream consisted mainly of benzoyl peroxide. Benzoyl peroxide is a big pain in the butt to use; it can stain your clothes, towels, and pillowcases, and severely dries out your skin. It actually dries out your skin to the point that your skin begins to flake, and you have to use a gentle cleanser and lotion to offset the dryness. My doctor recommended Cetaphil cleanser and lotion, which I still prefer to this day.
I remember having to take the pills twice a day in high school, and applying the topical cream once a day before bedtime. I can vividly recall going to my friend’s house for a sleepover, and having to pack all of my skincare products, pills and all. I felt embarrassed that I had to take my medicine, so I got the pills out when my friend was in another room. I scooped a few sips of water from the tap. One of my pills was a capsule, and I didn’t drink enough water for it to go the whole way down. We were in the middle of laughing and joking around, and something in my throat popped. I sputtered, and white powder went everywhere. It was so humiliating!
I tried an array of different products prescribed by the dermatologist. Unfortunately for me, all of the products required time (4-6 weeks at the least) to show improvement or if they were effective at all. We upped the dosage and changed other products, in what seemed like an ever revolving door of medication. Among those tried were Differin gel, spironolactone, and clindamycin. At one point in my early twenties, we found a winning combo of topical medication and drugs, including birth control and Differin gel. It had cleared up so drastically that I felt like my acne was finally gone forever!
With all the scarring, it took a few good years of this combination of medications to completely clear up my skin. With the medicine, I would get the odd pimple or two, but nothing major ever happened. After a few years, I tricked myself into thinking that my skin was okay again and medicine was no longer needed. For the first few years of not using pills or topical creams, my skin looked mostly the same.
Pimples Rear Their Ugly Heads…Again
A few years ago, when I was in my mid-twenties, I was going through a stressful, life-changing event: getting divorced and selling my house. My anxiety and depression both spiked, and I lost a ton of weight. In addition to that, my acne started flaring up again. When you are very anxious and stressed, your body releases cortisol, which is the major stress hormone in your body. I’ve noticed that every time that I am really stressing, my acne resurfaces.
At first, I tried going back to my old dermatologist. We reverted to the same combination of medications that had worked the first time around, but nothing seemed to be working for me. I wanted a quick solution and I felt more impatient than ever! Who wants to have severe acne in their late twenties? One of the last solutions he posed to me was trying Accutane. With all of the negative, scary things that I had heard about it, I refused.
I was so frustrated and stopped going to the dermatologist. Instead, I started trying Pro-Activ treatments. At the time, you could only get Pro-Activ if you ordered it monthly online. It included a benzoyl peroxide cleanser and treatment plus a salicylic acid toner. I had the same issues that I initially had with the other benzoyl peroxide products. My skin got so dry and irritated, and my acne barely cleared up.
Accutane Saves the Day!
My acne had gotten to the point that it was really affecting my self-esteem and confidence. I began to feel powerless and depressed that acne would be in my life forever. At this time, I had recently moved to a new city. I decided to suck it up and go see a new dermatologist. I told them right off the bat that I was interested in trying Accutane. I shared my history of medications with my doctor that I had previously tried. I was so nervous that she would turn me down, and put me on another useless and random combination of drugs.
Luckily, my dermatologist agreed that I could give Accutane a try. She had a huge amount of paperwork and information to go over before I could begin the treatments. She told me that most people take it for 4-6 months and usually don’t have to take it or any other treatments again. She explained that Accutane is a form of vitamin A, and it works by reducing the oil released by oil glands in the skin. Some risks included severely dry skin, birth defects, and depression.
My first step was to take a pregnancy test and start birth control pills. I also had to get bloodwork done before my treatment and each month before my monthly dermatologist appointment. My doctor explained that it was imperative to come back to see her every month to discuss how the treatment was going. I also had to answer questions on an online program about the treatment. These questions checked my general knowledge about taking Accutane to make sure I was using it correctly.
As a teacher, the end of the school year was the ideal time to begin my treatment. I begin birth control pills in April and could begin Accutane in May. I used the summer for my doctor’s appointments and to get my bloodwork done, without having to take off any days of work. i finished my last month of Accutane in October 2016. Overall, the most inconvenient part about taking Accutane was probably the many appointments and that my lips got fairly dry. Other than that, it was smooth sailing!
I took the following photos to show my progress using Accutane. All photographs are with foundation and concealer on. Believe me, it looked much, much worse without the makeup! You can still tell how the number of cysts and amount of scarring decreased from month to month. The most current photo is from today (May 2018), and I stopped my treatments in October 2016. Even though I still get a few hormonal or stress-related pimples, I am super happy with how my skin looks.
I would recommend Accutane to anyone who has tried everything else and has not seen results. It is so heavily monitored by doctors, so that if you do experience any side effects, they will catch it right away and have you discontinue its use. I can honestly say that Accutane has changed my life in a positive way. I have a short, pixie haircut so I can’t hide behind my hair! I always felt extra introverted when I had severe acne, because I didn’t want people to notice me. I thought that they would be noticing my pimples, and not the REAL me! Now that my skin is clear, I feel so much more confident in my appearance.
May 2018- Clear Skin!
Have you ever struggled with adult acne? What treatments have helped your skin the most? Please share so that others who are having acne issues can learn from your experience.
Until next time…