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Punch Excisions -

 

 I've had some successful punch excisions in the past, which effectively replaced deep icepick scars with less conspicuous line scars.  Recently this year, I had some more punch excisions, and well, those failed miserably.  The two procedures were 4 years apart.  I'm not sure what caused the second set of punch excisions to fail, but I suspect it may be related to Accutane.  Let me explain.  The first procedure was done pre accutane.  My skin prior to accutane was always an oil slick.  I had very oily skin and hair and without a doubt this contributed to my severe cystic acne.  However, I think the oily skin tends to lend itself better to wound healing, in particular healing without bad scarring.  This seems to make sense, because it's a known fact that scars heal better in moist environments.

 

Post accutane, my skin has gone from being oily to pretty dry.  To me, it seems like this is a critical factor in how your skin heals after being cut.  I definitely do not regret taking Accutane, because it essentially cured me of my severe cystic acne.  However, the downside is that I feel it has affected my wound healing abilities.  Another important factor is tension.  If you get the punches done in a highly dynamic area, like the cheeks or mouth areas, the constant movement of the skin will cause excisions to stretch and fail from the tension.  

 

Another interesting trend is that the dermatologists I have visited this past year have discouraged punch excisions.  They felt it was too unpredictable and prone to bad scarring in some folks.  There are others though, who get pretty decent results.  

 

Both procedures were done by dermatologists.  Perhaps if I went to a plastic surgeon it could have made a difference.  

Austra, it's the same story for many of us.  Other people without skin issues just really do not understand it on a visceral level.  They have the luxury of not worrying about lighting, angles, and the like.  It's damn exhausting to be hyper conscious of your appearance all the time.  It's the same people who freak out if they have one blemish.  Getting treatment is as much mental as it is a physical transformation.  It's the feeling that you are taking control of a situation that also is therapeutic in itself.

Also, Tokyo/inspired your skin is definitely improving.  The hyperpigmentation is lightening up.

Actually, the fear mongering is precisely what caused me to delay my treatment well into my 20s.  That is probably the decision that I most regret, which is not starting treatment EARLIER.  I was scared to death of precisely the same things that are constantly being bandied around - hairloss, depression, suicidal ideation.  I wrestled tremendously with the decision to take accutane.  No one is naive enough to think that a drug that requires routine monthly blood tests is a simple run of the mill kind of drug.  For many of us, this truly is the end of the line.  

To someone who has not undergone the process, it's easy to think that Accutane is like getting Nyquil from the drugstore.  That is one of the myths about Accutane.  It is NOT easy at all to convince most dermatologists to put you on it.  It's an incredible pain to convince doctors to put you on it because they are well aware of opening themselves up to being blamed for the side effects, real or imagined.  Simply put, I begged and pleaded because my skin was being scarred left and right.  If I was put on this earlier, I would have saved myself a tremendous amount of money which I've been sinking into my treatments for acne scarring.  

Accutane clearly is not for everyone.  It says so right on the label that it is only indicated in the most severe cases.  I assure you that only the smallest minority of people are ever put on Accutane, because it is really a measure of last resort.   Frankly your example of a 17 year old smoking cigarettes serves to underscore one point---- its easier to be underage and get a pack of cigarettes then convince a doctor to put you on accutane.

And it's not that I recommend Accutane.  I assure you my accutane treatment was far from pleasant. My point is that it should NOT be off the table if all other therapies have failed.  Everyone here is clearly in the same boat.  We're either currently suffering from acne or have suffered from it, and it's good that all sides are presented.

Have any you of actually taken Accutane?  I for one can say that Accutane effectively put my acne into remission.  After years of suffering from severe cystic acne and failing every single therapy out there, Accutane was the only thing that worked.  It worked for me and it has worked for thousands of people.  Unfortunately the extreme voices dominate the conversation about Accutane and there is an obscene amount of misinformation out there.  So I guess I must be lying or a pharma sales rep.  

Every person on here has to make an educated decision based on the facts and not ridiculous fear mongering or wives tales. I put this ridiculousness in the same category as using lemon juice to cure acne scars.  Really?  I mean really?