I wanted to write this because when I first started to countless hours of research on why I have acne in my late 30s and if Accutane was safe, I was surprised that I didn't find someone else quite in my shoes. A lot of women took Accutane in their 20s and have healthy kids afterward (in their 20s and 30s) but for me it was a tough decision because I was 38 yrs old wanting to get pregnant but dealing with very severe acne and unfortunately feeling like I was gambling with my 'biological clock'. Honestly, if I was dealing with issue even in my early 30s, I would have done Accutane because it would give me a few yrs to get it out of my system but being 38... I was at a crossroads and had to make a decision... do I want acne on my face but try to get pregnant or do I want some time to clear my face and wait about a year to try... (6 months of treatment, 6 month grace period)- when I'm 40.
My acne background for those who are searching for commonality. Kinda always had bad skin but not bad enough I felt I needed to wear makeup. Once I hit my mid-30s, my acne was getting worse but I did painful extractions for years. Always had some 'deep' pimples that never quite made it to surface so I still didn't think it was an issue and it stayed that way until I was 36-37. My acne was getting bad. I started to pop them. They got worse. My bf suggested a few times to see a derm. Before him it was my mom.
*It just occurred to me that maybe the reason why I couldn't quite find anyone else in my shoes is because other women were already being proactive with their acne and sought medical help whereas I stuck with extractions and basically lived with it (plus didn't have health insurance) and didn't think about acne and medication and getting pregnant and my biological clock...
I went to a derm clinic. My acne was already bad by then. They put me on Doxy for a ridiculous amount of time, between 2 and 3 months and different topical creams. This was the worst part. Doxy and the topical creams really broke me out. My face not only looked horrible, it was painful. The lotions would sting but wanting to believe it would work, I stuck with it. There were days I could not leave the house. People stared. stared. stared. I cried sometimes. It sucks. Having to deal with this at anytime in your life. having such bad acne that taking a shower hurts. I started to look at everyone else on the streets or in the subway, looking to see if anyone... anyone had bad acne like me and usually, I had the worse. Sometimes I'd find a teenage boy with severe acne like mine. Having acne probably isn't so bad if there's a game plan on what to do about it but if there's no concrete course of action, acne isn't just pimples on your face, it becomes a bad joke, a cruel one, it can be brutal on your psyche, it's a maze you feel lost in, a 'game' you did not agree to play and have no opt out button. It's hard to go out and face the world when your face is full of red tender cystic bumps with white pus waiting to ooze out, but it's not one, it's not even on one side of your face, it's everywhere. Do you know how hard it is to try to be invisible when you have acne on both sides of your face? For awhile, my left side was the worst side, so at least, if I got on the train or walked down the street, I would stand on everybody's left or make sure I was at the very end of a car, so only the wall of the car would be on my left or sit at the very last seat at the bar or table farthest left; silliness. Eventually there was no hiding it. I started to hide. I was consumed with researching acne, causes and looking for answers online.
There's at point I hope we all get to with acne even if you feel completely defeated, frustrated and angry. Do things that make you feel good and continue to find answers if you don't have them. My face was jacked, I was on all type of medication-the derms often looked as perplexed as I did, I tried vegan diet, holistic therapy, "gluten free" diet (you'll be amazed how many people will say this to you, "have you tried a gluten-free diet" - when i hear this phrase now, especially from the same people, after 9 months, it's like chalk screeching on a blackboard... but I got tested and I'm not allergic to wheat and that bandwagon is not for me.) I emailed writers from health magazines, I scoured youtube, I read blogs and I got every test I could possibly think of to help me figure out why and how to resolve it.
I was convinced my juicing diet would work. I religiously drank vegetable juice for 2 months, every day, 3xs a day... prolly about 75 ounces a day and my skin (on my body) and hair was beautiful and baby soft but it did nothing for my acne. The derms now had me off the topical solutions and doxy and on Spirolactane, which did nothing for the cystic acne on my cheeks but did make my chin and jawline break out immediately and aggressively that my skin felt like an alligator or porcupine. All my bumps had the texture of pebbles or cat litter. Sometimes, I would run the back of my hand against my face just because it was so weird to feel something so hard and artificial but it's wasn't, it was my skin.
*Being proactive. Unless you have a great derm or a caring one, you really have to communicate with them. I went to a derm clinic so I rarely saw the same person twice and even by the time students are residents, I feel like they're taught to not care. One did but many kinda of shrug their shoulders. The thing about Accutane is there are so many loops you have to go through and it's so specific that one mistake can prolong treatment for another month. So, even when one doctor tried to help me get on it quickly (meaning I had to wait two months) she actually had me take a preggers test at 27 days instead of the 28th day and because I was one day too soon, I had to wait another month to take my second preggers test. I'll get back to this later... thing to remember here is know, it will take two months to get on Accutane so if derms are trying to make you do all other drugs before Accutane... think about it.
Why I decided on Accutane? I spoke to my boyfriend about all my concerns. I spoke to my therapist about it. I spoke to friends and family, etc... most of my friends who have perfect skin say don't get on Accutane, even those who had some pimples who found results with... (fill anything here that I tried too) said don't get on Accutane. More people you ask, the more answers you'll get, the more confused you'll be, the more you'll go back and forth with deciding. My bf encouraged me to get on Accutane from the start but I even convinced him how we could have a 6 legged creature for a child and that he was a monster for not understanding the risks involved, I was a little hard on him but he could have been more involved with reading up on Accutane too)... so what really got me to get on it? Talking to as many doctors as possible. All types of doctors, not just derms and I heard a few things over and over...
1. If I didn't find resolutions fast, I would have a lot of sunken scars on my face then I would have to treat that...
2. I would be a very healthy 40 yr old and "do you know how many women I know who have kids at 40?"
And because I did check out every fertility test I could to see if I was healthy and because my bf and I weren't quite in the right place for a child and because I didn't want tons of scars on my face and because I was tired of that hopeless feeling at the derm clinic when they sounded like they were guessing at what new drug to give me, I wanted nothing more than to get on Accutane and in the end, I stopped asking everyone else and I did what I thought was best for me.
When I decided to get on Accutane, it was in December. My first month was March. My patience was being tested and I was angry and frustrated at how difficult 'they' made it for me- female, reproductive age- to get on Accutane.
*Side Effects. I went from working out 2 hours a day to doing zero activities for almost 6 weeks straight. My heart rate is about 51, I'm very athletic so 6 weeks of nothing was not a good sign. By May, I was really depressed. Obviously it is hard to say Accutane played a role in it because there's so much else happening or not happening in life that can make you sad and hopeless but do I think Accutane heightened it... maybe, yes. Without anytime at all though, what I did not focus on was new pimples. All my pimples vanished. All that was left were the scars. And if I do get a new pulpy pimple, it makes it way out eventually. I don't think Accutane is a miracle drug. It's not going to give you perfect skin but it will improve it to the point you never even think about people staring. I still get pimples but there's no emotional consequence to that pimple anymore.
...but I wasn't "emotionally" stable so was it the Accutane or me or a bit of both? I firmly believe everything is intertwined in the body, not like some hippie jargon but like, if you take medication for 'one thing' that drug isn't 'targeting' only one part of your body, it's in all your body. So, now it's July and I just picked up my last month of treatment. I caint wait for this to be over. I can move on to the next phase, treating my scars but Accutane did make my scars much better, each month the scars get smaller, tighter and less red but they're there but it's doesn't bother me enough to wear makeup.
As for being moody, lazy, tired, hopeless and sad, it's hard to say... a lot of my friends say, "it's the Accutane" but that's kinda what they're suppose to say. I didn't go into treatment a joyous happy go lucky person, that's not my personality. I'm a writer. My friend recently said, "how can someone so beautiful be so unhappy..." hearing this didn't make me feel pretty, it made me feel pathetic.
I guess that's the thing, having acne, getting treatment is all a challenge and hopefully you're in a good place in your life to help you push through. I think having other things going on in your life and a support system is key. As moody and angry as I get, I have a good man who stuck with me through all of this--- it's about perspective... I sometimes force myself to adjust and make changes, even if it's the slightest change, anything to get me out of the rut that seem to be deeper and longer... the thing about the "mental and emotional' side effects of 'accutane' is that I know it's not stronger than I am and I know like my pimples, it will pass.
Some stats in case it's important for those who are finding themselves in my shoes... I'm now 39, 5ft 5 inches, 118 pounds, taking 30mg of Accutane twice a day for 6 months, had severe acne.
As silly as it sounds... hang in there and look for resolutions... it will come.