After years of struggling with acne problems intermittently I finally feel ready to share my story in the hopes it will bring comfort to others.

I am a 30 year old female and have suffered mild to severe cystic acne at various stages of life. My skin was pretty great until my early 20s where I would get cystic acne occasionally. There were times due to stress or other factors I would have severe breakouts and these were treated by my GP through tetracycline and panoxyl gel. Antibiotics worked for a limited period and I would come off them and my skin would behave until my next breakout and the cycle would begin again later.

Nothing really prepared me for the outbreak I had in the year 2011 though. It started off as a few pimples which I could cover to cystic acne all over my chin and cheeks. I had never experienced a breakout so severe and my confidence took a severe knock. Normally an outgoing and confident person I would find myself not going out or not looking at people when speaking of covering my face with my hands when speaking. Working with the public became unbearable. I went to my GP who put me on Dianette. I was patient and waited six months and the spots became worse and they were sore and at times I would have 10-15 cysts just on my chin. They left black pigmentation marks on my skin when they healed and then would rise again. I broke down and went back to my GP. He suggested I get referred to a dermatologist. In the UK it can take up to 18 weeks for a referral so I opted to go privately and was given an appointment for a few days later.

The dermatologist was sympathetic and took one look at my skin and uttered the word: Roaccutane. I knew nothing about the drug but he seemed confident and explained the treatment and the tests involved to qualify. I was booked in for blood tests to ensure I was healthy enough for the treatment and a pregnancy test was done. Everything worked out and I started treatment. I was scheduled for a six month stint at 40mg to try to avoid the dreaded initial breakout.

Day one to fourteen seemed ok. No changes to the pimples and my body reacted well except for skin rashes which appeared on my arms. These disappeared after a few days. Day sixteen and I realised all the oil had evaporated from my skin and no new spots. It was in the third week that my IB started. It was an intense time and new spots albeit smaller and mostly whiteheads appeared everywhere. Being a habitual skin picker I popped pretty much all of them. By the time my second month rolled in my skin was doing ok. I was getting new spots every week but nothing that rivalled pre roaccutane. I felt good.

Until month three when I walked past a mirror with fluorescent lighting. That's when I saw what normal lighting didn't pick up. I had scars from all the spots I had popped. Most were tiny and could be covered with make up but one was a rolling scar on my chin which was huge.

After that I was obsessed with scarring. I looked it up on the internet went to see a cosmetic surgeon about treatments after Roaccutane. Despite the fact they were probably not as obvious to others as they were to me I was constantly preoccupied with scarring. It never occurred to me that I had barely noticed them in normal and natural lighting before. It became all I talked about and I became very reclusive and even more introverted. It would take me two hours to put make up on to go to work and have a melt down if I felt it wasn't covered enough. I went back to the dermatologist and he confirmed that skin is much thinner during treatment and is more easily torn and may not heal properly but he pushed for me to finish and see how it would heal.

By this point I was not getting any new spots but my problems with scarring and obviously low mood was the problem. However, I never realised that I was in the grips of depression then and everything I was seeing ws magnified. I will never know if the drug contributed to my depression or if it was the combination of all the events that year that caused me to have a emotional breakdown where my mum had to move in with me to watch over me. As a formerly confident and outgoing person i had stopped socialising, avoided work, and never left the house unless I had my family around me and never went to places were there was bright lighting. I refused to go anywhere and had to be coaxed to go to out for dinner where I was convinced everyone was staring at me.

Getting better was a long process and the self consciousness and reclusive behaviour lasted over a year but my depression was brought to a head when my business went into free fall. Faced with other issues and personal problems I was forced to deal with my insecurities and leave the house to save my business. Over the months I got better at compartmentalising the constant scrutiny of my skin and wondering if people looked at me in disgust. If I am honest my skin was healing and looking better which contributed to me feeling better. Ultimately even now I am not totally better mentally and have really bad days and it only takes one person to stare to make me feel bad about my skin. It's been 2 years since my treatment and only now do I feel I can come back to the forum. At the height of my depression I would trawl the forum and my mum had to cut me off as I would spend days on the forum and internet looking up acne and scars.

I am telling this part of the story not to scare but educate. I know now that everything was so exaggerated in my mind and being vulnerable in the start didn't help but if you experience anything of the sort don't be embarrassed go seek help. I dealt with it by myself as I was worried the derm would take me off the drug but being wiser now my mental well being was seriously tested.

Ok back to the acne. By month four my spots had vanished my skin was clear. It was dry and the only side effects was back pain and dry skin which was amazing!!! I obviously never appreciated it at the time but I will say it was great now.

Month five and six I started to get whiteheads every so often and went back to the derm who told me that in his experience Roaccutane works with 80% of patients and for the other 20% a second course may be needed. I was so down hearted but pushed on.

Finishing the course was a struggle but only mentally not physically. A few months on and the spots returned. I was only partially clear for a short while and went back to the derm. He prescribed retinol A which I tried but I was allergic. The cosmetic doctor prescribed clenziderm which I tried and caused a rash so bad I was off work for 2 weeks. I then went back to the derm who prescribed Zindaclin Gel 1%. He also referred me to an endocrinologist (hormone doctor) who tested my hormone levels which came back normal and requested a scan for my ovaries as he suspected I had a condition called Polycystic ovary Syndrome. It came back positive. I was so relieved. Finally a reason why. I was still spotty as hell but there was a light at the end of the tunnel. I was prescribed Metformin and he warned it would take 6 months to really work. I started and used my Zindaclin religiously. I also worked in Clinique Anti blemish 3 step. Finally after 3 months I started to notice a difference. I have no idea what it was but it worked. My skin is largely clear and I am touching wood as I write this but I am still meticulous about my skin care regime and still use my gel to this date. I still have the scars that I got during Roaccutane (a total of 14) but I have largely made peace with them. Roaccutane changed my skin. I have very dry skin now with an oily nose when I used to have very oily skin. My hair is dry when it was greasy. I also developed mila on my upper arms from the dryness but I combat that with bio oil. Aside from this I don't think I have any lasting side effects.

I do not regret my treatment for a second. I believe it was positive despite it all. But I do wish I was better educated at the time of the side effects and understood why I was feeling what I was. Writing this has been me facing my demons really as I find it difficult to talk about the time without crying but if it can give one person hope it will have served its purpose. Roaccutane affects people differently and some people will never experience what I did but some will have it far worse. I am just lucky I made it through the other side which sounds dramatic but there were times seriously I thought the world was ending. I am very fortunate to have found a solution even though roaccutane was not my saviour. I guess there moral of the story is that there is a solution out there.

I hope I have not bored you with a long winded account of my truth. But if you are struggling I am proof there is better times ahead. Stay strong and best of luck!!