Hey ! My name is Rachel. I'm a 25 year old white female from the UK and I'm a long term acne sufferer.

I'm new-ish to these boards ... in the sense that I've never really posted any comments ... sent messages, etc ... but I'm an extensive lurker of the site having registered 6 years ago when my cystic acne was at its worst. I'd like to give you a little background info on myself if you dont mind. I always find its best to start at the beginning ...

... I started to get acne in my early teens ... around 13/14 ... and it was severe. It didn't even ease me in gently to puberty. It just hit me like an explosion. An explosion of whiteheads, blackheads, cysts and patches of irritated skin. Holy crap it was painful. And hideous to look at. The kids at school didn't help. Bastards. Pardon my French. I hated school. If you hadn't already guessed. I saw several GP's over several years, all prescribing several variations to both topical and oral antibiotics. Tetracyclines, BP, erythromicyn and the birth control pill dianette. All had little to no success towards the clearing of my acne, which was extremely frustrating and upsetting.

I also found that the GP's in my local surgery were not particularly helpful. "Its just your teens", "you'll grow out of it", are just some of the more passive lacklustre comments aimed my way during my usual monthly check ups. After 5 years of bullying, pain, self conciousness, low self esteem and an aversion to reflective surfaces, my GP reffered me to a Dermatologist. I explained my skin history to this ... 'doctor' ... who decided in all her wisdom, after I had a mild nervous breakdown in her presence, to put me on another course of some tetracycline that I dont remember the name of and that I didn't even bother ingesting because I knew it wouldn't work. I've jumped the gun a little. I do apologise. A few months prior to this appointment I had my first refferal to a derm at my local hospital. Upon the day of this particular appointment my skin had been going through a particularly good patch. It was 90% clear and showed little to no signs of previously having cystic acne in all its severity. I believe my intensive 4 week course on a tanning bed contributed to this short bout of skin clarity. It was nice while it lasted. Anyhoo the derm I saw prior to seeing mrs personality 2008 took one look at my mostly clear skin and said "you could do with some accutane". To this I replied ... "meh??" ... and toddled out of the office, information leaflet in hand and follow up appointment booked for the following week to inform her of my decision.

After extensive research online I declined her offer of what I deemed was an unnecessary, dangerous drug and suggested I stick to my dianette birth control pill and recently revised skin care routine, which at the time consisted of exfoliating every other day with St. Ives apricot scrub and either Clearasil or Oxy face wash I cant quite remember. Just FYI ... I used every over the counter face wash, cream, lotion, gel and scrub known to man. All of which worsened my conditon. I believe all these cosmetic brands (clinique, oxy, clearasil,etc), which formulate their treatments with harsh chemicals and colourants, contributed to my eczema later in life. But thats another painful story.

Back to derm appointment number 2. Having expecting to be prescribed accutane after returning with a face that looked like a melted pizza I genuinely was heartbroken when she bluntly explained that "accutane costs 500 per course of accutane, per month, per patient and the NHS cant be handing this out willy nilly'. Exsqueeze me ?? I was more than the perfect candidate for this treatment ! If the NHS made accutane accessible to only those who passed a pop quiz I would have sailed through it like a cruise liner in the paciifc ocean. Was this woman out of her mind ??!! My mam sensed my depression and urgency to get my life and skin back. So we went private. It cost her a fortune. 50 per consultation, which I had to have every month including the initial consultation and 90 per 30 day supply of the wounder drug. We, sorry she, was financially crippled. I was emotionally exhausted by this point. 4 weekly blood and pregnancy tests were leaving me physically exhausted too. But it was worth it all. And I think my mam would say the same thing.

Accutane is like ... a reliable but slightly annoying friend who you know you can count on to cheer you up ... but can also cause you a few problems. I had the usual side effects. Extremely dry skin and lips ... like literally to the point where my skin was so fragile it would literally fall off in to my hands if I touched it. Headaches, nausea, achy joints and dry eyes. Eurgh. Small price to pay for clear skin after 6 months though. I was prescribed 40mg per day that I split as 2 20mg pills on a morning and evening to lesson the niggling nausea and migraines. And every time I swolled that little congealed miniture pill of miricle-ness (probably not a word), I was optomistic I was going to be acne free FOREVER !!!

Ooooohhhh how I was wrong. Welcome to present day. June 27th 2013. After 1 child born 2010, 1 mortgage, a holiday to Vegas and Disneyland and a new car, I have been blessed yet again with cystic, all be it mild, acne on the lower part of my face. Oh great. Its by no means severe. It is certainly in no way shape or form as painful or hurrendous looking as it has been in previous years. But its still acne. And it has made a glorious return to my face. Bringing with it red and brown hyperpigmentation marks and a few mildly deep craters on my right cheek. Marvellous. This particular bought of acne has been persistant now for 2 years on and off. And the nodules do just erupt on either side of mouth in clusters. Its like one pimple will appear and then after a few days it gets lonely so it brings its friends and family. And so I was again referred to a derm by my GP. I say referred. I walked in to the GP's office a month ago and said in no uncertain terms ... "make me an appointment with a skin specialist because I'm not going through this crap again". So I didnt really leave her with much choice. I can be pretty persuasive when I want to be right ??

I did not for one minute expect the derm to suggest accutane. In fact, because my skin was again having a clear day today, I half expected him to laugh and tell me to stop fanticising acne on my face. Alas, I have been given a 30 day prescription for 1 20mg pill per day with the potential to increase the dosage in the future should my skin need it. I'm happy with the dosage. As I understand the severity of the side effects and the dreaded IB are dose dependant. Something I discussed with my derm. So here we are. Night 1. First pill taken. Carmex applied generously to lips and the preparation for either an erruption of nodules and pustules and/or a face so dry the sahara desert would be jealous fully in place. I'm optomistic again. And not as worried about the treatment this time around. I will look to update every day on my progress (see ... optimism). I find this very therapeutic which is marvellous for my mood as I often find my on/off breakouts get me down and leave me in fear of the next explosion. So here goes nothing. Accutane ... round 2.

Also I'll just give you an idea of my existing skin care regimen:

*AM*

Dermalogica Ultracalming Cleanser

Dermalogica Ultracalming spray mist

generous dollop of aloe vera gel (99%)

Dermalogica Barrier Repair

Quinoderm on problem areas

*PM*

organic honey mask (with or without bicarb of soda and/or asprin) left on skin for at least 15 mins

Dermalogica Medibac acne clearing wash

generous dollop of aloe vera gel (99%)

Dermalogica Barrier Repair

Azelaic acid on problem areas

Dermalogica Prep Scrub every 3 days

twice weekly glycolic chemical peel (which have been fantastic by the way)

I'm most likely going to tweak this regimen a little. I may alternate days with quinoderm and azelaic acid with cocunut oil on the whole of my skin as it is highly nourishing and moisturising. I really want to keep on top of the suspected dry skin as if it is anything like it was previous my face will feel like it needs to drink 500 gallons of water. Oh I have also taken to drinking so much water my manager at work thinks I have a 'personal problem' due to the sudden increase in personal time.

The likelihood of continuing the fortnightly chemical peels is slim. I am aware of how accutane works and due to it causing skin to repair itself much slower than usual I am inclined to cancel my next peel on the 2nd July. However I am in 2 minds about this as I also feel like I am on such a low dose of accutane it may not necessarily effect the repair rate of my skin so greatly it would cause averse effects with the peel. I'll get back to you on this one. I actually, some where deep down in my twisted little brain, think the peel combined with the accutane will serve as a successful acne treatment. Hmmmmm. We'll see.

So ... my skin today ... scars and pigmentation aside, is more or less clear. There are a few remnants of past pimples from previous weeks still lurking either side of my mouth but my skin is relatively smooth and nicely textured. So all in all ... not too bad. I only have to put on a slight, light coverage of concealer (Bare Minerals Honey Bisque if your interested), which is great. But i'm not going to count my lucky chickens. My skin will more than likely going tomresemble the surface of the moon next week.

Well I hope I haven't bored you to death.

If you have any questions for me please dont hesistate to ask.

Have a pleasant and acne free tomorrow.

Toodles.

x