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Dear Dr. Greenburg

I wrote this to a dermatologist, pleading to get on a second run of Accutane (April 2007). It chronicles how I've tried during my near-20 year battle with cystic acne.

Dear Dr. Greenburg,

I’ll start by saying that this is a hard thing for me to write. This thing that I’ve been afflicted with for 18 years crushes my spirit, my confidence, and makes me feel like a monster. I compulsively try to catch a glimpse of my reflection to make sure my makeup is still in place, only to be repulsed by my own appearance. I am so sick and tired of looking and feeling this way. I would do ANYTHING to make this go away. If I could cut off my face with a razor blade with the knowing that it would grow back so I could have a normal face I would do it in a heartbeat.

My past:

I started breaking out when I was 12 years old. It got progressively worse – spreading from lumps on the sides of my nose to lumps on my chin, forehead, cheeks… and on to my chest and my back… and growing everywhere that I had hair. Yes, carbuncles in my private areas and even on my bottom. Forget about wearing a bathing suit, tank tops, or anything that revealed skin below my neckline. By the time I was 16 the sores got worse, and larger, until they were purple lumps the size of a quarter, one right next to another, to where you couldn’t touch a spot on my entire face bigger than the diameter of a fingertip without touching a lump. My cystic acne was very aggressive, the lumps would get huge and grow around my eyes – affecting my vision. They hurt, hurt so bad on my face that it was painful to talk – I took Tylenol so I could move my lips – but NOTHING compared to how my emotions were in pain. I would cry and beg God to take them away. I was deeply affected over my appearance – and it began to manifest itself in very self-destructive ways. I was not invited to parties, I was an outcast, but how could I blame them? It was a chore to look at me in conversation, I felt hideous. My alcoholic, abusive father would agonize me over it… something I have a lot of trouble dealing with to this day. Little kids would ask me why it looked like I had “purple pox†and asked me why I had a lumpy purple and red face. I was already disfigured. Their parents would apologize in embarrassment. I was a freak.

When I was 19 I married a man that I thought looked past my ugliness. He was another story… but anyway after years of various treatments I finally got on Accutane – a lifesaver. For the FIRST TIME IN 8 YEARS I LOOKED NORMAL!! The peeling of my lips and the “shredding†(as I called it) was such a tiny little price to pay for looking like a normal girl for the first time. I felt normal. I could look people in the eye. My confidence soared. When I took accutane it was for 3 months, and afterward I still got big break-outs more than normal people get out but it was NOTHING like before I took it! My dermatologist told me I would eventually grow out of my acne when I got older and my hormones evened out.

When I got pregnant and had my first baby I was 24. My acne started to get a little worse. Then I got a very demanding job that was 12 hours a day and a 3 hour commute. I started breaking out a little more. After I had my 2nd baby when I was 27 my bigger cysts started coming back.

My current situation:

Although they were not cropping up on my chest and back like they did when I was a teenager, the multiple, big cysts are prevalent on my cheeks and jawline. They are even cropping up on my neck – giving me the appearance of Frankenstein-line red bolt-lumps. They are growing on my scalp, and coming back on my private parts and bottom. They are coming back in clusters, and on my lips – growing in families of 12 of more cysts. It is so shaming to be 30 years old, and dealing with a scaling, bloody, purpled face. I need to attend meetings and present myself to clients. How can I do this when my face is getting worse… when I am hard to look at? I am back to hiding inside my house when I’m invited to go out. I LIE and say one of the kids is sick… I will try to schedule visiting my long-distance boyfriend when it’s 3 weeks before my period, because my face will probably be at it’s worst 2 weeks before my period. It’ MADDENING and I am sick and tired of looking this way… feeing this way… feeling and looking like a monster.

Things I’ve tried to clear it up:

I have tried everything along the way starting when I was only 12 years old. EVERYTHING over the counter – stridex, oxy, Neutrogena, Cetaphil… Then one dermatologist after another gave me pills that gave me diarrhea and only temporarily took the edge off my cysts: Tetracycline, minocycline, doxycycline, erythromycin, and everything else that ends in a “cineâ€. I was even prescribed birth control pills, orthotricycline but of course had very little effect. ALL the topicals – clindamycin, retin-A, benzoyl peroxide, glycolic gels, salicylic acids…. Tried them all. NOTHING.

I ordered things off the TV – Proactive, which did nothing even though I used it for an entire year. I bought the mineral-makeup for $120 which did nothing and didn’t cover my scars which made me more embarrassed.

I’ve used homeopathic medicines – Calcerica suplpherica, Ignatia Amara, Sulphur, and blends designed to clear acne… amongst others. NO IMPACT. I’ve taken Nature’s Cure both internally and topically. Again, no difference.

I’ve been using Acne Free 3-step program for the last year and it takes the edge off. I alternate with Olay’s “clarify†with salicylic acid and Nature’s Cure with papaya and salicylic acid just for balance.

I’ve restricted my diet: eliminating milk, wheat, chocolate, and sugar. Currently I take in a probiotic capsule supplement of 4 billion bacteria containing Lactobacillus acidolphilus and bificobacterium lactis. I eat 16 ounces of unsweetened yogurt per day, I eat two different brands so I get L. acidolphilus, L. bulgaricus, S. thermophilus, L. casei, L. rhamnosus, B. bifidum, bifidus, and I drink DanActive’s L. Casei Immunitas daily. When I first started doing this about 3 months ago I noticed a difference, but it has since stopped working. Oh, I also use the yogurt as a mask, which seems to help sometimes.

I’ve used countless herbs and concoctions: Royal Jelly, drinking aloe, red and yellow burdock root, burdock root tea, Echinacea, grape seed extract, grapefruit seed extract, charcoal capsules, calendula oil, stress-blends, EVERYTHING that I could find between talking to herbalists and naturopathics. I’ve even tried taking Chinese herbs and drinking disgusting teas and they had absolutely no effect on my skin.

I’ve taken/taking multivitamins with zinc and vitamin C supplements and lozenges. I have spent hundreds if not thousands of dollars on supposed-miracles that didn’t do a damn thing – Cellfood silica fomula, MSM supplements, Candida and yeast management systems…

I sought a year’s worth of treatments from an Acne clinic in Walnut Creek. They blended special makeup for me. I got expensive, painful facials from them. They were shocked when I was unresponsive to their expensive treatments.

I spent $150 on a “premium†glycolic system from a high-end plastic surgeon in San Ramon. I also spent a couple hundred bucks getting microdermabrasion treatments there, along with 2 quotes from other plastic surgeons to perform laser resurfacing (where for $5,000 they burn off your entire face, and when it grows back in 30-60 days a great deal of the scarring has been eliminated.)

I’ve used several jars of Elicina over the last 18 months – it’s snail gel from South America. It actually works, believe it or not. It’s had a profound impact on my scarring. However it does nothing for prevention.

I purchased a ZINO zit-zapper thing for over $200. Replacement tips are $30 or so, and I’ve used quite a few of them. While this works for little tiny bumps I think it may provoke the cysts a little bit.

I’ve been using Acne Free, Neutrogena, and Maderma scar treatments for the last year.

I have spent thousands of dollars on various makeups throughout the years – carefully blending yellows and greens with expensive counter make-ups. I’ve found that Estee Lauder has a “camoflauge†makeup that they sell for $40 an ounce. One tube will last about 2 months. I’ve been using it for 11 years, along with the $30 matte-powder compact and double-matte foundation that costs $37 for 1 ounce. Conservatively, I figure I’ve spent $7,062 on makeup alone in the last 11 years - in an effort to appear “normalâ€. However, it doesn’t make me look “normal†and in more cases than not, when I am having a particularly bad breakout I will cancel social invites to stay at home because I am too ashamed to show my disgusting face.

Please…. Please help me.

I don’t want to take another antibiotic that is going to stop working the minute I stop taking it, and all the while killing off the good bacteria, making my problem worse.

I don’t know what is wrong with me. I do know that I have given a huge 18 year considered effort to so many treatments, and NOTHING has worked for me except Accutane.

Please help me not live like this anymore. I am 30 years old and all I want is to look somewhat normal. I hate the way I look, I can’t stand it any longer. Please help me.

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