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,
Iâ€™ll start by saying that this is a hard thing for me to write. This thing that Iâ€™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.
I started breaking out when I was 12 years old. It got progressively worse â€“ spreading from lumps on the sides of my nose to lumps on my chin, forehead, cheeksâ€¦ and on to my chest and my backâ€¦ 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 couldnâ€™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 â€“ affecting my vision. They hurt, hurt so bad on my face that it was painful to talk â€“ I took Tylenol so I could move my lips â€“ 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 â€“ 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 itâ€¦ something I have a lot of trouble dealing with to this day. Little kids would ask me why it looked like I had â€œpurple poxâ€ 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 storyâ€¦ but anyway after years of various treatments I finally got on Accutane â€“ a lifesaver. For the FIRST TIME IN 8 YEARS I LOOKED NORMAL!! The peeling of my lips and the â€œshreddingâ€ (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 â€“ 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 â€“ 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 worseâ€¦ when I am hard to look at? I am back to hiding inside my house when Iâ€™m invited to go out. I LIE and say one of the kids is sickâ€¦ I will try to schedule visiting my long-distance boyfriend when itâ€™s 3 weeks before my period, because my face will probably be at itâ€™s worst 2 weeks before my period. Itâ€™ MADDENING and I am sick and tired of looking this wayâ€¦ feeing this wayâ€¦ feeling and looking like a monster.
Things Iâ€™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 â€“ stridex, oxy, Neutrogena, Cetaphilâ€¦ 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 â€œcineâ€. I was even prescribed birth control pills, orthotricycline but of course had very little effect. ALL the topicals â€“ clindamycin, retin-A, benzoyl peroxide, glycolic gels, salicylic acidsâ€¦. Tried them all. NOTHING.
I ordered things off the TV â€“ Proactive, which did nothing even though I used it for an entire year. I bought the mineral-makeup for $120 which did nothing and didnâ€™t cover my scars which made me more embarrassed.
Iâ€™ve used homeopathic medicines â€“ Calcerica suplpherica, Ignatia Amara, Sulphur, and blends designed to clear acneâ€¦ amongst others. NO IMPACT. Iâ€™ve taken Natureâ€™s Cure both internally and topically. Again, no difference.
Iâ€™ve been using Acne Free 3-step program for the last year and it takes the edge off. I alternate with Olayâ€™s â€œclarifyâ€ with salicylic acid and Natureâ€™s Cure with papaya and salicylic acid just for balance.
Iâ€™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 DanActiveâ€™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.
Iâ€™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. Iâ€™ve even tried taking Chinese herbs and drinking disgusting teas and they had absolutely no effect on my skin.
Iâ€™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 didnâ€™t do a damn thing â€“ Cellfood silica fomula, MSM supplements, Candida and yeast management systemsâ€¦
I sought a yearâ€™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 â€œpremiumâ€ 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.)
Iâ€™ve used several jars of Elicina over the last 18 months â€“ itâ€™s snail gel from South America. It actually works, believe it or not. Itâ€™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 Iâ€™ve used quite a few of them. While this works for little tiny bumps I think it may provoke the cysts a little bit.
Iâ€™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 â€“ carefully blending yellows and greens with expensive counter make-ups. Iâ€™ve found that Estee Lauder has a â€œcamoflaugeâ€ makeup that they sell for $40 an ounce. One tube will last about 2 months. Iâ€™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 Iâ€™ve spent $7,062 on makeup alone in the last 11 years - in an effort to appear â€œnormalâ€. However, it doesnâ€™t make me look â€œnormalâ€ 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.
Pleaseâ€¦. Please help me.
I donâ€™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 donâ€™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 canâ€™t stand it any longer. Please help me.
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