". . . little shall I grace my cause

In speaking for myself. Yet, by your gracious patience,

I will a round unvarnish'd tale deliver . . ."

(William Shakespeare's Othello, I.iii.88-90)

Friday, January 11, 2008

Self-Pity Party

Warning: the following post is an exercise in total self-absorption and whininess. Please feel justified in navigating elsewhere at any time!

Can I feel sorry for myself a little today?

I have struggled with acne my entire life. During high school and college, it was of the nuisance variety--sometimes better, sometimes worse, but generally managed with over-the-counter remedies. I consoled myself by looking forward to that coveted day in the future--in my late twenties or thirties--that I would finally "outgrow" the acne curse.

That day never came. I got a job teaching public school and found myself wondering why my adolescent middle school students had better skin than I did. When I got pregnant, the acne worsened considerably. Interestingly enough, during my second pregnancy it got better! But after the second baby, it came back with a vengeance, unlike anything I had ever experienced. For the first time in my life I consulted a dermatologist.

For several years I underwent preventative antibiotic therapy, and it worked. But after a move, I had to change doctors, and the new doctor decided it was time to phase out the medication.

Having already tried several times to go off the antibiotics, I knew the strategy wouldn't work, and I told the doctor so. But he insisted, and as I remained off the medication, the acne returned, worse than it had ever been before. It's hard for me to describe the severity of it. It wasn't just a cosmetic issue. My entire face was swollen and throbbing. It was painful to talk or smile or eat. I didn't want to get out of bed. The lesions were more like boils than pimples. Once as I was eating out with my family one of the lesions spontaneously erupted and started running down my face. Sorry for the gross-out factor, but that's what happened.

Finally the dermatologist, still resisting a medicinal approach, decided to perform minor surgery. He put me on the examination room table and lanced and drained a number of the lesions (sorry, more gross-out). I had bandages all over my face.

The problem was that draining the existing lesions did nothing to prevent new ones from coming. And come they did. In desperation I went to my family doctor (my husband and I were soon to depart on an anniversary trip to Grenada). He took one look at me and immediately prescribed a fresh round of antibiotic therapy. It took time, but finally things improved.

A few years and a third baby later, I decided something needed to change. I didn't want to remain on antibiotics the rest of my life. I knew that part of the reason for the acne getting so bad in my adulthood was probably antibiotic resistance from so many years of taking medication. So as I approached my forties and considered that my husband and I were not planning on more children, I finally decided on a an extreme measure: isotretinoin (better know by its trade name of Accutane).

The isotretinoin made all the difference in the world. It shrank my pores, cut back on my overactive oil production (the root cause of my acne), and succeeded in banishing the acne! The only side effect I experienced was excessive dryness of skin, mouth, and lips--a small price to pay for the elusive dream of clear skin.

Now to the self-pity. In the last few months I have been having those teenage-style outbreaks again. I use Retin-A on my skin nightly, but it is no longer doing the job. I have been putting off seeing my dermatologist, trying to manage this myself, but each outbreak has been a little bit worse. So Monday I see the dermatologist. My fear is that if something is not done now, I will find myself reliving the nightmare of a few years ago.

Yet what are the options? Another round of Accutane? I am willing, but after the recent tightening of government regulations on that drug I am not sure if it is even being dispensed anymore. Then there is the antibiotic route. Again, I am willing, but will it work? And if so, then what? Antibiotic therapy until I finally go through menopause?

I always thought there would come a day that the acne would be history and the wrinkles a future event. Instead, I now have both, plus lots of lovely scars. And as the aging process has its way with my body and the skin sags, it is sometimes hard to tell where the scars end and the wrinkles and "fine lines" begin. Thank heaven for modern make-up. I know: vanity is a sin and beauty is only skin deep and true beauty comes from within and you're only as young as you feel and . . . . sorry, but none of that is helping right now.

So, class, since you made it this far, let's review:

1) My skin is breaking out.
2) I have a very special social engagement coming up this weekend (two of my best girlfriends are coming to visit).
3) I am 43 years old.

What is wrong with this picture?


Susan K said...

Okay, must comment immediately.

I'm only 24, but I too have been struggling with the horrors of adult-onset acne. I had problems as an adolescent as well, which all but disappeared for less than a year during college, at which point the type of breakouts changed for the worse. I tried every miracle cure I could find.

I am far from cured, but the best relief I have been able to find is with 2.5% benzoyl peroxide gel. Just as effective as 10% but a lot less drying and irritating. Check out acne.org, which has the best products (and not too expensive, compared to prescriptions!) and instructions for use. It's not just about slapping it on your face; I've noticed worsening if I don't take enough time to rub it in. And perhaps best of all for you, Dan Kern, the man who came up with this "Regimen," did so because he was experiencing break-outs after Accutane. Even checking out the site may help you figure out this problem on your own to find the right cleansers and moisturizers for you. I suspect most dermatologists just have certain drugs they always prescribe without trying enough to get to the actual cause. It sounds like your problems are hormonal, like mine, so it may never go away (my mom even had problems AFTER menopause), but this BP gel does help. I've also read about how some doctors will prescribe birth control pills (which helped a little for me) as well as other synthetic hormones to great success. Good luck!

Rev. Paul T. McCain said...

Suffering with any physical ailment is very difficult. May the Lord give you peace in the midst of these problems.

Psalm 31: 7: "I will rejoice and be glad in your steadfast love, because you have seen my afflictions; you have know the distress of my soul."

A prayer for you:

Heavenly Father, You teach us in your holy word that you do not willingly afflict or grieve your children. Look with compassion on Cheryl. Remember her in mercy, strengthen her in patience, comfort her with the memory of your goodness, and let your face shine on her that she may be guarded by your peace in Christ Jesus, who lives and reigns with you and the Holy Spirit, one God, now and forever. Amen.

Elephantschild said...

(That's why Pr. McCain is my favorite pastor-blogger.)

Cheryl, we'll commiserate this weekend. I have this too, but not as severe as what you describe, and I'm slowly narrowing down a foods that seem to trigger the issue, although lots of times it's pretty mysterious.

Genuine Lustre said...

Oh Cheryl - just sending some hormone crazed sympathy from here! Have fun this weekend!

I shoulda bought stock in Clean and Clear Advantage . . . .

mz said...

Cheryl, I am so sorry you have to go through this. I have had cystic acne since grade school that was made worse (to the point you described) by nearly 5 years on the pill. I was on antibiotics in high school, as well as Retin A. I finally found a group of doctors who were able to pinpoint a cause - estrogen dominance.

Some links for you: www.johnleemd.com - Even though Dr. Lee is deceased, his research into this condition has been invaluable.

www.homefirst.com - These doctors were able to identify the problem as a hormone imbalance and took steps to treat it. Since I have been using the progesterone cream, my skin has improved dramatically. They have several offices throughout the metro area.

If you don't already, you may want to look into taking a probiotic supplement. Years of being on antibiotics have undoubtedly killed off the beneficial flora that should live in the gut, and that is an important foundation for good health.

Hope this helps, and I hope that you find some relief very soon!

Presbytera said...

Looks like your readers have come up with some great suggestions. I can only offer heartfelt sympathy for you. Enjoy the girls : )

Cheryl said...

Wow. You all are amazing. I am completely touched by everyone's caring and concern for something that must seem so trivial. I appreciate your understanding that it's not trivial to me.

To Pastor McCain: thank you for the Psalm verse and the beautiful prayer--especially the prayer for patience, for which I have been sorely in need lately, not only in this but in other things as well. I am humbled that you "stopped by" today and took the time to comment and I greatly appreciate the encouraging words and the reminder of whence all comfort comes.

Thanks also to everyone who had advice and suggestions! I will look into all of these! Just when you think you know it all and have explored every option, here comes an army of new possibilities!

And finally, thanks to those who just sent love and "cyber hugs." I appreciate the sympathy and commiseration!

mz said...

I forgot to mention tea tree oil. It seems to help combat the larger welt like cysts, and helps keep smaller ones from turning into those really painful ones. You can get spot treatment creams with TTO at any good health food store, but what I have done is to just get a bottle of the essential oil and anytime you need it, put a drop on a q-tip and apply where needed. A word of caution - this stuff can burn. Usually when I've used it on a welt, I can't feel the burn but do not get it anywhere near your eyes nor any other sensitive area.

Also, have you tried Proactiv? I had some success with it on and off, but like anything else I seemed to develop a resistance after a while and would have to stop it. I actually have a brand new set sitting in my linen closet that I won't be using. If you'd like to try it, it is yours. Email me a srhblog AT gmail DOT com if you're interested.