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?