As I stared at my surprisingly smooth skin in the mirror this morning, I made note of how far I’ve come but also how far I still must go. There was a lingering pimple hanging on for dear life right in the middle of my forehead and fading hyperpigmentation all over my face, a gift from pimples’ past. I quietly analyzed my skin and I had to ask myself, “what the hell took you so long?”.
I started my isotretinoin treatment (commonly known as Accutane) two months ago and I must say that I am already impressed with the results. Now, one reason I was initially hesitant to take the treatment was because I never considered my acne to be severe enough. I always thought that I could ‘lifestyle’ my way into better skin. That meant changing my eating habits, exercising consistently, drinking copious amounts of water, and having an immaculate skincare routine with some of the best products I could get my hands on (both natural and chemical). As you can probably guess, my efforts went unrewarded. It has been a vicious cycle since I hit puberty. Sometimes, I would have great skin days, but when they were bad? They were bad. Again, I never had to endure painful, oozing cystic acne. My acne was just incessant with nodules and papules being the stars of the show. As soon as I got rid of one pimple, five more would pop up in its place. To make matters worse, every time I had a breakout, I would be left with stubborn and unsightly hyperpigmentation. Although I never stopped trying to get my acne or hyperpigmentation under control, it seemed like I was swimming against the current and, after 15+ years of fighting this battle, I was reaching the end of my rope.
Another reason it took me so long to take this route is all the ‘scary’ information that’s out there about this medicine. I will be honest and say that I let the horror stories influence my decision without doing my own research. I’ve heard the stories of side effects too severe that the treatment had to be discontinued. The more severe risks like excessive dryness, migraines, birth defects, muscle weakness, changes in eyesight, spikes in cholesterol and blood sugar, joint pain, and more hovered over my decision like a dark cloud. Not to mention that some of those things could be irreversible, possibly fatal. Certain restrictions were also attached to this treatment and I assumed the average timeline to complete the medication was a year. It was enough for me to dismiss the thought of ever taking it altogether. However, after I noticed how my skin began to impact my mental health (I’ll get to that soon), I decided that it was time for me to face the big, bad wolf. It became my mission to do my own research and seek out a reputable dermatologist to help educate me on things I did not understand and offer me their expert advice on how to move forward.
Much to my surprise, there were a lot of misconceptions about this medicine. The treatment time varied depending on each person’s situation. Since my acne was not considered severe, I would only do six months. Restrictions also didn’t seem as off-putting. Pregnancy is completely out of the question during this treatment and for a short while after due to severe birth defects being highly probable. However, once the medicine is out of my system (about a month after completion), it will be safe to move forward with reproduction if I choose to do so. My husband and I both decided that we were okay with that considering we had just moved halfway across the country and were still amid a global pandemic. Liquor is a no-no as well. Both the liquor and medicine are filtered through the liver, so heavy drinking while taking this medication is a recipe for disaster. Although I love a good mixed cocktail and a glass of wine or two on the weekends, I was willing to sacrifice it for six months. Even though I always drink in moderation, I'd rather err on the side of caution. My weekend wind downs were not important enough for me to risk permanent liver damage. Finally, certain beauty services had to be put on pause which hurt me a little bit more than the aforementioned restrictions. Whew. Ya’ll. I’m still grappling with this. Beauty services that can cause ‘trauma’ to the skin such as waxing and chemical peels must be avoided during treatment and for six months after to prevent further scarring. That was a tough pill for me to swallow; I had to let go of some of my favorite beauty services for, essentially, a full year. If that meant finally getting clear skin, though, I was willing to give it up temporarily. After all, I will eventually be able to resume my pampering, but I may not get another chance to put my acne to rest. As for the scary side effects, I realized that they were no different than what could occur from other common medications on the market. Nothing is guaranteed and everyone is different. Our bodies are different and the way our bodies react to medicine is different. I had to release the fear that isotretinoin is somehow more dangerous than, say, acetaminophen. In reality, all medications carry severe risks. In most cases, only mild side effects are experienced, but the severe ones still must always be disclosed. That doesn’t guarantee that it’ll happen. I just had to do my part to follow the guidelines of my doctor and do what I could to minimize the possibility of adverse reactions.
Moreover, another somewhat shocking (and comforting) aspect of this treatment is how it is heavily regulated. Because I’m a healthy woman of child rearing age, its essential that I’m using two birth control methods throughout the entirety of my treatment to ensure I don’t get pregnant and I have to show proof of that. Additionally, I’m required to report to my doctor every single month and be cleared to receive my prescription. Being cleared involves a negative pregnancy test as well as a blood test to monitor certain things like my cholesterol levels. Once everything checks out, I have approximately 7 days to pick up my medicine or else I will have to get cleared all over again. Tedious? Yes. Annoying? Absolutely. But, I don’t mind being mildly inconvenienced if that means making sure I’m healthy and well for the duration of my treatment.
Although still anxious, within a matter of months, I felt confident enough with my newfound knowledge of this treatment to make the decision to move forward. This would be my last-ditch effort at achieving clear skin. Now, this journey was not about vanity for me. It would be remiss if I didn’t mention another defining moment that pushed along my decision was the realization that my mental health had taken turn. I wasn’t in this deep pit of self-loathing, but the change was significant enough that I had to notice it, process it, and take the necessary steps to change it. I noted how I didn’t enjoy doing my makeup anymore because the texture of my skin was so bothersome. Furthermore, I developed this irrational belief that, somehow, my reputation as a beauty professional would be diminished. How could I educate someone else about their skin if I seemingly can’t take care of mine? Why would potential clients trust me to provide quality services if I look like this? Thoughts such as those flooded my mind more frequently than ever. My passion for beauty dwindled as I failed to see my own. Having tried so many options to clear my skin and none of them prevail, I began to lose hope.
That’s when I knew I had to venture into the realm that I had been so apprehensive to stay away from. I owed it to myself to keep trying, even if this would be my last attempt. I shouldn’t feel shame about not being able to get my acne under control naturally. This is real life. There is not a cookie-cutter way to achieve clear skin and I had to be at peace with my journey. Instead of dwelling on the negatives of the situation, I started to shift my mindset and think of all the good things that could come from this. This was a chance to be transparent about the complexities of skin and use it to strengthen my position in the beauty industry. Who knows? Maybe someone else is experiencing something similar and will find inspiration in my story. Maybe they will feel a camaraderie and know that they are not alone in this. Either way, my biggest hope is that my choice to be candid about my situation will inevitably help someone else.
Above all else, I made sure to make the best decision for me despite what others had to say. When I divulged my choice to move forward with this treatment with others, I was inundated with opinions and stories that both urged me to stay far away and gave well wishes. While I respected everyone’s personal experience, I had to separate my journey from theirs. There was no way to know if the treatment would be successful or not without committing to it. I just made sure to remind myself that I could stop treatment at any time if I started to feel uncomfortable or if I began to develop side effects that concerned me. Thankfully, I am 2 months into my treatment, and I would consider my side effects to be minimal. I certainly have dry lips that require a coat of balm every hour on the hour and fairly dry skin when normally, I am combination. I had a neck rash the first week of treatment but, other than looking a little unpleasant, it did not bother me and resolved itself within 7 days. That’s it. Now, imagine if I had let the opinions of others scare me away? I would still be in search of the next miracle skincare product, wasting money and desperately grasping at this false sense of hope that this time will be different. I’ve done that for over 15 years. This treatment, however, is something new for me. And to see such results in as little as 2 months is monumental for me. While I understand that this may not be a cure, it’s given me something that I haven’t had in a while: hope.
And I finally see a light at the end of the tunnel.