Five years ago, my mom booked my first dermatologist appointment. I had just started high school, and was so insecure about my skin. While many other kids by age got the occasional mild breakout, it seemed my face was persistently inflamed and irritated.
In the five years since that appointment, I’ve spent almost every day waking up and hoping it was a ‘good skin day’. Antibiotics, topicals, and diet attempts — improvements ebbed and flowed, but no result satisfied me. One medication made me sick almost every morning, another resulted in a sunburn so bad my face blistered. Neither of them ‘fixed’ my skin. I felt hopeless. Sometimes, no matter what you try, there is just no easy fix to such a complex genetic condition.
Eventually I brought up isotretinoin (commonly known as Accutane, though that’s actually just a brand that is no longer available) to my dermatologist. I had just started my freshman year of college, and knew of a friend who had a very positive experience on the drug. My doctor acknowledged it as an option, but pushed back, suggesting we try different more treatment routes first.
After more unsatisfying results and a particularly bad flareup, I felt my frustrations reignite. I returned to the office and insisted that I wanted to give it a shot.
To be clear, isotretinoin is a complex drug that can have severe and intense side effects. Naturally, in depth conversations with a physician are needed before anyone can decide it’s right for them. But as someone who struggled for so long with difficult and unresponsive skin, I do believe in patient self-advocacy and knowing what is right for your body.
Health is truly such a personal and complicated experience, and all I can say is that starting this medication was the right choice for me.
Starting isotretinoin was a complex process involving several consent forms, pregnancy tests, and bloodwork. In my opinion, the iPledge program can be clunky — I, as well as some friends, have dealt with logistical hurdles or confusion getting the prescription filled. But since starting isotretinoin in May, I’ve noticed such a great transformation in my skin. I had some mild purging and dry skin (I will never again be caught without Aquaphor in my purse), but no other side effects. Acne itself can be painful, and not having to deal with that discomfort truly makes a huge difference.
Of course, the journey hasn’t been perfect. At the end of the summer, my skin broke out again — worse than it had since I started the medication. I tried to control my stress, but I still felt old fears resurface. When I asked my dermatologist, he said this was abnormal, since my dosage hadn’t changed since the second month. Hearing this worried me. What if my skin just continued to get worse? Was I doing something wrong?
Though things have improved again, I recognize that might not be a guarantee. In a world constantly influenced by social media and pop culture, where it can seem like everyone has a perfect, poreless face. But I try to remind myself that I’m my own biggest critic. I think that because you can feel your own skin, it feels like everyone else can too. But nobody judges us like ourselves, and it’s not worth letting that inner judgment control your confidence.
I truly encourage anyone reading this who currently feels that same sense of hopelessness to consider a discussion with their dermatologist. Ultimately, medical self-advocacy is an important skill. But it’s also important to note that a big part of your journey will also involve coming to terms with the complexities of skin and your own self-judgments, which I have found are not often reciprocated by those around us.