Saturday, December 12, 2015

I have bad skin

I am exhausted from this not-so-secret secret that I have.

For well over a decade I have been fighting the ignoble acne fight, and now in my thirties I get to fight acne and wrinkles together, bonus!

This used to be professionally embarrassing to me.  I work in medicine, after all.  How can I do anything but hang my blemished head in shame with my skin the way is it?

Well, to be fair, at work I wear tasteful makeup.  Not heavy.  But enough to hide the worst of it.

Mostly, I stopped worrying so much that my skin isn't perfect.  And my story has become a story I share with patients, too - it's important to manage expectations, because what's ok to me might not be the desired end state for them.

I spent 10 years on oral antibiotics like doxycycline.  Among the many uses for this  medication, it's a malaria prophylactic, and if I stumbled on anthrax, lyme disease, or syphilis during that time well then I didn't have to worry either.  I took once- or twice- daily antibiotics for years amid creams and gels and topicals of all sorts. 

A decade of antibiotics is about 9 years 6 months too much for me, as I didn't know otherwise at the time.  Nausea and vomiting daily?  Burning skin and peeling flakes and redness and dryness and cracking?  I'm not so fond, and I was sick of using stacks of $$$ prescription products because it just made me feel like the "cure" was never in sight.  Eventually I just decided that all of this medication was too much, and my happy medium for my skin is just (significantly) less than magazine perfect.  I'm satisfied this way, blemishes and all.  And you know what?  There may not be a cure for me, but I've settled for what I think is a livable level.  And I think you should, too.  I've whittled down my medicine cabinet to one prescription topical acne product because it's affordable for me, simple, and relatively free of side effects, and I don't have to spend my time feeling -- stupidly -- like a victim of zits.  More time for running and eating Cheetos!!

Let's be honest.  The skin of your face is what the world first sees of you.  And it sucks when it doesn't look so conventionally nice.  Yes, just about any medical condition on the planet is more serious than acne, but it really stinks that it shows up and sticks around and for some of us is just going to be a part of the way we live.  I used to worry that people would subconsciously disrespect me or otherwise prejudice me for my skin, but that hasn't happened.  At least in this instance, people are less judgmental than I've judged them to be!

And my skin is not that bad.  I would say I have moderate inflammatory facial acne, with hormonal flares that sometimes border on grotesque.  I'm going to spare you (and me) from sharing any photos.  I've seen patients where my heart breaks for their scarred skin, and that no one has told them that it could have possible been improved earlier.  In some cases their skin will look practically perfect after some treatments, but in many cases it's unlikely to be perfect, but maybe just better.  Is it so bad to settle for "better?"  I think not.

Yes, some people have severe scarring acne.  That is not what I'm talking about.  That likely needs specialty dermatology care, for advanced products like Accutane.  There are serious side effects!  You can go and get care and your skin will likely get much better.  Don't delay!

What about you?  I'll answer general questions/skincare medical advice but not as a substitute for your personal healthcare provider!  Don't take internet medical advice kids!!

Well that's a burden lifted...a jolly good day it is then.