30 January 2019

My Journey with Severe Acne


My Journey with Severe Acne - Roaccutane

My skin has been bad since I was 11 years old.

It had never crossed my mind that I had spots, until two of the boys at school {one of whom I had a secret crush on} ran across the playground to me and said, "Eurrrgh. What's that mark on your face?" That evening at home, I asked Mama Maggie May what was wrong with my face, and what I could do about it {whilst also noting that it was unlikely I'd be holding hands with my ex-crush any time soon - his loss!}

Mama Maggie May was awesome; in gentle defiance of my school's no make-up policy, she would carefully apply light powder or concealer to my spots in the morning so I could face my peers. After a while though, we noticed that the acne was not restricted to my face, but was affecting my neck, shoulders and back too, and was really starting to bother me.

Hypotheses about food intolerances or allergies were suggested and quickly disproved, and by the age of 12 I had been started on the combined oral contraceptive pill in the hope that the hormones would help my troubled skin. I felt like I was keeping a dirty secret, and that I was committing an awful crime by being on such a grown up medication which was only for adults. But - it did help!

Although I still struggled on with mild to moderate acne during my teenage years, the Pill was great, and it had an even better effect once I switched to Dianette. I'd still feel the need to pile on lotions and potions {Clearasil, Neutrogena, Freederm - I'm sure I've tried them all} as my skin did seem to be worse than the average teenage Joe's, but it was manageable.

I went on several courses of topical and oral antibiotics over the years, which sometimes had an effect, and sometimes didn't. I was referred to the dermatology team at the local hospital a few times, who tentatively mentioned the super drug roaccutane {also known as isotretinoin}, but advised that my acne wasn't really the right type to be prescribed roaccutane; they explained that the best type of acne to respond to this treatment was severe, cystic acne. They showed me horrific pictures of painful-looking acne eruptions, and I nodded in agreement that I was definitely not as bad off as these poor people. Due to the well-documented side effects of roaccutane, they were reluctant to prescribe it without being quite sure it would treat me, and Mama Maggie May and I agreed with their decision. So on with the antibiotics and topical treatments I went.

I left home for university at 18 years old with my repeat prescriptions in hand and hardly a care in the world, until I met one of the GPs at the Student's Health Service. She informed me that with my history of migraines with aura {flashing lights and visual symptoms}, I should definitely not be on a contraceptive pill containing oestrogen, due to the increased risk of stroke. I was heartbroken, and initially adamant that this couldn't be the case - but with hindsight, I'd never really spoken to a doctor about my migraines before, and so it had slipped the net. My medication was stopped.

My skin rebelled. I remember being so unhappy at how my skin drastically changed for the worse that I sat crying in my room in university halls, thinking, "Why is this happening to me? Everything was fine as it was." I went to my GP several times to try different creams and gels, but after a while, I suppose I started to get used to the fact that I had bad acne and always would have.

In my early twenties, I remember having a particularly sad thought one day; do people remember me as the woman with bad skin? If someone can't recall my face or name, are they reminded when another person says, "You know, the one with the awful acne, poor woman." Is that what defined me? Would that be the main characteristic people would remember about me?

And still I ploughed on. Until 2017.

My skin gradually seemed to become a bit worse during the summer - maybe it was the heat, or stress. I contemplated my diet for a while, even though I know there is no evidence to show that certain foods cause acne. I visited my GP who prescribed a course of oral antibiotics, and things cleared up after a few months. Great.

But then it happened again a few months later. So I tried the antibiotics again - and this time they didn't work. Meanwhile, my skin was becoming more and more sore and painful. Some days my face would actually ache from the pain of the large spots blistering my face. One day, it suddenly hit me: I was now one of those people in the horrific photos I'd been shown by the dermatologists, all those years ago.

It's taken me a while to pluck up the courage to share the photos below. But I'm doing it because I know there will be young girls, teenagers and women out there like me whose acne wears them down; who feel like it will be a burden they carry with them forever. I want to share these images with you, so you can see my before - but more importantly, so you can see my after.

My Journey with Severe Acne - Roaccutane. Maggie May
June 2018

My Journey with Severe Acne - Roaccutane. Maggie May
July 2018

This is my acne when it was at its moderate to severe stage. I haven't got any photos of when it was at its severe stage, as I found it too upsetting to take photos.

The more astute of you will have noticed the dates on the above photos - 2018. With my wedding coming up in October 2018, I was starting to feel desperate. Back to the dermatologist I went - but this time I knew I was finally ready to give roaccutane a go.

Roaccutane is a controversial drug; there has been much hype in the past about its side effects, and a lot of media attention regarding a link between low mood and suicide in young adults taking the drug. Aside from mood disturbances, other side effects include dry skin, photosensitivity {so you're prone to sunburn even on a cloudy day}, dry lips, dry eyes, fatigue, muscle aches and nosebleeds. During my time at university, I had visited dermatologists once or twice to discuss whether I should start roaccutane, and there was always a reason not too - I was concerned about the effect on my mood, or I was worried about my chronic fatigue. Friends and family would ask, "Why don't you give that wonder drug a go?" But I was too scared, and I could always think of a reason not to take it. This time though, the acne was different, and I didn't want it to be a defining feature of my life anymore.

As I started to talk with my dermatologist about starting roaccutane, we both knew that I didn't want to turn up on my wedding day with peeling lips, an inability to wear my contact lenses, and a dry, red face! So the decision was made for me to start taking my 6 month course on my return from our honeymoon.

Here I am, 3 months on:

My Journey with Severe Acne - Roaccutane. Maggie May
January 2019
Yes, you might see a woman with a red cheek that looks like it has some scarring {when the dermatologist recently said to me she could see lots of scarring, I was shocked, as I didn't think I would ever let it get that bad}. Me? I look at this photo and could almost cry with happiness. My skin almost looks normal. And if I carry on with the next 3 months of my course, there's a good chance my skin will be clear, for the first time in my adult life. Over 80% of patients who have a course of roaccutane will be cured of acne - for good. 

Have I had any side effects? Yes. I can't wear my contact lenses because my eyes are too dry, and my lips are constantly chapped {this lip ointment is excellent though, and is currently on sale!}. The dry skin and photosensitivity hasn't been too bad, especially as my dermatologist recommended taking roaccutane over the winter months so this would be less of a problem. I have a small amount of bleeding from my nose everyday. And yet despite all of this, I am so glad I have finally given roaccutane a go.

Acne is awful. Everyone gets spots from time to time, but when you have severe acne, it's not a case of waking up in the morning to find a zit on your chin - it's a case of checking how many more have appeared overnight to join the patches which already inundate your tired, sore skin. I know how awful it can feel, trying to cover it up with make up and let it breathe at the same time. My advice would be to speak with your GP straight away, so you can at least get started with some simple topical treatments. They will be able to try a few different treatments, and refer you to the dermatologist if appropriate. It may not be heart failure or diabetes or high blood pressure, but that doesn't make acne any less of a medical condition.

If I can sort out my acne, I know you can too! Please don't battle on with it for 15 years like I did.

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