Living with adult acne
Acne. It's something that everybody is familiar with. I've always thought that acne mainly occurred during puberty and fizzled out when we reach adulthood. I was perhaps lucky that I had flawless skin during my teenage years. Because of this, I was able to gain more confidence during my developmental years, which helped me become a more optimistic person. I've always been one to somewhat care about my appearance, but I would never let it affect my state of mind. I was convinced that I was good enough and that those who mattered most to me would look past my blemishes. I mean, pimples here and there, didn't really affect how I looked. I was blissfully happy and carried myself with poise. Because its inner beauty that wins in the end, right? Unfortunately, that's not how the world works. The world is more superficial than me. The world is judgmental. The world will always favor those who uphold the standard of beauty. Before, when I had a few pimples on my face, I still was considered average or slightly above average in terms of beauty. So of course I would have remained happy, despite these small "imperfections".
However, adult acne slowly creeped in and struck a huge blow to my previous high self-esteem. About a year into my PhD, I started to have more acne. I didn't think much of it back then because they would come and go after periods of stress. I lived a fairly healthy and active lifestyle so it did not occur to me that my acne would worsen. By my second year, I started to notice some recurring and widespread pimples on my forehead and cheeks. I went to the dermatologist, who gave me a prescription of doxycycline and Tretinoin Gel (0.025%). After a month, I stopped taking this prescription because the doxycycline upset my stomach too much. My acne wasn't too bad anymore so I didn't bother going to the dermatologist again. I also began to be even more active by training for the half marathon. The exercise and healthier eating habit helped me with my acne flares.
After the half marathon, my acne became out of control so I went to the dermatologist again. I was prescribed Spirolactone, Tretinoin Gel (0.025%), and a sulfur-based cleanser, which I have been on for a month now. Long-term acne treatment is a commitment and it requires incredible patience and resilience. It is not a quick fix.
Because I'm a scientist, I'd like to provide some information on the mechanism of action and side effects of my prescribed medication. Spirolactone is a prescription drug used to treat hypertension. However, it can be used to treat hormonal acne because the pill works by blocking androgen receptors, which reduces the effects of testosterone, resulting in a decrease in oil production in the skin. I take 100mg once a day before I sleep. I was prescribed this because my acne worsened during each menstrual cycle. The first week of Spirolactone was rough. Spirolactone is a diuretic, so there were frequent trips to pee for me - about once every hour. I had to plan my bathroom routes every time I wanted to walk a long distance! Because of this, I had to drink SO much water. Fortunately, the frequent pee sessions lessened overtime. Spirolactone also lowers blood pressure so I felt more fatigue and had to be careful with exercise because I would feel lightheaded if I exerted myself too hard. It lowers potassium levels and requires a trip to the doctor once every month or 3 months for monitoring of potassium levels in the blood. In addition, since Spirolactone is a hormonal drug, it also causes irregular menstrual cycles. My periods still occur, but they are more sporadic. This is something I will address to my dermatologist during my next visit.
Tretinoin is a topical cream that is a form of the Retin-A drug, a derivative of Vitamin A. Tretinoin stimulates cell life cycle, which causes skin cells to get pushed to the surface of the skin. This hinders excess oil and dirt from blocking our pores, which will lead to the formation of blackheads and pimples. Tretinoin is a beast of an ointment. Because the formulation consists of 90% alcohol, Tretinoin causes excessive drying and peeling of the skin. Moisturizer became my best friend. I have incredibly sensitive skin so I used a moisturizer from Elta MD, which is expensive, but worth it, because it is very long-lasting. Tretinoin also makes users more sensitive to sunlight, which is why I apply a pea-size amount of the cream on my face before I go to bed. In the beginning, I was able to walk in the sun for shorter durations. Towards the end of the month, I realized that my skin was getting incredibly itchy after being in the sun for more than 2 hours. Thus, I started to apply sunscreen to prevent this sensitivity. I do recommend putting on sunscreen if you're outside, regardless of being on Tretinoin, because sun rays are incredibly harmful to our skin!
Due to my sensitive skin, I use a cleanser that consists of 10% sodium sulfacetamide and 5% sulfur. I started off just washing my face before I go to bed because I didn't want to irritate my skin. After a few weeks, I started to wash my face in the mornings too. My nightly routine would be 1) take a Spirolactone pill, 2) Wash my face with the sulfur-based cleanser, 3) Apply moisturizer, and 4) After 30 minutes, apply a pea-size amount of Tretinoin. After a month, I was seeing some positive results.
However, this was counteracted when I applied a new sunscreen for sensitive skin that was tinted, which I now learnt not to buy because it may aggravate acne. Also, I'm supposed to wash my face with make-up remover after sunscreen usage to prevent pore blockage. I'd recommend checking every external product you use with your dermatologist, even if its the brand they had suggested. After a week of sunscreen usage, my skin broke out even worse than before and it kept getting worse every day. I went on vacation to visit my family during this time. My face looked so horrifying that I decided to get a facial extraction. This process was incredibly painful. It basically is professional pimple popping under sterile conditions. I'm supposed to go to 2 sessions a week for a month. My cystic acne covered my entire forehead and cheeks by this point. For my first session, I had 70% of my face done and it took 2 hours. My face was inflamed for the entire the day. The following day, the scabs from my pimples looked like chicken pox all over my face. This was probably my lowest moment because I felt that I was at a point of no return. The acne was now openly marked for the entire world to observe. I was ashamed of my face. I was ashamed that I cared about something so trivial and superficial. It was the first time I cried over an imperfection with my body. These were tears of embarrassment with both my appearance and character.
I've been told that long-term acne treatment gets worse before it gets better. That's the difficult part of acne treatment. I have to blindly trust that the medications will eventually work. Acne isn't life threatening. However, it is threatening to our mental health and this can have long lasting effects. It affects how we feel and how we interact with people around us. Even though I didn't start off as someone who really cared about my appearance, my adult acne has been incredibly debilitating. It's hard to love myself when every time I look into a mirror, I'm seeing the worst I've ever been. I've considered wearing make-up to cover up this (a huge deal for me because I've always gone natural), but decided against it because it will just clog my pores and prolong my treatment even further. I know that acne doesn't define who I am, but at this moment, it feels like it defines my entire face. I want to wear my hair down because it hides my face. I want to go into places with dimmer lighting so people can't see my acne. Sometimes I don't feel like leaving the house because it's too shameful. I don't dare to look people in the eye anymore because I'm afraid it will draw their attention to my face. I fear living with this vulnerability.
I am not one to mope around for long periods of time because I like to take action to find a solution to the problem. I am a firm believer that our happiness stems from our perception. I can't control my acne breakouts, but I can control how I view my progress. Acne treatment needs to be taken seriously, just like treatment for any disease or injury. When someone breaks a bone, you don't tell them to use it immediately. They need to be in a cast and wait for time to heal. People aren't going to judge them for breaking a bone. They are going to want to help out. Similarly, when someone has acne, you can't expect them to just shrug it off. Acne is also a medical problem. It's an injury to the face and mind, both needing time to heal. Just like any other injury, acne can be manageable with the correct treatment. Good people aren't going to judge you for your acne; they will want to help you find a solution to it. I am taking the best steps possible to address the problem. I can eat healthier and maintain an active lifestyle to facilitate this treatment. During this time, I can focus on ways to accentuate my other beautiful features. I can practice self-love.
Living with adult acne has given me a completely different perspective on life. I have gained a sense of empathy with those who suffer from acne. I want you to know that you are not alone in this fight. It's easy to give into the judgement and criticism from those around us. It's okay to feel helpless because you are putting your face on display. Your emotions are real and you should never feel ashamed of it. However, it is important to remind yourself that you are strong enough to overcome this obstacle. You will come out mentally stronger and this is something you need to be proud of.
In the end, imperfections are what makes us human. To embrace imperfection is to embrace being human. And to be human makes us, us.
However, adult acne slowly creeped in and struck a huge blow to my previous high self-esteem. About a year into my PhD, I started to have more acne. I didn't think much of it back then because they would come and go after periods of stress. I lived a fairly healthy and active lifestyle so it did not occur to me that my acne would worsen. By my second year, I started to notice some recurring and widespread pimples on my forehead and cheeks. I went to the dermatologist, who gave me a prescription of doxycycline and Tretinoin Gel (0.025%). After a month, I stopped taking this prescription because the doxycycline upset my stomach too much. My acne wasn't too bad anymore so I didn't bother going to the dermatologist again. I also began to be even more active by training for the half marathon. The exercise and healthier eating habit helped me with my acne flares.
After the half marathon, my acne became out of control so I went to the dermatologist again. I was prescribed Spirolactone, Tretinoin Gel (0.025%), and a sulfur-based cleanser, which I have been on for a month now. Long-term acne treatment is a commitment and it requires incredible patience and resilience. It is not a quick fix.
Because I'm a scientist, I'd like to provide some information on the mechanism of action and side effects of my prescribed medication. Spirolactone is a prescription drug used to treat hypertension. However, it can be used to treat hormonal acne because the pill works by blocking androgen receptors, which reduces the effects of testosterone, resulting in a decrease in oil production in the skin. I take 100mg once a day before I sleep. I was prescribed this because my acne worsened during each menstrual cycle. The first week of Spirolactone was rough. Spirolactone is a diuretic, so there were frequent trips to pee for me - about once every hour. I had to plan my bathroom routes every time I wanted to walk a long distance! Because of this, I had to drink SO much water. Fortunately, the frequent pee sessions lessened overtime. Spirolactone also lowers blood pressure so I felt more fatigue and had to be careful with exercise because I would feel lightheaded if I exerted myself too hard. It lowers potassium levels and requires a trip to the doctor once every month or 3 months for monitoring of potassium levels in the blood. In addition, since Spirolactone is a hormonal drug, it also causes irregular menstrual cycles. My periods still occur, but they are more sporadic. This is something I will address to my dermatologist during my next visit.
Tretinoin is a topical cream that is a form of the Retin-A drug, a derivative of Vitamin A. Tretinoin stimulates cell life cycle, which causes skin cells to get pushed to the surface of the skin. This hinders excess oil and dirt from blocking our pores, which will lead to the formation of blackheads and pimples. Tretinoin is a beast of an ointment. Because the formulation consists of 90% alcohol, Tretinoin causes excessive drying and peeling of the skin. Moisturizer became my best friend. I have incredibly sensitive skin so I used a moisturizer from Elta MD, which is expensive, but worth it, because it is very long-lasting. Tretinoin also makes users more sensitive to sunlight, which is why I apply a pea-size amount of the cream on my face before I go to bed. In the beginning, I was able to walk in the sun for shorter durations. Towards the end of the month, I realized that my skin was getting incredibly itchy after being in the sun for more than 2 hours. Thus, I started to apply sunscreen to prevent this sensitivity. I do recommend putting on sunscreen if you're outside, regardless of being on Tretinoin, because sun rays are incredibly harmful to our skin!
Due to my sensitive skin, I use a cleanser that consists of 10% sodium sulfacetamide and 5% sulfur. I started off just washing my face before I go to bed because I didn't want to irritate my skin. After a few weeks, I started to wash my face in the mornings too. My nightly routine would be 1) take a Spirolactone pill, 2) Wash my face with the sulfur-based cleanser, 3) Apply moisturizer, and 4) After 30 minutes, apply a pea-size amount of Tretinoin. After a month, I was seeing some positive results.
However, this was counteracted when I applied a new sunscreen for sensitive skin that was tinted, which I now learnt not to buy because it may aggravate acne. Also, I'm supposed to wash my face with make-up remover after sunscreen usage to prevent pore blockage. I'd recommend checking every external product you use with your dermatologist, even if its the brand they had suggested. After a week of sunscreen usage, my skin broke out even worse than before and it kept getting worse every day. I went on vacation to visit my family during this time. My face looked so horrifying that I decided to get a facial extraction. This process was incredibly painful. It basically is professional pimple popping under sterile conditions. I'm supposed to go to 2 sessions a week for a month. My cystic acne covered my entire forehead and cheeks by this point. For my first session, I had 70% of my face done and it took 2 hours. My face was inflamed for the entire the day. The following day, the scabs from my pimples looked like chicken pox all over my face. This was probably my lowest moment because I felt that I was at a point of no return. The acne was now openly marked for the entire world to observe. I was ashamed of my face. I was ashamed that I cared about something so trivial and superficial. It was the first time I cried over an imperfection with my body. These were tears of embarrassment with both my appearance and character.
I've been told that long-term acne treatment gets worse before it gets better. That's the difficult part of acne treatment. I have to blindly trust that the medications will eventually work. Acne isn't life threatening. However, it is threatening to our mental health and this can have long lasting effects. It affects how we feel and how we interact with people around us. Even though I didn't start off as someone who really cared about my appearance, my adult acne has been incredibly debilitating. It's hard to love myself when every time I look into a mirror, I'm seeing the worst I've ever been. I've considered wearing make-up to cover up this (a huge deal for me because I've always gone natural), but decided against it because it will just clog my pores and prolong my treatment even further. I know that acne doesn't define who I am, but at this moment, it feels like it defines my entire face. I want to wear my hair down because it hides my face. I want to go into places with dimmer lighting so people can't see my acne. Sometimes I don't feel like leaving the house because it's too shameful. I don't dare to look people in the eye anymore because I'm afraid it will draw their attention to my face. I fear living with this vulnerability.
I am not one to mope around for long periods of time because I like to take action to find a solution to the problem. I am a firm believer that our happiness stems from our perception. I can't control my acne breakouts, but I can control how I view my progress. Acne treatment needs to be taken seriously, just like treatment for any disease or injury. When someone breaks a bone, you don't tell them to use it immediately. They need to be in a cast and wait for time to heal. People aren't going to judge them for breaking a bone. They are going to want to help out. Similarly, when someone has acne, you can't expect them to just shrug it off. Acne is also a medical problem. It's an injury to the face and mind, both needing time to heal. Just like any other injury, acne can be manageable with the correct treatment. Good people aren't going to judge you for your acne; they will want to help you find a solution to it. I am taking the best steps possible to address the problem. I can eat healthier and maintain an active lifestyle to facilitate this treatment. During this time, I can focus on ways to accentuate my other beautiful features. I can practice self-love.
Living with adult acne has given me a completely different perspective on life. I have gained a sense of empathy with those who suffer from acne. I want you to know that you are not alone in this fight. It's easy to give into the judgement and criticism from those around us. It's okay to feel helpless because you are putting your face on display. Your emotions are real and you should never feel ashamed of it. However, it is important to remind yourself that you are strong enough to overcome this obstacle. You will come out mentally stronger and this is something you need to be proud of.
In the end, imperfections are what makes us human. To embrace imperfection is to embrace being human. And to be human makes us, us.
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