I usually reserve Tuesdays to show or talk about wedding-related subjects, but we’re going to veer off-course today. So here is a rare Tuesday personal post, and one that is slightly embarrassing to write.

      It’s about skin.

      I’m 27 and have the skin of a 16-year-old. By that I mean, I’m always breaking out. I wake up in the morning and there are three new zits of varying sizes all vying for attention. They hurt. They look terrible. They make me feel bad about myself.

      It didn’t always used to be this way. My face before high school was enviously nice. It wasn’t until sophomore year that my hormones changed that. I went from smooth, even skin to red, sad skin. I think this photo taken by my friend Matt shows the typical teenage acne at 15 or 16:

      Oh, I’m sorry, were you eating? 

      Soon after that I went on hormonal birth control pills and my skin cleared up beautifully. My college years were relatively blemish-free, as a combination of hormones and using Proactiv solution helped keep everything in line. I don’t think I ever had perfect skin, but it wasn’t anything a few dots of concealer couldn’t hide.

      I stopped using the Pill when I was 22. It was great when it came to regularity, to deal with the pain of cramps, and my complexion, but it made me feel sick all the time — I was constantly queasy if I didn’t eat enough — or queasy if I ate too much — and I felt like I was living with feelings that weren’t mine… like there was a buffer between me and the world, and I was tired of feeling like I wasn’t myself. Instead, I got an IUD, said goodbye to hormones, and because I was in my twenties I figured bad skin was no longer an issue.

      And it wasn’t! Not for a while, anyway. I remember on my wedding day, I wore two beautiful dresses that showed off my back, and I had only one zit on my shoulder that one of my bridesmaids covered up for me. All seemed fine. (Photo by Nessa)

      That was 2009. In 2010, the trouble started up again. My shoulders broke out, just a little bit. Then some more. My chin had a few more pimples than usual. I shrugged it off; I was starting a business and of course stress was involved. 2011 rolled around and the breakouts continued. I attributed it to sweat rash — that shooting weddings in the summer heat had disrupted my normally-clear skin. That sweating while wearing makeup on my face was obviously going to lead to a few more breakouts.

      But it didn’t stop. It kept getting worse, and over the winter, while there were no weddings out in the heat to shoot, my “sweat rash” continued. A constellation of acne cropped up on one cheek and stayed there for months. In the meantime, I tried all sorts of products and skin-care regimens, none of which seemed to do a bit of difference. (You name it, I’ve done it — provided it wasn’t a prescription method.)

      I want to say this: I don’t have a terrible body shape image — by that I mean, I know I’m doing all right. I don’t look like Milla Jovovich as the Fifth Element, but I’m fit enough to feel confident wearing a pair of leggings-as-pants on Halloween. But due to the acne, the past two years have been a middle-kind of misery. All of my fashion choices have been picked to minimize any exposure of my back or shoulders. Gone are tank tops, strappy dresses, and bathing suits. For the past two summers I’ve declined any poolside party invitations because I don’t want to show my back to anyone. It’s such a silly, “first-world” problem but it still affects me. It makes me feel unattractive and even sloppy — like I’m not taking care of my skin, not eating right, not drinking enough water, not choosing the right makeup for my skin type — when in fact nothing has changed besides my diligence to eat even better, drinking more water, and testing different makeup brands (for my face).

      It wasn’t until the last two months, when I had not just red spots but painful, large swellings on my face that seemed to increase exponentially by the day, that I realized that this was not going to go away without some professional intervention. I decided to finally make a dermatologist appointment, with someone highly recommended by my primary physician, and whose walls informed me via many gold-leaf calligraphed papers that my dermatologist has been licensed since the year I was born. Meaning, he’s been around and knows what he’s doing.

      And that’s when the very swift diagnosis was made: cystic. In a well-rehearsed speech he said, “It’s not anything you’ve done. It’s not your diet, your skin treatment, or anything like that. It’s hormones and genetics.” I wanted to cry when he said that.

      My dermatologist wants to put me on Accutane. I am hesitant. I always thought of Accutane as a last-resort option. Due to the rules and regulations surrounding Accutane, there is a two-month waiting period before I can start treatment, so I have some time to research, educate myself, and think about other routes. All last night I was combing through forums about people’s experiences, and they either loved it or hated it. The lasting effects of Accutane are scary, and every body is different. I don’t know if I will do well on it or not.

      So this is where I leave you… I don’t know what I am doing. I don’t know if I will accept that treatment. I feel silly writing about this here, but I’m hoping that by putting myself out there, people I know (rather than strangers on the internet) will tell me about their troubles with acne and if they have used Accutane successfully.


      Was there any discussion of prescription topical meds? I used two in college (one every morning and every other night, the other every other night) and overcame a nasty battle with cystic acne that would appear on my face and back. I still don’t have perfect skin and I have plenty of scars, but my skin is so, so much better. I’ve even kept the boxes to those meds for seven years (!) and two cross-country moves because they made such a difference and if it ever comes back, I will bring those boxes to the dermatologist.

      Good luck!

      Yes, the dermatologist gave me prescriptions for Epiduo (cream) and Doryx 150mg (antibiotic) and it’s been working wonders so far. His reasoning for suggesting Accutane is that antibiotics work for a while but once you stop taking them the acne just comes back, so Accutane is the longer-lasting solution. I would be content with just Epiduo, though.

      My sister went on Accutane twice as a teenager and it was totally worth it for her – the side effects weren’t bad and it did clear up her skin. That said – I have crazy problem skin, not acne but extreme sensitivity and skin allergies that were misdiagnosed as rosacia more than once. My skin care people changed my life, and they actually specialize in extremely-hard-to-treat acne (including Accutane resistant acne.) They’re in California, but have a specific program to work with long distance clients – take a look and give them a call. http://facerealityacneclinic.com/

      Girl I love that you are putting everything out here! ((((((HUGS))))))

      This same thing happened to me recently (but on my face, not back). After going to twitter for help – everybody suggested the same thing to me… Neutrogena Oil-Free Acne Wash. You can use it on your face and back and it has been AMAZING to clear up my skin. I also bought the exfoliating kind to use occasionally. I should note I only use it 1x per day, because when I used it 2x a day my skin got super dry and irritated. I hope you find something that works for you because it is no fun being self conscious about your skin! :( ::: hugs ::::