Starting Accutane

All throughout my adolescence I have struggled with mild acne. Small whiteheads would occasionally appear around my mouth, chin, and forehead, especially before my periods. However, I never experienced significant issues with acne.

The spring of my senior year, I wanted to address some of the minor acne before starting at CMU in the fall, so I visited a dermatologist in Duluth.The doctor prescribed Clindamycin to use twice a day and Tretinoin 0.05% to apply only at night. My skin responded amazingly well to this treatment—it became the clearest, smoothest, and shiniest it had ever been. I consistently used the medication throughout my first semester of freshman year, and my skin remained clear, even though I was dealing with more stress and less sleep. However, during the spring semester, I started noticing breakouts, particularly on my cheeks, which were now deep cystic pimples instead of small whiteheads.

She prescribed me clindamycin to use twice a day and tretinoin 0.05% to use only at night. My skin loved the medication. It was the clearest, shiniest, and smoothest it has ever been. I consistently used the medicine all throughout my first semester of freshman year and my skin was still clear despite experiencing more stress and getting less sleep. It wasn’t until the spring semester when I noticed that my skin (especially my cheeks) was starting to break out more, but this time instead of small white heads they were deep cystic pimples. 

I first tried to manage the acne by cleaning up my diet. I incorporated more vegetables into my diet, making spinach smoothies in the morning, and ate less processed sugar. I started changing my pillow cases more frequently. I threw out my snail mucin that I was suspecting was causing my skin to break out and I also stopped using the clindamycin because I had concerns that I was building up antibiotic resistance. But I did this to no avail. My skin continued to break out with these deep cystic acne. 

In late March, I had reached my breaking point and went to a dermatologist in Pittsburgh to ask for a topical acne treatment, but my doctor prescribed Tretinoin and Clindamycin again. She told me that there was no need to worry about building up bacterial resistance. After two months of using these medications with minimal improvement, I returned home to Georgia for the summer. The hot and humid weather, combined with the stress of taking two summer classes, caused my skin to worsen further. My mom attributed the acne to "internal heat." (photos shown below)

At my 2 month follow up visit to my dermatologist, she recommended I go on Accutane, but at this point I was still hesitant about taking an oral medication. She ended up prescribing Winlevi. I waited 2 weeks for the medical to arrive and in that time my aunt, who is an herbalist, made me a detox tea that helped reduce some of the inflammation, so I never ended up using Winlevi. 

I returned to CMU to start my sophomore year with my skin now calm. Throughout my sophomore year, my skin wasn’t perfect, but it was manageable. I occasionally had breakouts around my mouth and forehead, but nothing major. When the school year ended I went back home and my skin started breaking out again (cry). This time there were cysts on my cheeks and pimples on my chin. My breaking point was when I had to cake on makeup for my cousin’s wedding to cover the acne. (One thing about me is that I don’t like wearing face makeup—it feels heavy and uncomfortable on my skin.)

Right after the wedding, I came back to Pittsburgh for a summer class and research. I scheduled an appointment with a new dermatologist, who immediately put me on 30mg of Accutane. Thankfully, my insurance covers most of the cost, making the medication only $15 per month, with a $25 copay. 

I’m ready to stop worrying about my acne. I feel very fortunate to have access to healthcare for what may seem like a minor issue, but the daily stress and emotional toll of managing my skin have been truly draining.