My sisters and I all had teenage acne – we can thank our Greek/Italian heritage for our beautiful, yet oily complexions. I have continued to struggle with it throughout my thirties as I have had two sweet baby girls and all the hormonal swings that accompany that blessed period of time. I am now staring forty in the face, and to have to continue to struggle with acne seems particularly cruel, as I also have to worry about the onslaught of wrinkles and gray hair at the same time! Shouldn’t I get a pass at least in the acne department?
The worst part about my acne was that somewhere in my mid-twenties it changed from the occasional small pimple in the T-Zone or at the edges of my forehead which could be healed with Stridex pads and a weekly mask to the deep, painful, cystic type that occurs right in the middle of the cheeks and around the mouth. If you have never had cystic acne, let me describe it to you: It begins when a particular area of your face starts to feel tight and tender. There is no actual blemish present, just the sensation that something terrible is about to happen. A few days later, the area starts to get red and puff up a bit so that it looks like you had a mosquito bite. At this point, the pain is worse, and you would like to get relief by letting out the pressure… however, there is no obvious place to do an extraction or pop the pimple.
This continues for 2-4 weeks. Even if you try to cover it with makeup or foundation, the bulge is obvious. When it finally does come to a head, there are usually 3-4 small areas that drain, which means the overall cystic pimple is large – the size of a pencil eraser or sometimes bigger. Then, to make matters worse, these giant pus-filled monsters leave behind a hyper-pigmented scar. This darkened area in the middle of your face can stick around for years to remind you of it’s month-long reign of terror.
After the birth of my first baby, when I had my acne pretty well-controlled, a summer full of stress at work and continued breastfeeding had my face a mess all over again. I would have 3-4 active cystic nodules on my face with several more in the early “threatening” phase. I remember counting one time and having 13 of these monstrosities on my face and feeling very hopeless and helpless.
I had tried most over the counter acne products: ProActive, Clearasil, Neutrogena, Biore, Clean and Clear, etc… They would all work for awhile, but cystic acne proved to be harder to eradicate. I was on Accutane in my mid-twenties when it first started. That drug is a miracle and worked great, but I didn’t want to go back to that with all its side effects and my plans to have another baby soon. I had been to several dermatologists, but found their oral antibiotic regimens ineffective and their topical medications harsh. As a woman physician, it was embarrassing to have such a visual problem that I felt I should have been able to solve. So, I went back to my roots and began researching medical literature on cystic acne. The results surprised me and lead me to try a different combination of products and treatments that have produced effective and long-lasting results. The most important part of my research and the reason for the change in my skin care philosophy revolves around inflammation. The lack of anti-inflammatory properties in many of the over the counter regimens make them less effective for most people. Salicylic acid and Benzyl peroxide are vital components in any acne regimen, but using them alone and in high concentrations tend to leave skin dry, angry, inflamed and ripe for more acne nodules. After all, acne is essentially an inflammatory disorder, so we must employ anti-inflammatory skin care technology to combat it properly. Once I knew this was a missing component in most prescribed regimens, I was able to choose the products and services that would work to clear my skin and keep it mostly clear of acne. I still get occasional cystic nodules, but they are few and far between and I mostly enjoy clear skin.
As a physician, I recently decided to start offering these products and services in my office. I am not a dermatologist, or even a family practice physician. I am a general surgeon. While it is not standard to offer facials, professional exfoliation and skin care products in a surgical office, I have felt called to share my personal troubles with my skin and help others in my situation clear their skin as well.
At the heart of the matter, I truly believe a skin care regimen can’t be too complicated or too expensive. If the patient cannot remember the steps or even afford to purchase the products, what’s the point? To that end, I intend to offer this skincare regimen through a combination of professional products and skin care treatments at a price point that anyone can afford.
If you are interested in our program, please contact our office to make a complimentary consultation.