Confessions of a Zit-Riddled Adult

“Oh my God, that acne looks miserable.” This is not the sort of greeting you want from your dermatologist. Or anyone, really. But especially not your dermatologist.

“…I thought it was doing better than it was,” I said meekly.

He kind of cringed. I assume that meant no, not really.

Style Quirk focuses on beauty and fashion. Lots of our articles deal with treating and preventing acne. Mortified as I am to admit to my acne problem while working here, I am indeed tossing it out there into the world. Might as well document it here for posterity, right? I can't be the only one. (Considering the booming anti-acne industry, I know I'm not. This one's for all of my fellow zit sufferers.) The ironic thing in all this is that I was visiting the dermatologist for my yearly Mole Check, which is what pale people like me are supposed to do to make sure we aren’t sprouting any melanomas. I wasn’t there for more zit anguish. My skin has been a horror recently, but I’m pretty good at covering it up, and the doxycycline (an antibiotic) my regular doctor (who greeted me in similar fashion in February, come to think of it) put me on did seem to be helping.

I'll preface this by saying I have given up on ever having nice skin. It’s not going to happen for me. There are times when my skin behaves (September through November of last year I had no zits whatsoever), but mostly it’s just a mess, and nothing can really fix it. I will not go on Accutane and mess up my joints and liver. I will not go back on birth control and screw with my hormones -- I've tried several brands, and all of them made me severely anxious. I’m 28 years old, my skin's behavior has been off and on since high school, and my doctor tells me I’m never going to look cherubic without extensively messing up my internal functions.

So be it. I have accepted all of this. My dermatologist, who I really like (hence my traveling from Orange County to San Diego to visit him), has not. He knows I won't try the Pill again, so he offered some sort of androgen-blocker, spironolactone, which is actually used as a diuretic, among other things. It’s prescribed off-label for acne, because it can block the androgens that lead to adult acne in females. There’s a litany of side effects that come with it – it’s no minor drug. I told him I’d pass, although I did thank him for identifying the cause of my problem. It's the freaking androgens.

The dermatologist, bless his heart, peered at my stoic expression. “Well, if you don’t care, let’s just try upping the doxy…”

I adopted the “screw my skin” attitude because I don’t really have a choice. I dutifully rub on my two topical medications every night, change my pillowcase frequently, and pop antibiotics. I don’t wear makeup unless I am actually going out. But I don’t expect much of a change anymore. I can’t. If I start hoping this crap will work once and for all, then I will very likely break down and cry when it doesn't. Of course I want nice skin. I do. I want people to look at me and think, “Ah, she does not look like a pustule-ridden alien. How refreshing!” I’m tired of piling on tinted moisturizer and concealer (which does the trick – people don’t know how bad my skin is) just to go outside.

But if I admit to myself that I care, I’ll just start feeling awful about things again. I’ve felt awkward about my looks since I was a teenager. Acne makes it even worse. “California is really hard on women,” the dermatologist is fond of saying. “My wife went off birth control so we could have a baby, and she broke out, and…” He shook his head. “It’s hard on women.”

Upon closer inspection, he was pleased to see that the red marks were just red marks – I’m very pale and my zits do tend to go red, so what he was really seeing was the healing remains of my terrible breakout. Maybe in a couple more weeks they won’t look as frightening. Until then, I use Cargo’s HD concealer, for what it’s worth. That stuff could hide a festering sore.

So ladies (and hell, gentlemen too), you’re not alone if you haven’t managed to conquer this crap. My new regimen is Differin and Clindamycin creams at night, two fish oil pills during the day (hooray omega-3s), and doxycycline two times a day with meals. I’ll let you know my progress.