FeR

For those I grew up with in school, they all had the same reaction when they saw pictures of me in Glasgow – “What happened to your skin??”

It was both frustrating and infuriating – I KNOW it’s horrible but I don’t know what’s going on!

Puberty was kind to my skin, but I think the reason why it was so is because my hormones decided that it would more fun to start torturing me from my 20s. That my skin would bring me grief once I’m no longer a “teen”.

I’ve tried all sorts to clear my skin – from switching face care products (going with what family/friends recommended that worked for them), changing diet, detox, sleep, water, etc. Nothing helped.
Funny observation – skin is (more) horrible out of Malaysia (which led me to my latest “theory” of hard/soft water).

Anyway, I couldn’t take it anymore.
I really didn’t want to go on medication but I had no choice. My acne problem involved cysts and nodules (the kind where it’s under your skin, never coming up to the surface and the very angry looking ones) – I had no choice but to resign to the fact I need professional help. I didn’t want to be left with scars (though at this point, I already have a few).

There is only one dermatologist serving the HawkesBay area (so I’ve read) and it’s a loooooooooong wait to see him. I didn’t know who else to turn to, so I thought I’d have to wait it out – I went online to get the clinic’s number (the one I found in the phone book seems to be engaged ALL THE TIME – so I wondered if I had the right number) and instead, I found a GPwSI (GP with a special interest or “gypsy”) who can see me the week I called up! I chose the week after, 9th July, because it was my day off.
Since I was willing to spend my money on a specialist’s consultation, the fact that her surgery is not under the HawkesBay PHO did not bother me – I’m sure the fees would be more affordable than a specialist.

Now, a side note.
It’s not that I don’t have faith in GPs but I have no idea who to go to. I understand most would do a trial-and-error (as each patient would be different) but I know I would want to go to someone who has seen more skin problems than your usual coughs&colds. I hope to get some answers (apart from what I could search for online) as to why am I inflicted with adult acne.
[I know it's hormonal - but why? Why now? Still no answer to that, unfortunately.]

I guessed she would give me Doxycycline 100mg – it’s the only funded tetracycline (and strength).
Azelaic acid apparently suits my skin type – not only it’s an antibacterial, it will help reduce pigmentation as well (judging from the residual brown marks from previous spots). I am to use this at night and Benzoyl Peroxide in the morning.

She did give me a few choices – doxycycline+topical preparations, the pill (Estelle – but I would have to be tested for polycystic ovarian syndrome first) or isotretinoin (it does work but she admits that she is reluctant to offer that as a first choice for my case).
I said I’d like to go with the antibiotics first.

Pictures of my skin is a click away – you have been warned.

This is when I first started treatment – left side.

This was taken at 6 weeks – left side.

Ah! The flash makes it all the more horrible looking but I had to be honest with my actual skin condition. It’s also easier to use one pre-set function (thus the flash) so I could use the same function to take pictures of my progress (so that I have something “constant”).

After 4 weeks, I see no difference (in fact, I thought it looked worse!) – so I upped the application of azelaic acid to twice a day and omitted the BP.

Start of treatment – right side.

At 6 weeks – right side.

Doesn’t look like there’s any difference, right?
The doctor reckons it’s not as red anymore and the area around my chin is clearer (no breakouts but the scars are there) – this is when I saw her on Thursday, 3rd September.

She did warn me in the beginning that I would have to be patient. There is no miracle cure that works instantaneously or overnight. I’ve been “patient” for so long, trying out different face care products, so what is a few more months, right?

Both the doctor and myself, are surprised that the combination of azelaic acid and benzoyl peroxide did not cause any flaking – I think I may try a higher strength of BP.
I was sent away with a suggestion I could up my tablets to twice a day for about 2-3 weeks (it’s currently once a day and let me tell you this, I would never judge a patient ever again about compliance! ) – then reduce to once daily again.

She asked me to go back to her for another review in 2-3 months’ time. If there isn’t much progress, I think I would get tested for PCOS before considering the next step – Estelle.

Here’s hoping I need not progress to the next step!