Michelle’s Skin Journey

September 24, 2014
Michelle - 7th Grade
Michelle – 7th Grade

I’m sharing my skin journey because now, in my 40’s, my skin is the best its ever been. When I meet with new patients, particularly those with acne or acne scars, I can see their frustration and understand their feeling of defeat. It’s particularly hard for people to share their skin story when my skin looks good. So, I resolved to write my own experience with bad skin.

At age 14, I started developing facial acne similar to that of my friends and classmates. Unfortunately, within 6 months it turned into cystic acne involving my face, neck, chest and back. This condition was very tragic for an already angsty teenager, and I was mortified to go out in public without full makeup and clothes that completely covered my body.

My mom helped me seek medical help and I remember being given multiple prescription and non-prescription remedies.  I had a drawer-full of products and treatments that did very little to improve my skin. I also began using tanning beds, several times a week, as I felt that it covered up my acne. Looking back at pictures, it wasn’t very helpful and put me at high risk for skin cancer.

By junior year in High School, I had tried and failed multiple topical acne products and my doctor decided to prescribe tetracycline, an antibiotic often given to people with cystic acne.  Unfortunately, tetracycline had some awful side effects for me such as stomach aches and extreme sun sensitivity. After a year of oral antibiotics and modest improvement of my skin, I developed an allergic reaction to tetracycline which caused itchy, swollen hives and redness everywhere.

From that point on, I was unable to take this group of antibiotics for acne and once again I felt defeated. Because of a ruptured ovarian cyst, it was discovered late in my senior year of high school that I had a hormonal condition called Polycystic Ovarian Syndrome (PCOS) or also called Metabolic Syndrome. This common disorder causes symptoms of irregular periods, ovarian cysts, abnormal hair growth and cystic acne in women. Regulation of the hormonal cycle by the use of combination birth control pills prevented ovarian cysts and cleared up my skin nicely.

cystic acne
Adult Cystic Acne

For several years I felt like my skin was tolerable, I still had various breakouts but never as severe as when I was in high school. I also continued to tan because I was worried my condition would come back. The frequent tanning caused my skin to look red and irritated all the time and significantly raised my risk for skin cancer and premature aging.

After the birth of my second child in my early 30’s, I developed multiple infections related to breastfeeding and required repeated courses of antibiotics. This led to an itchy, acne-like skin condition called Pityrosporum folliculitis which is a yeast infection within the hair follicles of the skin.

It took months of testing to determine the cause of my acne-like eruptions and that time I became allergic to ALL of the products that I was using, including medications, soaps, lotions, creams, shampoo, conditioner and more. At the same time, I re-developed cystic acne worse than I had as a teenager. I was miserable, depressed, horrified at my awful skin and felt like never leaving the house.

With the help of a thoughtful dermatology Nurse Practitioner, I began a long course of Isotretinoin (Accutane) and oral antifungal medication. My skin slowly improved although both Isotretinoin and oral antifungal drugs can cause severe side effects and blood/liver problems. I needed laboratory blood tests monthly to remain on the course and other than dry mouth and bloody noses, thankfully I didn’t have other problems.

A year later, I needed another course of Isotretinoin but for many years now, my skin has been fairly clear. I struggle with occasional breakouts, weird allergic skin reactions, rosacea and the underlying fear that my skin will turn against me once again but I am also hopeful and excited for the present and future of skin care.

When I was taking Accutane, I remember throwing my hands up in the air and saying “Why isn’t there some kind of technology that can take this all away?” Well, it’s finally here. With laser and light technology, it IS possible to improve the skin; naturally, safely, and effectively. When I get a laser or light treatment, I know I am doing something healthy for my skin that won’t cause allergic reactions or side effects. The treatments have been far more effective than any medication I have used in the past. They’ve also improved my multiple chronic skin issues including premature aging, large pores, acne breakouts, spider veins, redness and rosacea.

Along with lasers and light therapies, I have discovered amazing and “natural” enhancements with injectable treatments such as Botox and dermal fillers. These have addressed my frown lines, crow’s feet, dark under-eye circles, sagging and facial deflation related to aging now that I have entered my fourth decade, in turn, improving my skin self-esteem.

Michelle with Daughter 2004

I feel so lucky to be taking care of people that have struggled with similar problems as my own. Skin care has become my passion. I know what it feels like to be that person who doesn’t want to leave the house because of my bad complexion or is discouraged with the drugstore aisle promises of great skin. I believe it’s okay to put ourselves first at times and whether you have acne, a small skin tag, a facial spider vein, or an annoying frown line that makes you look angry all the time, then you have every right to seek help.

The treatments I do are for you and you alone. I know that when my skin started improving, so did my self-confidence and that spilled over to every area of my life. My goal is to help each and every person with their individual skin concerns so that they may find their own self-confidence. As the physical body improves, the emotional body blossoms. I found in my own journey that both are equally connected and immensely important.

Post by: Michelle A. Niesen, MS, PA-C
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Updated on 7/12/18