I decided to write this because I experienced many encounters over the past couple years with new patients in the clinic which challenged my knowledge of skin care. One patient even said, “What do you know? Your skin looks perfect!” They couldn’t possibly have known what I have been through over my past 40 years, however, I knew what it was like to be in their shoes and understood their frustration and feeling of defeat. So I resolved to share my story.
I started developing facial acne at age 15. As a teenage girl, this was very traumatic but nothing out of the ordinary compared to my friends and classmates. Unfortunately, the common facial acne quickly turned into extensive, cystic acne involving my face, neck, chest, back and shoulders. I was mortified and felt like I couldn’t be out in public, even with most of my skin covered.
I sought medical help and tried many types of medications for acne, both prescription and non-prescription. I also began using tanning beds, frequently, as I felt it was helping my skin. I now believe because I was tan (or red), my face seemed more covered-up but my acne was not better. I finally found an oral antibiotic which took most of the cystic acne away but caused terrible side effects such as stomach aches and extreme sun sensitivity. After a year of oral medication and modest improvement of my skin, I developed an allergic reaction to the antibiotic which caused itchy, swollen hives over my entire body. I remember feeling like a looked like a monster and begged my mother to let me stay home from school. I was out for a week. From that point on, I was off and on various topical acne treatments but nothing worked as well as the oral antibiotic. By senior year in high school I was finally placed on hormonal medication for Polycystic Ovarian Syndrome (PCOS) which stabilized many issues in my body but most important to me, my skin.
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 constant tanning caused my skin to look red and irritated all the time and significantly raised my risk for skin cancer and premature aging.
As I became older and had children, the lure of tanning beds and laying out in the sun stopped but the fear that my skin condition would come back never did. After I had my second child in my early 30’s, I developed multiple infections related to breastfeeding and required repeated courses of antibiotics. This led to a skin condition involving my face, neck, chest, back and shoulders that mimicked acne but was actually a fungal infection related to the antibiotic use.
It took months of treatments and testing to determine the diagnosis and within 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 kind and thoughtful dermatology Nurse Practitioner, I began a long course of Accutane and counseling. My skin improved although the Accutane caused severe side effects that I was willing to endure for anything. I eventually had to go on a second course of Accutane 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 to the sky 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 have 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, rebuilding my skin self-esteem.
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 is okay to put ourselves first at times and if all that bothers you is a tiny skin tag, a small 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 particular skin concern 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 both are immensely important.
Post by: Michelle A. Niesen, MS, PA-C
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