At the end of last year, my cystic acne– for which I have dealt since my late teens– was resurging. It was no where near the severity of my younger years (full face of hard boils and nodes) but in many ways, it had the same damn resistance. I was back to getting facials and taking strong antibiotics on top of already being on BCP and spironolactone… In mid-December, my primary care physician (whom I love) was out of ideas, so she suggested we connect with a dermatologist. After I rattled off my list of past treatments, the derm immediately said that I was a case for Accutane. There is nothing else for this degree of stubborn-ass cystic, hormonal acne.

First question: why are my hormones so fucked up? I mean, does this explain my overall unruliness and “aggressive” attitude/behavior? My mother always claimed that I wasn’t a “natural” woman… maybe we can blame my issues on my hormones? Hmm, why haven’t I been measuring my hormone levels my whole life?

Just some wandering thoughts. Regardless, I’ve been on BCPs my whole life, so shouldn’t my hormones actually be controlled and stable? I dunno. If you’re curious, here’s my list of my past meds and treatments: clindamycin, minocin, tetracycline, erythromycin, augmentin, doxycyline, Retin-A, sprionolactone, benzoyl peroxide, IPL, dermarolling, light masks, chemical peels…

So I jumped through a gabillion hoops to join the mandatory Accutane iPledge program and get on the damn med. After my initial discussion in December, I finally started my course in February. Now, two months later, I’m having a helluva time with symptoms. Granted, I had taken the Tane in my 20s while we were overseas in China. There, this shit is OTC. I don’t recall any side effects other than dry skin and chapped lips. Then again, I could not contain my absolute elation about having clear skin.

This time though, I’m experiencing all kinds of issues: dry skin, cracked lips, skin rashes/hives, dry eyes, twitching eye, undereye circles, headaches, joint pain, jaw pain, muscle aches, and now with my bloodwork, I apparently have increased triglycerides, cholesterol, and A1C. Plus John insists that I have “Tane rage.” So yeah. Meanwhile, I had already cut down on carbs/rice/breads (lost 6 lbs) for my pre-diabetes and eliminated alcohol completely. And I just am not feeling comfortable in my body.

I explained this to the dermatology nurse who sent the message up the chain. Basically, the response was: if I am still functioning for work, NBD. Continue on the path. Not even a discussion on whether we can decrease the dose or shorten the treatment course. I am def vain enough to admit: I will endure pain for clear skin. Dry skin, crapped lips, even some occasional joint/muscle pain. But add now daily headaches, daily joint/muscle pain, fucking undereye bags??? Now I’m re-evaluating. Especially bc it was just the cystic acne on my chin. I can’t help but think about all the famous people (e.g. Kanye West’s mom, Linda Evangelista) who underwent some seemingly simple procedure for a “glow up,” and all of the sudden, they’re dead or something goes irreversibly wrong. Will I be one of those people? Did I conduct enough due diligence to understand the risks?

My childhood friend Nathalie died earlier this month– on the day of the eclipse, actually. She died from uterine cancer. Before the cancer, she struggled her entire damn life fighting obesity and mental health challenges. It was decades of a roller-coaster ride. She tried to lose weight all this time, and now she’s dead. Just as Ozempic has gone mainstream. It really could have changed her life. Who knows, maybe like Accutane there are a shit ton of side effects. I dunno, maybe that’s just me viewing everything through a black and white lens.