derma-lame-ologist

(...says my sister)

so this morning i got in my car, and the first thing i see is this:

a cutey cute 'have a happy heart day' valentine from miss l

this is the first thing i see in the car, and i did that intentionally- who wouldn't smile at a one eyed monster wishing you to have a happy heart day??

today i had an appointment with a new dermatologist. i was feeling hopeful, as i've had good experiences with dermatologists in the past, and secretly, i was even hoping for, possibly, a new break through. see, the thing is, i've been around the acne-skinned block. i've had breakouts and lumpy, bumpy skin for years, and for the most part, i just dilligently wash it and put up with it. a few years ago it just got too out of hand, and i went to the dermatologist, who put me on accutane. two and a half years later, and two 6-month treatments (each) of the crazy medicine later, i had great skin. for the first time in literally 28 years, i could go out without makeup on my face and i felt free. see, my struggle with acne has led to a lot of imprisoned, agoraphobic  feelings: calling in sick because my face hurts and has exploded in giant, dime-sized lumps is just not acceptable, and for the most part, pretty un-fixable. everyone sees your face; i can't hide it, dress it in slimming clothing or flatten out the bumps that can go from (literally) my forehead to my chest. it's been a loooong, painful, and humbling experience.

so where were we? oh, yes: accutane. freedom. it was the best; i didn't, and don't, care about the crazy side effects, the feeling was that good. i finished my last dose in late 2008; since then, the breakouts have slowly started again, but nothing nearly so unbearable, and definitely something manageable. i have accepted the skin o' kaci will never be perfect. and that was ok with me, until recently, when the breakouts started again, in full, pre-accutane force. hence, the dermatology appointment.

i was prepared for today: i had a list of all washes and creams i've been dilligently using for the past month or so; a list of the meds i'm taking and the makeup (#1 skin care professional recommended mineral powders, which, btw, aren't cheap) with me. i had outlined the routine i've been following daily: water, exercise, sleep. i had in my head a list of things i've tried (everything) and what has worked (less than two things) and what hasn't worked (everything else). i was ready.

i was hoping for a team approach at defeating, or at least putting it to rest for a while, this life long struggle. bad news: i was sorely disappointed. my dermatologist came in, put foamy, anti-bacterial liquid on his hands and, before rubbing it in the way, gave me a limp, wet handshake. gross.

then he sat down, i took off all my makeup, and he proceeded to write out the word, 'non-comedongenic', and asked, 'do you know what this word means?'

doctor. you saw on my chart, and we mentioned, the two year stint on the crazy, bone-melting accutane. you think i don't know what 'non-comedogenic' means? do you think i have not traveled a life-long journey of drug stores and fancy makeup counters and specialty over the counter places to find the best creams, the best washes, the best make-up that actually works yet feels like air? you think i haven't done that? this ain't my first rodeo, doc.

apparently he thinks this is my first rodeo.

he continues to tell me that 'experts say...' and 'you shouldn't wear makeup at all...' and 'i'm sure you should just continue what you're doing...'. ehhhheeem. WHAT? 'experts say'?? didn't i just pay a premium copay to see you, the SKIN EXPERT, to tell me what YOU think? do you think that not wearing 'any makeup at all' is really going to clear me up, after years of intense drug-taking and makeup-skipping?? does it LOOK like what i am doing is working just fine?

he asks me how i feel about anitbiotics. i name a few i've been on: one that sort of worked, a few that didn't work. he prescribes me one on the 'didn't work' list. he tells me to continue with over the counter cream i'm using. 'but i'll give you a retin-a prescription just in case. have you heard of that?'

again, doc: they don't sign you up for the big leagues (accutane) twice without any training (antibiotics, retin a, diferin, etc).

he didn't ask me what my routines were. didn't ask me what meds i was taking. didn't ask me how much water i drank, or if i have any food allergies. he did, though, have a heyday with my makeup, telling me how greasy (it's made of minerals only) it was, and how that was probably my issue.

he did inform me that my skin's lack of response to the twice-presribed accutane put me in the lower 25% of people that take it, and that was rare. he told me he was surprised at how little i responded to the med, but then informed me 'don't worry, we're going to get you better'. hm.

thirty minutes later, i left with tears in my eyes, my voice in my throat, and two prescriptions for meds i took when i was 13.

i was not having a happy heart day.

i sat in the pharmacy and waited for them to fill my useless meds. part of me wanted to trust him: maybe things have changed since i took the accutane? maybe i'll respond better to these lesser strengths because my skin is so sensitive? maybe...maybe... maybe...

i wracked my brain for changes in my lifestyle, and the only, only thing that has changed in the past two months since hte breakouts increased was an addition of vitamin b complex to my daily med regiment. i quickly googled 'acne and vitamin b complex'.

voi-freakin-la.

first hit: "vitamin b complex causes acne outbreaks". second, third, fourth, tenth hit... all suggest that a surplus of vitamin b, and the yeast/gluten complex it's made with, can lead to acne outbreaks or irritate acne prone skin.

i ran to the vitamin section of the pharmacy, grabbed a yeast/gluten free multi-vitamin and paid for it triumphantly with my prescriptions.

i was back on track to a happy heart day: hope restored. and i didn't need a (non) expert doctor.
just google.