When Shamban sees my face, the doc is brutally honest. "You only use a cleanser? You're being lazy with your skin." OK. She didn't say those words exactly, but that's what she was intimating. I can feel my face turning red -- which probably makes my acne look even worse. And I'm fighting back some tears. I feel like an ugly, hormonal teenager again. What's wrong with me? Why am I still dealing with this problem? But she's right. By only using cleanser, I have been lazy with my skin.
Shamban tells me that my acne is primarily hormonal. It's "red and active" with indented scars beneath the fresh acne. Usually oral acne medication combined with birth control helps keep hormonal acne under control, Shamban says. But when I tell her I've already tried that combo and hate the idea of needing an Rx, the doctor puts me on an extensive four-step treatment plan, which includes everything from topical creams to laser treatments.
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Phase 1: Oral + Topical = Acne-Be-Gone
Shamban isn't messing around. The first part of my treatment is to toss my salicylic cleanser and use three different at-home topical creams: Finacea, Aczone, and Acanya. Here's the breakdown: Finacea decreases the production of keratin, a natural protein in your skin that can cause acne; Aczone is an anti-infective to help prevent infections in the cysts; and Acanya is a topical antibiotic that kills acne-causing bacteria. Shamban also prescribes Spironolactone, the same pill I stopped taking two years ago. But the doctor thinks the combination of the oral and topical medications will deliver better results this time.
The takeaway I've passed to my girlfriends dealing with zits as well: The key to treating acne at home is to stick to a strict four-step regimen -- wash, medicate, moisturize, and protect.
Dealing with acne as an adult is like a cruel joke. Shouldn't acne be something you leave in your past, along with scrunchies and bad taste in boys? And I'm not talking about the monthly hormonal zit or two. I see bright red pimples and inflamed cysts all over my face, all year round.
Even though I've been dealing with cystic acne for years, I still cringe at the sight of my skin when I look in the mirror. Every morning, I force myself to wash my face and get dressed, even though I feel like crawling back into bed and hiding under the covers.
And yes, I've tried everything to get rid of it. Oral medication. Proactiv. Even Acutane, the strongest form of acne treatment available, and one that has very risky side effects. Each time I try a new treatment I'm filled with hope. And each time that treatment doesn't work, I'm crushed.
The only thing that's sort of worked is Spironolactone, an anti-androgen that helps regulate hormones, in conjunction with birth control pills. But popping two pills a day was making me feel like a geriatric, so I stopped taking them and started a new, way simpler regimen: I wash my face with a salicylic acid cleanser -- and that's it. And the acne is back in full force.
A few weeks ago I decided it was time for a last-ditch effort. Why now? I just got into a new relationship. My boyfriend, Ben, tells me he loves me no matter what my skin looks like. But I'll admit, sometimes I doubt that. And I know I won't really feel good about myself until my acne is gone. So I make an appointment with Ava Shamban, MD, owner of the Laser Institute-Dermatology in Santa Monica, Calif. Shamban is the celebrity dermatologist on "Extreme Makeover," and the author of "Heal Your Skin." If she can't help me, I'm afraid I'm un-helpable. But here comes that hope again.
