Beauty Guru goes to the Dermatologist…. Expensive? Worth it? Accutane??

1. Before break out
This is the average state of my skin before it broke out. Lots of scarring near the cheeks, (evidence of hormonal acne in my younger years) 1 or 2 active break outs at a time, with non cystic acne.

I’ve always had issues with my acne when I was younger… as an adult I thought I was done with pesky pimples until I was diagnosed last year with a condition that apparently my skin hates.

I found skin care products since then and found a skin care regime that works for me! Then… something happened…. and I’m not sure what that something is. I’m always adjusting my medications but my skin got to a level where the pimples my skincare were zapping was no match for the pimples my skin was producing…

WHY SKIN??? WHY!!

When it became physically painful… I decided to get some help. I’m an adult now…. I have insurance! So I swallowed my pride, and as a beauty guru I accepted the fact that my acne was caused by something that needed medical management…. I made an appointment at the dermatologist.

Now I’ve been to the doctor for acne before (thought it was a primary care, and not a derm) and they gave me birth control (which helped when I was a teen), and some topicals (that worked no better than my over-the-counter options)

So this is my first visit to the dermatologist at the age of 25.

Yes I’ve tried proactive

Yes I’ve tried birth control

I know every over the counter ingredient used for acne………………………………………and tried it.

I need help!

 

So if you want to know how much money I spent, my results, how long it took to see results, keep reading! And I hope this helps you figure out if you should try going to the dermatologist.

 

Disclaimer: Everyone’s insurance and coverage is different including what is considered into your Deductible. If you haven’t met your deductible then there might be more cost than what I’ve listed!

 

First Steps

I just have to start by saying that I recommend that you get regular check ups and visit your primary care physician 1x a year. Most insurances cover 1 check up a year fully (You don’t have to meet a deductible or pay a co-pay, but you might have to pay for blood tests which can be expensive). About 1 year ago when my acne first started to get worse I went to my primary care doctor, and I was actually diagnosed with pretty advanced thyroid problems that could have become more serious. Sometimes the skin is just a way for your body to tell you that you are accumulating toxins… so if something seems different, make sure you get it checked out!

Check up at (university) student health center cost: $0 copay and lab test
(Following year, check up at primary care cost: $0 for copay, $300 for lab test costs)

 

I miss being a student and having a health center that’s super cheap….

Getting an appointment was at the dermatologist was surprisingly easy, and had a much shorter wait time than the primary care appointments that I’ve gone to the in past! I didn’t require a referral for a specialist for insurance coverage so make sure if you need a referral for insurance purposes you ask your primary care for a referral with your check up

The Dermatology Visit

So I waited to go to the dermatologist until my face physically started throbbing and becoming painful… I wrote down my symptoms, and what I’ve tried on my phone so I wouldn’t forget to tell my dermatologist anything:

  • I’ve had acne since early teens, birth control helped in the past
  • I was diagnosed with XXX 1 year ago which caused me to break out again
  • I am taking the following medications…..
  • I’ve tried 10% Benzoyl peroxide, 2% Salicyclic acid, Differin gel which all help, but lately the acne I’ve been producing is more than these topicals can take care of
  • I tried not wearing make up for a month with no improvement in acne.

Additionally they asked me the following questions:

  • Do you use sunscreen? What SPF?
  • Do you regularly wash your pillow cases/ face towels?
  • Is your menstrual cycle regular/ does your acne worsen during your cycle?
  • What prescription medications have you tried?
  • When was your last physical/blood test?

Because I had a recent blood test with hormonal levels, my dermatologist did not request a blood test and recommended the following medications:

  • Antibiotic: She told me that I did not have a bacterial infection on my face, and told me that my acne was probably due to my face reacting to my natural hormones. Apparently antibiotics can act as a strong anti-inflammatory so it could tone down some of the flare ups on my face. Insurance covered all by $10 of this medication, and the only think I hate about it is the fact that the pills are HUGE and you can’t lie down after you take it, or you can risk burning a hold in your esophagus.
  • Epiduo topical gel: I feel like this would have worked better if my skin was a virgin to these types of ingredients…. This is a 0.1 % adapalene and 2.5% benzoyl peroxide gel that you put on your face every other day, so your skin does not dry out. It did come in a pretty big bottle with a pump… but this sucker was $125. It does come in a “forte version” which has 0.3% adapalene. The reason I didn’t like the regular Epiduo gel (which I was prescribed) was because I use Differin (available over the counter at 0.1% strength) as well as a topical 10% Benzoyl Peroxide spot treatment. So my skin was used to harsher, stronger ingredients… I was warned I would have dryness and my oily skin laughed at my dermatologist… dry skin? I wish.  If I had known the active ingredients I would have asked for the “Forte”… also there might be generic versions of this topical that is not as expensive that you should ask your doctor for! This product definitely works but if given the option to go back in time I would not purchase this again… also I think the market value of this is $500, and I got it for $125 at a specialty pharmacy.

Cost so far with insurance

Dermatologist Co-pay (specialist): $50
Cost of antibiotic medications: $10
Cost of Epiduo topical: $125

Total cost so far: $185

The Progress

By the time I had gotten my medications my acne was physically and emotionally painful… and sometimes itchy. I didn’t want to take a picture at the time but here’s the most current picture of the state of my face before going to the dermatologist’s office.

My “Normal” Skin before breaking out

1. Before break out
This is the “normal” state of my skin of my super sensitive skin (Before the crazy 2018 break out). Some acne scars around the jawline, some non-cystic acne, and some comedones and clogged pores. I can live with this amount of imperfection and be content.

Sometime around the beginning of the year my skin started to attack me, and my skin ended up… LIKE THIS

When my skin attacked.

2. Break out.jpg
My face physically hurt. I had pustules and cystic acne that would pop while I washed my face. I tried cleaning those spots with rubbing alcohol, covering with hydrocolloid patches, but still it felt like it was getting worse and worse. THIS is why I sought medical attention… my holy grail skin care was zapping pimples but not at the rate that I was producing them. I stopped wearing make up, hoping that would help… but nothing helped! Most of my acne is along the jawline which is consistent with my personal hormonal acne.

 

2 week check in on medications and topicals from the dermatologist:

3. Week 2 check in.jpg
The percentage of cystic acne did decrease, and my face hurt much less…. but it was 2 weeks on medications and my face was still kinda painful. I was getting NEW break outs but I felt that they did go away faster than before my medication regiment. After dropping $185 dollars on medical bills I wanted results RIGHT NOW… but my dermatologist did want 6 weeks to give the medications a chance before my follow up…. so I will try to be patient.

My skin was so oily that I had no drying effect (which is what my dermatologist said would happen). I was on regular probiotics to prevent digestive difficulties with being on long term antibiotics… and in general had no major issues.

Three big thing I realized in these first 2 weeks:

  1. Oral birth control is not as effective with oral birth control! So be safe if you’re sexually active
  2. These antibiotics pills were HUGE, and I was told not to take it at night to avoid the corrosive effects on my esophagus if I lie down after taking it. I’m already taking regular daily pills for other health concerns… So I was taking pills multiple times a day which was a pain in the butt to remember.
  3. You skin is very sensitive to sunlight…. everywhere (not just on your face). I wore long sleeves, and used The Bareminerals Prep Step or the IT cosmetics celebrated foundation spf 50 to help me out. (I’m sensitive to sunscreens, and these 2 are the only ones that never break me out)

 

Week 5 check in

4. Week 5-6.jpg
Ahh… finally much better. These pictures were taken morning vs night because 1 side of my face was blurry (sorry!). One side of my face had completely cleared up! The other (always worse) side still was healing but hey, no cystic break outs!

I was just about to get frustrated in week 4 because my skin was less cystic but still painful, but sometime in week 4 going into week 5 my skin calmed down significantly. So it took a whole month before I was happy. (Be patient guys! You’ll get there)

My pain level is now 0, and I will occasionally get a break out on parts of my face that I touch (around my nose when I was sick and blowing my nose). There’s still a lot of redness on 1 side of my face but it’s all scarring, and not really active break outs. I think I have about 4 or 5 active pimples at this point.

 

Week 6: Back to the dermatologist office

So 6 weeks was when my dermatologist wanted to see me again. We were both happy about the results.

The first time I met her she looked at my skin and told me that I might need Accutane.

Accutane is a super strong retinol derivative that requires lots of regular blood tests due to its impact on your health, and possible birth defects if you were to get pregnant while on this medication. You do need to get approved for it via urine test, and wait 30 days to get approved… but we decided that I wouldn’t apply for Accutane on my first visit until I give some other things a try… and I’m glad I waited.

At this point I still had a hefty supply of the Epiduo gel, so she told me to use it everyday at night (instead of the initial every other day) to use it up. She wanted me to be on 2 more months of antibiotics, but I had stopped taking it 5 days ago without an increase in cystic acne…. so she gave me a refill and told me I only have to take it if my skin becomes cystic again.

She also prescribed Tazorac which is stronger, and also helps with scarring and oiliness. I haven’t started utilizing it yet… but I will post on cost and how it goes when I do… (It’s supposed to be expensive)

Week 7

5. Week 7.jpg
So this is my skin now, using Epiduo every night. I have 1 active pimple on my face, and the rest is scarring. My face is a  little red because I woke up with half of my face smashed into a pillow, so there’s no real irritation. With using Epiduo everyday I did notice a little bit of drying. Will start using the new medication soon…

 

Week 12

6. 12 weeks

So I did not end up taking Tazorac because it would have cost me $120 from a specialty pharmacy because insurance doesn’t cover it.  Honestly I think my skin looks better than when I started and the scarring has decreased significantly as well. I do have 1 small non cystic pimple (due to my time of the month) but overall it took 3 months, antibiotics, Epiduo, and birthcontrol to get my acne under control. I plan on continuing oral birth control to regulate my hormones indefinitely… and for now I’m happy with that! Now my journey is to continue to decrease my scarring with treatments. I’ve also heard that Rose hip oil is great for scarring… Thanks for staying with me on my journey every!

 

Stay Happy and Healthy!

RicaIsHungry

 

 

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5 Comments Add yours

  1. Hi Rica, I randomly clicked on your blog looking for self tanner, and thought I’d commend you for bravely putting up photos of yourself that may not be flattering in your quest for clear skin. I had severe acne growing up, all the way into my 30s, due to oily skin and huge pores. What dramatically changed for me was finding another blog a few years ago:

    https://www.acne.org/my-acne-treatment-history.html

    Disclaimer, I am not in any way paid to recommend this company. The founder was a guy who started a similar quest of testing over the counter treatments to identify what works the best for his skin. He ended up forming the company with a 3 step program similar to Proactiv that I have been using for nearly 6 years and it works very well for me. Even if you have no interest in purchasing his products, there’s a blog on their website full of people who have tried other beauty treatments. Maybe it will help simplify your search. There are a number of Asian-American women who have posted Success Stories, maybe they have tried something that will be helpful. I wish you the best.

    Like

    1. ricaishungry says:

      Hello!
      Thanks for the resource. My skin is doing much better, but it usually has highs and lows. I’ll check it out if I ever have a rainy skin day! I do hope my skin clears up, but I hope that being transparent will help people with their own skin confidence… beauty from within and all that jazz =)

      Like

  2. Gayathri says:

    Hi Rica, I love your blog. It is one of the most thorough and authentic skincare blogs, and addresses some issues that are usually not talked about elsewhere in depth, such as the pore-clogging effect of silicones. You leave no stone unturned in finding a solution. Which is why I was wondering if you’ve tried an elimination diet. Maybe a month or so of completely staying off common inflammatory triggers? Bringing this up because I too have acne-prone, oily skin and I can’t use silicone products. Ever since I started paleo diet, my skin has cleared up a lot. Diet slipups and consumption of grains/carbs/sugar/dairy continue to make my skin break out.

    Thank you again for such an amazing blog. And good luck 🙂

    Like

    1. ricaishungry says:

      Aww thank you Gayathri! And you’re right, I’ve definitely noticed a correlation between my acne and inflammatory triggers. I haven’t done enough research to know which foods my skin hates but definitely excess sugar and carbs. I might do a post about recipes once I get more research in… best of luck to you too!

      Like

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