Tuesday, May 21, 2013

Acne

November 2012; hello i miss you.
this was me, without a trace of makeup or sunblock or anything at all.

/golly, i could probably do a before and after post with and without makeup just check out that difference yo. #imjustsaying

*warning: very long post ahead*
*i had wanted to include some pictures and rubbish to make it more readable but i got a little lazy so maybe i will.. one day. but not now. just going to go ahead and publish this after 4 days already.*

i can't believe i'm writing a post about this, here. it takes a lot of courage to post personal issues here, just like how it takes a lot of courage for me to step out of the house without an inch of makeup on these days. which is pretty much why i would rather stay home most of the time. so, i apologize to anyone and everyone whom i've not met up with at the last minute just because i don't want to get out of the house.

it's hard and people tend to think that i'm overreacting about my skin. but honestly, for someone as vain as i am (yes that's what i said), it really is hard.

on certain days i feel like i couldn't be bothered any longer and i can't be bothered at how people look at me or think. really. i just go out feeling... unbothered. but most days, days like these, i'd rather stay home.

anyhow! just an FYI for anyone who's interested, i'm currently on a makeup ban and it'll be my first full month without makeup tomorrow (19/05/13). *Achievement Unlocked* i miss makeup. it is my hobby and something else that i'm passionate about other than diet and nutrition. i feel really disturbed when i look at my makeup collection and know that i'm not going to be touching them till my skin gets better. :<

i'm going to start talking about my acne story so just a heads up if you're not interested or such th)ings bore you.

(please skip to bottom half if you're not interested.)

My Acne History
ever since i actually started to get acne (15), i visited a dermatologist - Maple Clinic at Tampines. and i've been on their regime for years. this includes probably many products and creams and i've used a whole lot of products on my skin since then. even after i stopped breaking out and had clearer skin, i'd always had that occasional pimple and my face was usually shiny and greasy due to the sunblock and my doctor's belief that oily is better than dry. i mean, my skin was still clear and under control so i learnt to live with it.

before i entered uni (18), probably right after JC, i decided to start weaning myself off her products. my skin broke out a fair bit. it lasted from the end of 2010 to early 2011. it did clear really slowly till mid 2011 just before i entered uni. i had started to use Simple. and my skin was relatively fine and clear all the way till the end of the year, after which i started to break out, presumably from my eccentric diet. and this breakout came with a vengeance. it was so bad - probably the worst i've ever had. i had gone back to see the dermatologist who gave me more products and scolded me for not keeping to her regime. but honestly it was like i was caged to it. and i didn't want to. but i went back anyway because i didn't know what else to do. her products only worsened my condition. after which i gave up and decided to try oral antibiotics from the GP that my cousins visited. that was early last year (2012). so i tried Minocycline first. it's apparently better than Tetracycline and doesn't harm the stomach as much. i was given a two weeks course together with topical medicine Clindoxyl Gel and Epiduo.

The first few days of antibiotics gave me side effects which only worsened with time. i started getting breathless, dizzy and a dead feeling in my heart which left me unable to do anything but to lie on the bed. i felt numbness in my fingers and my heart would race. the world would be spinning even when i was laying flat. i called the clinic and they told me to cut the dosage and take the medicine once a day instead of twice. also, i had to take the medicine on an empty stomach. so instead of 2 weeks, i took the course for a month and besides less angry acne, my skin didn't show much improvement.

The GP then told me that this antibiotic works for 95% of patients (wow that helps). because of the side effects however, he told me to try the other antibiotic and at the meantime, consider other drastic measures like laser, birthcontrol or Accutane. i took the other antibiotic - Tetracycline for two weeks. was barred from Calcium (i.e. no milk), had bad stomach issues like bloatedness, nauseousness and loss of appetite. this was when i became underweight at 47kg. also, i was perpetually grumpy and depressed. things didn't look up either.

On the last day of my dose, i went for a healing service at CSCC - my current church. the Awakening Group was there and one of the guys prayed for me. i guess desperation drove me. after all, if nothing else could save me. God could.

i was supposed to return to the clinic to pick up more medicine since i was out of pills but i didn't have the time. and the following two weeks, my skin just started to heal, miraculously. to God be the glory. i still believe. of course, i also credit Epiduo and Clindoxyl Gel still, since i was still on them. and ever since, my skin cleared up so well and was the healthiest i've ever seen. That was in March 2012. and i had nice clear skin all the way till early this year. probably because i stopped Epiduo for a while in December because i felt it was a little too drying and my acne returned. it may have been partly hormonal too i don't deny. considering i was quite distressed by some events in my life. it started with an allergic reaction to new products, also because i ran out of my usual Simple Sunblock which was discontinued. so searching for a new sunblock did break me out as well. (i tried Eucerin and Avene. Eucerin broke me out while Avene is full of parabens) it wasn't serious and i would just continue with my usual bbcream routine.

but i think the real breakout started in March-April, especially after i had gone through a stressful period then. i have since gone to another two dermatologists, one of whom was going to put me on Accutane, which i didn't want, and the other is the one i'm currently seeing. that's my fourth, by the way.

My Current Treatment and Trimethoprim 
i am currently on topical antibiotics for my skin as well as epiduo. twice a day. he also wanted to put me on Trimethoprim, which is a third-line antibiotic for acne as well. i researched on it before deciding to try it out. the worst side effect was apparently rashes, which i did get after 3 doses. they were fleeting however. came and went within a few hours and wasn't too bothersome. but i was very alert because there are people who may be allergic to the active ingredient. and i've read of cases of people being allergic and hospitalised, ICU-ed. and i was aware of these risks. until i googled about the skin rash (i wanted to make sure it was due to the medicine and not some other rash). then i came learnt that someone, locally, a poly student, died of being allergic to the medicine last year. being allergic basically weakens your immune system, affects your vital organs and may result in large skin peeling. you can google if you'd like. but anyhow, that scared me enough to stop. and i was getting a little uncomfortable. i don't know how to explain it but you'd probably know if something doesn't feel quite right in your system after a few days. that's how i felt. also, it's hard to know if you're allergic to the active ingredient unless you try it. and it could take up to two weeks, after which it may be a little too late. so i stopped and decided to rely solely on topical solutions.

i'd be honest though, and say that on days like these, i would think of trying out oral antibiotics again. maybe try Tetracycline or Minocycline again..

ANYHOW. that's irrelevant to my point.

Stuff I've Tried 
my point is. i have been through a lot with acne. and on top of the three antibiotics i've taken, numerous (honestly uncountable) products i've tried, and the four dermatologists i've seen, i have also tried TCM (traditional chinese medicine). but the TCM doctor refused to treat my skin until my stomach was better - as i mentioned previously about my CMI stomach which suffered my abuse when i went on a diet two years back. so he only gave me stuff for my stomach and not for my skin.

My Thoughts
so.. i really appreciate suggestions and alternatives and options that helpful people may feel obliged to give. telling me what to do, telling me what to eat, telling me this and that. they are good-intentioned and i appreciate that. but there are issues that i would like to bring up.

Things You Should Know About Acne 

  1. Acne isn't as simple as what i eat. if you've read the post below, you'd know that i'm quite the health freak. sleeping early, sleeping 8 hours, drinking 2 liters of water a day and not having fried food or fastfood. So don't tell me to drink more water or sleep earlier. or things like that. also, i have my vegetable intake daily including lots of tomatoes.
  2. Acne isn't as simple as not being hygienic. i change my bed sheet at least once a month. if i'm efficient, twice a month. i have to shower at least thrice a day and i make sure that i don't overstrip my skin of oils by only washing with non-soap dermatologist approved facial wash at night and rinsing with cold water in the morning. i also change my bathing towel frequently. i sanitise my makeup with alcohol spray and find a need to wash my hands frequently. on a side note, i also don't like people sitting on my bed. #justsaying
  3. Acne isn't caused by makeup. it absolutely nerves me when people accuse makeup of being the culprit of my acne. this is verified by my doctor. Makeup can only cause acne when it is not properly removed.  It may worsen existing acne but it is certainly not the cause of acne. allergic or sensitive reactions aside. it shouldn't cause long standing acne. according to my dermatologist, non-comedogenic and oil-free makeup should be fine. i didn't used to use them but i was fine. and a ton of people can have makeup on for ages but they don't breakout. check out the makeup gurus yo. 
  4. Acne is an illness. it is. it can be genetic (in my case i do believe it has a role). most of my cousins on my mom's side suffer from acne and took antibiotics to clear up their skin. my dad has sensitive skin. so i've got both acne-prone AND sensitive skin. my brother has his guy habits but has pretty decent skin. yes i got lucky. it is not so simple as mentioned above and not that easy to treat either. i don't really believe that there is a permanent cure to acne. especially after this incident. even after my skin clears, i do believe it's necessary to continue keeping my pores clear with Epiduo, considering i broke out after i stopped. some people genetically have good skin that don't break out no matter what junk they eat or how late they sleep. life is just unfair like that.
  5. Acne can lead to depression. I'd probably never understand how it really feels if i never had to go through all these. it's easy for me to tell you about acne depression. but people who've never gone through it will never understand the struggles associated. so the least you, or they go do is to be understanding. - when it feels like there's nothing else within your control that can be done to make things better. and that you may have exhausted all options. that was how i felt last year. it can be extremely depressing. i've done a fair bit (or my dermatologist may say an obsessive amount) of research about acne, acne antibiotics, topical medication and effects of acne and came across tons of blogs about acne depression. how girls, my age, younger and older suffer from acne and how they struggle to leave the house or how they hide under their makeup all day while being on Accutane. or how they cannot look at the mirror or cry themselves to sleep. or have random breakdowns. it does take a toll on life and the quality of living and can be very, very damaging.

i sometimes feel like my life has come to a halt, and i'm unable to truly experience living. i still feel that way on certain days but i'm trying not to. because i know i am only 21 once. and i only live once. i am well-aware. but it's not that easy. people blinded by love are sometimes well-aware too. but they do stupid things when they're in love. because we are human and are more often than not, unable to control, and are controlled by our own emotions and feelings.

my mom called me lazy today because i didn't leave the house for the whole day, or wanted to go out for dinner with them. it's not that i don't want to. i mean how i'd love to sit at Starbucks and chill to reward myself for a long week of work. but it's kinda hard with skin in my mind half the time.

I KNOW YOU'RE READING THIS AND I STILL LOVE YOU MOM<3<3

anyhow, all the above brings me to my next point.

Be Sensitive.
i have had my share of tactless comments and tactless people (still do). they don't mean any harm. i know that. but well-meaning or not, sometimes these comments hurt regardless. (TAKING ME A LOT OF COURAGE TO SAY THIS HERE EVEN OK. especially for someone with a lot of pride like me.) i am a girl nonetheless. a vain one too. i know my skin has broken out. and i thank you for your opinion and your suggestions. but the skin is mine, and i'm quite sure that i'm probably ten times more enthusiastic than you in trying to clear it up.

(my current dermatologist can prove it. he seems quite disturbed at how obsessive i am in my research after i showed him an excel sheet i complied of over 100 ingredients for skin products to find out what i'm allergic to. and how i'm aware of all the antibiotics and the risks and consequences. and the number of acne-fighting creams i know. lol.)

i'm not saying to avoid the topic completely. and i'm not saying that i am offended the moment you bring it up. in fact. i find it somewhat reassuring and comforting to discuss about my skin with closer friends. because i want to talk about it to let them know that i am doing something about my skin. and that i am insecure about it. i am perfectly fine talking about it. but it is the manner of speech and the approach of talking about it. maybe bother to find out more before giving any opinion or approach it in a less 'what's wrong with you' way. because it's rude. how'd you like it if i asked you why you're so fat or why you look a certain way. seriously people. some people can be very tactless when they speak. i don't think they think before they speak. yknow? because i didn't know. until i experienced it for myself.

also, healing takes time. especially for acne. as G likes to tell me. such healing doesn't happen overnight. "you think magic ah." lol. which is true. i know. the derm says that there may not be any significant positive change within the first month, or very slight. it usually takes 6-8 weeks. minimum a month. even oral antibiotics take weeks and months to fully come into effect and more often than not, there will be a breakout period. people call it the purging stage. right now however, i don't really believe it's purging per se. but from what i've heard, skin will clear up rapidly after the initial breakout period. but it's the hardest period to endure. time is our worst enemy at times like these. but it gets slightly easier when you know things will get better. i think.

i'd also like to believe that people are more understanding or non-judgemental than i'd always imagined them to be. but the truth is people are more understanding only when reasons, feelings, emotions and sufferings are told to them in their face. it couldn't be a truer fact. i get that all the time. people accuse me of not turning up or being late because of some ridiculous reason like how they're not important or i'm too lazy or i have bad time management or bad planning so i'm late. but the truth probably goes along the lines of, i didn't turn up because my skin really bothered me and i just didn't want to get out of the house, or i spent too much time trying to figure out what to do with my skin so i'm late. or i attempted to do some light concealing but failed and totally gave up so i decided not to get out of the house at all even though i probably was already all geared up to leave. then, people will either 1. think i'm ridiculous. or 2. soften up and realise that i have my reasons.

it couldn't be more true. which is another reason why i'm here. baring half my soul to the world, perhaps in some hope that the world will be more understanding. not just to me, but to everyone and anyone else. you don't know who could have had a bad day. see that slightly overweight girl in the corner? she may have been trying to lose weight for years. or weight may just have been genetic. see that army boy with acne? he may have struggled and felt so bloody insecure about his skin in NS and he even has to shave his head which he may have thought made everything ten times worst. who knows maybe he suffers from acne depression and may suicide if someone provokes him.

.

i exaggerate.

but you know my gist.

honestly, my breakout last year changed the way i looked at the world and i told myself that i will never look at people the same way again, especially when i'm on the train and people watching. #justsaying.

(like when that aunty cuts right in and snatches the seat in front of me. maybe she has terrible knees or has been standing for the entire day working while i have a nice chair to sit in. or if it's a guy and i'd usually think how ungentlemanly but decide that maybe he has a soccer injury or that he's alighting 20 stops later or something.)

if people would just be a little more sympathetic, a tad more forgiving, and a heart more understanding.

*
G constantly reminds me to be patient. i will be.

in the past i'd probably say i can't wait to get my life back. (i noticed this sentence appears a lot among people undergoing acne medication). but i'm trying not to say that any longer because i still want to live my life to the fullest. with or without acne. it's hard and i'm still trying.

i don't know if i scared anyone from writing this post. people who may have thought that my life is awesome (it still is). or people who may have seen me differently, thought that i have no issues with myself or with life. there you go i bared my soul.

nah i'm kidding.

everyone has their flaws and insecurities. this is mine.

and we all have a choice on how to deal with it. sometimes we don't. i try to be positive as you probably can tell. but you probably can also tell that i have my issues. (G, whom i confide in about all my skin woes (and my life actually), is convinced that i am obsessive and need to see a psychologist. not that being obsessed has anything to do with needing to see a psychologist.) yes. i struggle in dealing with it and often have occasional urges to just feed myself Accutane or get my derm to prescribe me more oral antibiotics to get it over and done with such that i sometimes don't really know what i'm doing to my body. if you read the possible effects of oral antibiotics for acne, you'd know what i mean.

anyhow. i'm trying and i'm still learning everyday.

don't get me wrong. i still think my life is relatively awesome and i feel extremely blessed. i know my parents try to give me whatever i want as long as they are able to, and they just want me to be happy. and i love them very much for that. i don't have any particular material desires or wants. i have almost everything i want and need. of course i could think of more but i would need to think. 

Being Thankful
i am going to Europe for 3 weeks in the middle of my internship and will most likely be taking a baking class in Paris. how. awesome. is. that. !!!!!
after which i will be flying to Korea for a 5 months exchange.  HOW. AWESOME. IS. THAT!!!!!

ok that aside. lol.

i have lwssom friends who deliver tauhuey to me at 2am on my 21st birthday because i'm stuck studying and can't go out.

i have amazing uni friends like G who listens to all my crap and knows the names of my friends whom she doesn't even know. super sweet Lyn who gets angry and actually throws virtual punches for me when i get bullied :').

i also have my family, my brother who tries to make me happy when i tell him about my skin, and ships UK stuff that i want to his place so i can get them when i go over later.

my cousins (and cousin's gf) who accept me no matter what (they don't have a choice really hahaha) and i'm mad proud of every single one of them and our (or rather their) ability to do the most ridiculous things ever (like asking the Macs drive-thru dude if we could polaroid him and he said yes hahaha). i love how close we are as compared to most other families.

my ultimate BFF and childhood friend wuzhijun who tells me that she misses me (and my macarons) when she's in Australia and won't be back for awhile. how we are both so thankful for each other because we know there's someone else in the world who thinks the way we do.

my dearest childhood friend claireylim who has always been there. a constant in my life who feels unjust for me. i will never forget how she told me that she wished life was fairer for me.

ok so i could go on being thankful for the two tiffs in my life, sammy, 30/09, eomma, meiling etc etc. but then i would be rambling. so i was saying. i do think my life is awesome and i'm thankful for what i have. it's just that.

i could be happier. that's all. (:

*

there are various reasons for writing this post. some of which i've already mentioned. i also want to state and clarify, once and for all, the misconceptions about acne. because it irks me to no end when i have conversations about this and have to explain repeatedly. i also hope that it may encourage anyone who may need the encouragement.

most importantly, i'm writing for myself. putting all these into words on such a platform gives me strength, in some ways. to keep me patient and sane. to keep me grounded and encouraged. to explain myself - not that it is necessary in any way. but it helps me believe that people may be slightly more understanding in this matter.

from the words of a 20 year old girl on Accutane:


The fact that I couldn’t control my skin, that it wasn’t my choice to look this way, just made matters worse and made me feel ostracized by those who were convinced I was unhygienic.
And then I realized that I do have a choice. The acne is on my face whether I try to hide it or not, but I can choose to be the awesome, funny, happy girl with acne or the quiet, depressed, standoffish girl with acne.When it’s put this way it’s hardly a tough decision at all. 
 - Kat@undermymakeup
not a tough decision. not at all.


*post was written from 18 May 2013 onwards and was published on 21 May 2013

/edit:24May2013

there is just a couple of other things i wanted to mention.

1. i can see you scanning my skin. no matter how fast, no matter how quick the glance. we know. since people with acne are doubly conscious of our skin, we can tell when people are staring. honestly. it's the same when guys glance at chest. no matter how quick the glance, girls know. always. it's just a matter of telling you if we know that you're looking. more often than not, we don't bring it up. but that doesn't mean we didn't notice. #justsaying

2. i am currently on my fourth kind of antibiotics. since the first three didn't really work out too well for me. i'm giving it a 4-6 weeks. although it's not too kind to the stomach, it's the current best option according to my dermatologist. someone once told me that all antibiotics have got side effects, it's just a matter of which is more tolerable. i hope this one will be more tolerable than the rest.

i'm actually experiencing the first effect now. some acid reflux making my throat rather uncomfortable. trying to make sure that i take enough food before having the pill now, or i'd probably risk some serious case of gastric or something. my cousin took the same antibiotic a while back and had to stop because of something along the lines of not being able to keep her food down. i'm keeping my fingers crossed and being extra careful by making sure i take more food and have more water. there are other side effects that i'd rather not mention at the moment.

OK THAT'S ALL.

4 comments:

  1. Hi Dianne,

    saw the link on your Facebook so I came about this blog post. Just wanted to tell you that you are not alone in this and that I can relate to every single thing you mentioned.

    Just like you, I have BOTH ance-prone and sensitive skin as well. For me, my skin breaks out before and after my period, which means I only get RELATIVELY clear skin for a week in a month.

    I have been and AM STILL very insecure about my skin condition. Ever since I started my tertiary education, I CANNOT leave my house without BB cream/foundation + concealer. Even with make up on, I still feel like the spots and blemishes are shamelessly grabbing for people's attention (which is the reason behind all the face-less YouTube videos I used to upload).

    The worst is, I am allergic to Benzoyl Peroxide (which is an active agent in most acne creams - those that actually work) and my mum REFUSES to let me take oral medications.

    Lastly, thank you for addressing the insensitive comments that some unknowingly give cause yeah, they mean much more to the person receiving them than the person giving them.




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    1. Hi Steph,

      Thanks for letting me know cos it really helps, knowing that someone relates to every single thing that i mentioned(:

      I know how insecure it is and I agree about not leaving the house without BB Cream or foundation. I did that during my University term and it really took me a lot to start quitting makeup for awhile. After which some people around me were surprised at the little, relatively minor blemishes that i seemed to have (as compared to my previous clear healthy skin, even when you get a couple of seemingly harmless pimples, people notice and they like to point it out for some reason.) so it was kinda more stressful cos some have never witnessed my acne stage.

      and... i kinda figured out the reason behind the faceless YouTube videos but when you started to put a face to that amazing voice on YouTube, i was honestly secretly mad proud of you. *^^*. it takes a little step at a time and to be completely frank, i can't even bear to have makeup on for an entire day now. not that i don't cringe at the sight of my skin anymore, but i just feel less burdened without my makeup. took time obviously and sometimes i don't want to leave the house.. but it gets better with time. (: so i'm looking forward to more of your pretty face in your videos.

      someone told me this last night, and it really made me feel better. and i hope it makes you feel better:

      "i guess we don't have control over our skin and its whims. BUT YOU KNOW WHAT WE ARE PRETTY DAMN PRETTY EVEN WITH BAD SKIN HAHAHAHA."

      teehehe:D

      and, i want to give you such a big hug now because i know the consequences of being allergic to Benzoyl Peroxide. you are right. MOST topical acne lotions and creams contain Benzoyl Peroxide and it is one of the most effective ingredients in acne treatment. it must be really horrible :/ *hugs* so i really understand. <3

      i don't profess to be a medical expert or anything. nor am i trying to give advice (or i'd be contradicting myself haha). just my humble opinion based on the limited acne knowledge i have so far. ^^

      i had gone through serious considerations before agreeing to take oral medications. my humble opinion says that if you can avoid, avoid. but if nothing else works it may be a viable option. alternatively you can consider birth controls (a bit too young for that - even the doctors says that i am too young for that at the moment), but again it's not a permanent cure. nothing really is la but you will eventually go off antibiotics and with topical cream can maintain clear skin. but for birth controls i would think that going off it would bring the acne back. so pros and cons.. but if you do consider oral antibiotics you can ask me (: i've tried 4 of them (on my fourth now) and can somewhat summarise for you(:

      one thing i want to add (if anyone else is reading this at all lol), is that acne can be chronic if not treated. which is why i think it is important to treat it at all. chronic cough becomes recurring. chronic acne becomes recurring. yknow my gist...

      about insensitive comments. yeah i completely agree. and yknow what's worst? when they apologise. because when they apologise it just make them feel better. it doesn't make me feel better. are they apologising for the rashness for speaking without thinking, and saying what they truly think or are they apologising because they suddenly decide that my skin isn't as bad as they say? so i'd rather not hear the apology sometimes.

      but it's okay. once you realise that tactless people exist it becomes a lot easier to not be too bothered about what they say. well unless that person really matters. but those who matter don't care. usually (:

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  2. DIANNE RIV LIM JIA YING. hahaha ( i hope i still rmb your chinese name right, but that is irrelevant la, but yknow..) hahaha can I just say that you are damn freaking cute with your excel sheet and short story long post on your acne problems..... and I also want to give you a big, fat high 5 because ~no surprise~ I have been plagued with bad skin for the past god-know-how-long of my life and your post just resonated within me and I couldn't help but laugh to myself with everything you've said. I have also tried to do everything within my means to try and get my skin to calm the hell down but after a while I kinda just gaaaave up. I decided that I will out grow my "qinchundou", so i supposed we can just pretend it's a sign we're still young. heh.

    I am surrounded with girl friends who all seem to have PERFECT (I'm not even kidding) SK-II skin while I'm stuck with my oily, pimple prone skin and it just sucks la hahahaha.. you've prolly heard this a million times but beauty runs skin deep and h8ters will h8! so don't worry, your skin will get better and in the meantime, thank God fr make up! but don't ever, ever let this make you depressed ok!!! I have had my "just let me stay home and be a hermit so I can hide my face from the world" days and I COMPLETELY understand how you feel.

    but yeaaaaah, I wanted to just drop you a note to give you some encouragement and love about the skin woes cos honey, I KNOW.

    (hahahaha dude it's been 9 years since primary school and we are bonding over acne problems, can I just point out the hilarity of the situation. ok)

    hehe, love debs

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    1. hehe. hi DEBORAH QUEK REN QI HEHEHE <3
      really thanks for dropping by and telling me these. yes bonding over acne problems is hilarious hahahaha. it is extremely heart-warming and comforting to know that so many people are able to relate. :') my skin has really improved a lot though, with all the pills and creams.. thankfully. took some time but i'm so glad i can leave the house without being self conscious again.

      haven't seen you in so long and i'm leaving for Korea on the 21st August. let's meet up when i get back (:

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