A couple weeks later, I'm back at the derm's office for the next phase in my journey to clear skin: I'm getting a chemical peel. Eubanks says this liquid nitrogen peel will "help stimulate my skin, bringing the acne to the surface layer," which will help the next part of my treatment -- the lasers -- actually work.
The facialist begins by applying retinol and salicylic acid-soaked strips across my face. Once the strips have dried, she takes them off and applies a high-frequency light, which is anti-bacterial and anti-inflammatory. It feels like tiny, prickly shocks on my skin.
But the shocks are child's play compared to the next step of the peel: The liquid nitrogen. Eubanks assures me that it's safe as she dips q-tips into the chemical. It hurts more than I can express, and I'm scared out of my mind -- but not as scared as I am when I see my face the next morning.
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They Weren't Kidding About the "Peeling" Part
As I'm leaving the office after the peel, Eubanks tells me to stay out of the sun for a few hours and warns me that my skin will be slightly yellow for 30 minutes. She wasn't kidding about the yellow skin part. I walk out looking like a neon highlighter. Then, after a few hours, my face starts to look like I got a sunburn that's going to blister. And as if that wasn't unpleasant enough, my skin starts to smell like alcohol. The next morning, my skin literally peels off in sheets.
And it gets worse. When I'm cuddling on the couch with Ben the night of my "facial/torture peel" I get up for a drink and catch a glimpse of myself in the hallway mirror. I run to the bathroom and ask Ben (through the door) why he didn't say anything about the fact that my face looks like it's melting. "I didn't want to make you feel bad," he says. See why I love this guy? We spend the rest of the night laughing and peeling off my skin together. (Gross, I know, but talk about a great test for a relationship.)
Once the peeling is over, my skin actually looks amazing. I guess it had to get worse before it got better.
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Phase 4: Laser Treatments
While the daily topical treatments and chemical peel are treating the actual blemishes, the laser treatment removes scars from old acne. I'm actually most excited about this part, because my scars are the bane of my existence. Even when I don't break out one day, my skin still looks red and blotchy from the previous scars.
Lisa Beaulieu, Shamban's acne specialist, applies a numbing ointment to my face before starting the treatment. Beaulieu uses a combination of the V-Beam and Smooth Beam laser treatments. The V-Beam laser helps with redness and stimulates collagen production, while the Smooth Beam plumps up indented scars. Even with the numbing cream, the lasers feel like someone's snapping a rubber band against my skin. It's awful, but I've already seen so much improvement that I suck it up and let her zap me.
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One Month of Laser Fun
Beaulieu tells me I'll be swollen, and that my skin might look "quilt-y" due to the small, square-ish marks left behind from the lasers. After the first treatment, my skin isn't so bad and I feel like one of the lucky ones who isn't going to experience the drastic side effects. But at my next laser appointment, Beaulieu reminds me that she starts with the lowest frequency and that over the next month and a half, I'll get three more treatments with a stronger frequency each time. After my fourth laser appointment, I walk out of the office with chipmunk cheeks -- but I'm excited because that means it's working, right?
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Phase 5: Photodynamic Therapy
The end of my treatment protocol is near. The last stage of my cystic acne treatment is Photodynamic Therapy (PDT), which Shamban explains is an "intense procedure." It'll hurt like hell and require me to stay out of the sun for the entire weekend. But Shamban says it'll be worth the pain and weekend boredom, because a week after the treatment, my skin should look better than it ever has.
Here's how it goes down: Shannon Sher, Shamban's tech assistant, applies a topical levulinic amino acid all over my skin. Over the next hour, my damaged skin cells absorb the medication. Then, they put me under the blue laser light of the PDT machine -- this destroys the scarred cells while leaving the healthy cells untouched, Shamban says.
I know I'm supposed to wait a week for my full results, but I notice a difference right away. My skin looks a little tan -- even glowing. When Ben sees me, he asks, "Did you go on an overnight trip to Cabo without me?" This makes my day.
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.
