Anxiety, Acne and Accutane

So I had my first wedding-related meltdown! Wooohooo! It’s official. Thankfully it was fairly short-lived and it’s not exactly what you might think. For the last few months my acne has gotten so bad and it doesn’t go away. It’s very distressing. I know it seems trivial, but the acne that I get is really big and under the skin and it scars. I started to feel really badly about myself and stress out about the upcoming engagement photo shoot. I didn’t want my acne to be the thing I focus on when I look at the pictures.

I went to the dermatologist with hopes that she could help me. I never had bad acne as a teen, just your normal pimples here and there. It wasn’t until my mid-20’s that it got bad. I saw a doctor then and they put me on an acne medication and over the years I’ve done antibiotics to get rid of it. For the most part I was able to keep it under control. I don’t know what changed (other than changing my birth control pill last year) to make this outbreak so terrible.

Unfortunately, the dermatologist didn’t have much for me. I had two options. She could increase my current medication and prescribe an antibiotic that supposedly works better on acne. OR I could take accutane.

I’ve been offered accutane before and said no way. The side effects sounded terrible (dry, cracked skin and lips, sunburn, sensitivity, liver damage, severe rashes, nose bleeds, joint pain, dry eye which effects contact lenses, birth defects…) but the thing that made me say no 10 years ago was the idea that it could cause birth defects. The doctor said it’s only while you’re ON the medication, not after you stop it, but I’m skeptical. Something that severe must stay in your system and what if does damage in the future that they just don’t know about yet?

I left the appointment feeling deflated and sad that I didn’t have other options. I really hope that the increased medication + antibiotics does the trick because accutane scares me. The doctor said for 2 months leading up to taking accutane, I had to come in for baseline blood work and pregnancy tests. Then, once I’m on the medication, I need to come in once a month for blood work and a pregnancy test. She said it can cause liver damage. The list is endless. It sounds like a poison! Not something that is beneficial.

Thus the mini meltdown. Michael was sweet and said all the right things and made me feel a bit better, but I’m at a loss as to what to do. I feel like I need to make a decision quickly if I have to take 2 months to “prep” for it. I don’t want to be taking the accutane close to the wedding or during the summer time because of the increased risk of sunburn.

Anxiety+Girl

 

In other, slightly related, news…my therapist is out on maternity leave for a few months so I saw someone different who happens to specialize in anxiety and Cognitive Behavioral Therapy. I’ve had anxiety for as long as I can remember and some of the things she discussed and explained really clicked for me. I said that it’s easy to say “just chill out” but when I’m in THE moment of anxiety, it’s hard to put a stop to that spiral. It’s easy to quickly get into the worst case scenario panic.

She explained that anxiety comes from the reptile part of the brain that controls the flight or fight impulse. Some people are just more sensitive and “reactive” in that area and when that part of the brain takes over, the frontal lobe shuts down. The frontal lobe is in charge of decision making, emotions, problem solving, etc. So when the “fight or flight” part of the brain takes over, the frontal lobe isn’t engaged to say “STOP. Calm down, relax, look at the facts before freaking out.” That really made sense to me and described why it can be so hard to put a stop to anxiety when it rears up.

She explained how CBT can work for anxiety:

Triggering Event –> Automatic Negative Thought –> Emotion/Response –> Behavior/Action

She called Automatic Negative Thoughts “ants“–basically annoying, unwanted things that come into your house and overtake everything. Changing how we react to triggering events can stop the anxiety from creeping in and taking over. She likened “ants” and anxiety to little demons on your shoulder that LIE. The anxiety lies to us. It’s the worst case scenario, something that probably won’t happen, something that we don’t need to waste energy stressing over. Once we realize THAT we can get a handle on anxiety.

I said, easy to say, hard to do. She agreed. She said to ask myself three questions when my anxiety pops up. 1) Is this thought REALLY true? Is there evidence to support this idea? 2) If a friend came to me with the same thought, would I say “yeah that could totally happen, you should worry about that?” and 3) Is this thought helping me? Obviously these questions are supposed to engage the frontal lobe and wake it up–forcing it to problem solve and think logically and get us out of the fight or flight mode. If the answer to the three questions are no, then I have create a counter statement to the incorrect/negative belief. Supposedly this becomes habit and easier with time to put anxiety in its place before it takes over.

So far I’ve been practicing telling myself “STOP” when anxiety starts to poke at my brain. I’ve asked myself the three questions and it really does help! It stops the tension and anxiety in its tracks. It’s not EASY yet, it doesn’t feel like it’s effortless yet, but I’m trying.

When I started to melt down about my acne and spiral into worse-case-scenario mode…(My acne will get worse and worse and all my photos will be heinous and ugly and 20 years from now when I look at my wedding photos all I will see is acne taking over my face… etc etc etc) I told myself to STOP. Wait. See if the antibiotics and increased medication works first. It might help. I don’t have EVIDENCE that this plan won’t work (yet).

I’m working at it. It’s a process. Clearly!

So what about you guys…if you suffer from anxiety, how do you stop it in its tracks? Have you ever taken accutane or some other method for acne?

Author: Lisa Eirene

About Lisa Eirene Lisa lost 110 pounds through calorie counting and exercise. She swims, bikes, runs, hikes and is enjoying life in Portland, Oregon. Her weight loss story has been featured in First Magazine, Yahoo Health, Woman's Day and Glamour.com.

47 thoughts on “Anxiety, Acne and Accutane”

    1. That doesn’t sound crazy. I was going to acupuncture once a week at the start of this year for my insomnia and knee issues. It helped the insomnia, not the knees. I’d be willing to try it again, though.

  1. Accutane worked for my sister. She had acne really bad in junior high/high school and took Accutane. She has absolutely beautiful skin now. The drying out part was horrible and she had cracked lips etc. but in the end she said it was worth it. She’s now 34 and has no acne flare ups at all. One of my co-workers wife is taking it now. She says it’s rough going through the drying out but she’s mid way through and says she can tell it’s working. Good Luck

      1. Yes she did. Her first pregnancy was twins which she lost at 21 weeks because of an abruption which we learned later is not uncommon with carrying identical twins. They were both in separate sacks but the placentae did not fuse completely to the uterine wall. There was no birth defects on the twins it was just one of those things that happens…

        After losing the twins she went on to have 3 more kids all single pregnancy and delivered to term on all three and there’s nothing wrong with them except being strong willed like their mother.

        Good Luck with your decision.

  2. I did Accutane 25 years ago so I’m assuming they have test result by now, but I knew I wasn’t going to have kids. If you can avoid it, I would. Maybe work with an aesthetician and get facials, etc. I know that I had a dermatologist that could zap bad break outs with some sort of light thing that was an antibacterial agent. Have you had facials? Maybe you could go that route and see.

    1. I have not considered the facial route. I’ll look into it. I had a facial once when I was a teenager (a mother-daughter spa day thing) but never did it again. I don’t remember what it was like or if it made a difference on my skin. How often do you get a facial?

      1. I don’t get facials very often now but I did like every two weeks when I lived in LA. I’m terrible about self-care now – few massages, pedicures, facials, etc. I really need to get back on it. But I do think that the great facials I got (some with micro-electric stimulation) are the reason my skin looks pretty good and people think I’m much younger than I am.

        1. I’m good about getting regular pedicures. But I don’t do much else in terms of self-care. It’s been ages since I got a massage and my shoulders need it….

          And you DO look younger!

  3. I struggled with acne too from the age of 18-19 thru my adult years. I still get occasional breakouts and I’m in my 40’s! I had really oily skin that was very clogged. It still gets that way sometimes but I’m doing retin-a which has been great.

    My poor teenage son is dealing with it now. I have not taken him to a dermatologist because I’ve been there many times myself, and know what the options are, and I was on pretty much everything except Accutane. I did get him some medicine (via the internet shhhh) called Acnelak that is clindamycin (sp?) and zinc and it’s made a big difference in his skin, the breakouts reduced dramatically. I’m also having him do retin-a as well. The retin-a sucks for a while until your skin stops peeling but it has the added benefit of being anti-aging too. His skin improved a lot, I’d say by 60% at least – 16 year old boys just are not diligent about skin care, if he were I’m sure the results would be better.

    I’ve never found a permanent solution but these things seem to keep it under control. If you’re interested where I get the stuff let me know. I spent a lot of time on acne.org reading other people’s stories about different treatments as well.

    I used to have major anxiety issues too, so I know EXACTLY what you’re talking about. It’s not easy to turn it off! Still happens sometimes but I’m better at telling my brain to knock it off now, it used to consume me and it felt out of control. It felt like self-abuse. In time it will get better but it does take work.

    You’ll be gorgeous on your wedding day no matter what!

    1. I use a topical Retin-A and also a topical clindamyacin lotion. I don’t know if it’s working yet!

      Thanks for sharing your anxiety story. I like the “self-abuse” part. It totally is! We get ourselves worked up and then it’s just a big negative mess. It is self-abuse.

      1. It is a process and it does get better! I’ve had anxiety since childhood and it can be so debilitating.

        I tried Celexa and Wellbutrin – both had several different side effects. One was common to both – loss of libido. Celexa did give me crazy vivid dreams – I kind of miss those 🙂

        I didn’t want to be dependent on anything, and I felt like it was a band-aid anyway. I needed to figure out WHY I do this to myself so it could stop – not just numb the feelings.

        I play little mind games with myself too and they do work. I would say it’s honestly 80% better than it was before. I feel much more peaceful in general and it’s so NICE! I can actually lay in bed and think about pleasant things now, rather than keep awake worrying about whatever pops into my head.

        You already proved you have the strength of mind to lose a ton of weight on your own, so I have no doubt you can conquer this.

        1. I’ve taken both too and had weird side effects. The lack of libido not on Wellbutrin but that one had it’s own mess of side effects (temper, etc). It is a bandaid, like you said, and finding out the TOOLS to change the cognitive behavior is going to actually fix it, not the drugs. The drugs are definitely the easier route…which is the route I’ve taken for most of my life.

          Thanks for the insight and pep-talk!

  4. Can I just say I LOVE question number 2? I mean, I can see how the anxiety could rationalize its way through questions 1 and 3, but 2 is a real hard hitter. It’s SO easy to be rational when our friends aren’t, so when you look at your anxieties from the perspective of what you’d say to a friend in a similar situation, I can totally see how the frontal lobe would perk up and kick in.

    I’m on medication for depression that thankfully helps with anxiety as well, but I think I’m totally going to steal these questions next time my brain starts spiraling out of control! Thanks for sharing!!
    Ashleigh @ Passion for Life, Love, and Health recently posted..What Does the Name of Your Blog Mean?

    1. I know! That question really made me stop and think. It helps! I’m working on the techniques. The other day I started to have anxiety about the dog we’re adopting. I started to work myself up that she’d eat my cats. I said “STOP” and went through the questions. I reminded myself that the dog LIVES with a cat currently and it’s just fine. The anxiety went away.

      What are you taking for anxiety?

  5. I don’t know much about Accutane, except that it can have very scary side effects. Sounds like a very last resort!

    I used to have very annoying breakouts during my teens and 20s. It was only when I started using Acne Free that my skin cleared up. (It’s a drug-store version of Proactiv, but sells for much cheaper.) I rarely have pimples anymore, except during that monthly thing. I’d recommend trying that out; it’s only about $20 per kit.

  6. A positive Accutane story: my college roommate had terrible cystic acne. All the antibiotics did was give her recurrent yeast infections, so her dermatologist asked her if she would consider Accutane. There was a lot of initial dryness (which eased within a few weeks), and there were regular blood tests for enzyme levels and pregnancy. The only real drawback (for a college student) was that she was not allowed to drink for the duration of the treatment. Her skin has been clear since the Accutane (15 years ago at this point), and she has 2 healthy, beautiful children born after normal pregnancies.

    1. That’s good to hear that everything worked out for the best. Oh, and I totally forgot to add about the drinking thing. No booze. Which I can do, but is kind of a bummer. Especially going into the holiday season….

  7. I can’t offer much help wit the acne problem. I had moderate acne as a teen and I tried everything- special soaps, Rx topical gels, played around with what type of make-up I was wearing. At some point I stopped wearing make-up except for special occasions, and I also stopped using soap on my face unless I wore make-up. My skin is great now except if I didn’t get all the make-up off- they I usually get a few pimples around my chin. My mom had terrible acne through her 40’s.

    As to anxiety, I have that same check list in my head when it hits. In most situations it works. Sometimes I will have to leave the situation and give myself a time out for a few minutes. I also take a medication that as an added benefit helps with anxiety (Geodon), but there are a few situations where I completely lose my s**t and nothing helps. Unfortunately those situations are always job interviews. 🙁
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  8. I had fairly severe acne as a teen and I took Accutane for about 7 months in my early 20s, about 10 years ago. The side effects in terms of dry skin were pretty awful and lasted most of those 7 months – my face and lips were often very painfully dry, I was constantly smearing lotion and chapstick on my face and lips. And my skin got much worse before it got better. But now my skin has been pretty great ever since, with only the occasional period-related flare up. So in the end, I think it was worth the pain.

  9. Like you, I didn’t get acne until my late 20s. After 3 years of trying topicals and some antibiotics that just didn’t knock out that cystic acne, my dermatologist recommended Accutane. IT TOTALLY WORKED! I got back my beautiful skin.

    I wish I had done it earlier. The only hard part was no alcohol. I developed slightly elevated liver levels so I went in every week for blood work. Once I finished the regimen my liver levels went back to completely normal. I did experience dry skin and lips so shea butter and Clinique Superbalm were always close at hand. It was winter so that added to the dryness. It’s been almost 15 years and I have no regrets what-so-ever! I know several people who took it and had completely healthy children later if that helps easy your mind.

  10. I can relate perfectly to your scenario at hand. I suffered from horrible acne that spread across my entire face for over a year and even had horrible acne on my wedding day. But if you’re able to find a great makeup artist – TRUST ME, it will not show up in your photos nor will anyone see them.

    I honestly don’t know what exactly caused it but I think living abroad and the stress of wedding planning and dieting was a huge factor. My acne was so bad that my husband would jokingly brush his hands across my forehead and say he was reading braille! It was that bad!

    What I learned from my experience was that after the failed dermatologist visits, antibiotics, creams, home remedies, etc … you have to just make the best of it. Try to de-stress, let the acne run its’ course and test out makeup artists! 🙂
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    1. My friend Star is doing my makeup. We did a practice session a few months ago and she did a great job! Michael also said we can photoshop my acne out. 🙂 And he’s really good at photoshop. So that made me feel a little better.

  11. I took two rounds of Accutane when I was in high school and it was the only thing that worked for me. I had painful, cystic acne on my chin and no other medicine helped. My skin started looking better immediately and I didn’t have any of the side effects that they warn you about. I am so glad I took it; I no longer have acne, and it’s been 15 years. If you’ve tried everything else with no luck, I recommend it!

  12. I am SO looking forward to seeing your engagement photos! We had ours done a few weeks back and I love them. They are all over our house which makes us look very self involved. Oops!

    I hope the medication+antibiotics helps. I have a dermatitis condition that causes a rash around my lips and looks hideous. Luckily I found a doctor that will give me steriod cream, otherwise I would be in a similar position. I really hope something works for you. When something is on your face you can’t help but be aware and self concious about it.

    1. Thanks Jess! We’re doing it this weekend. I’m sorry about your rash! I can relate to that as I have a very mild case of psoriasis, too. Thankfully it’s nowhere anyone can see, it’s just annoying.

  13. are you trying any benzoyl peroxide face wash along with your medications? Someone mentioned Proactive, which is good but Panoxyl is another brand you can find at most drugstores and drugstore.com. It’s drying, but really helps. p.s. love your blog!

  14. Hi LIsa,

    My son took accutane when he was 13 for about 8 months. His pediatrician didn’t want him to, but we had tried everything else. His acne wasn’t that bad on his face, but his back was a mess. It got to the point to where it was affecting his confidence, kids can be mean. He is also a football player, and his breakouts would be very deep and would bleed, and he wouldn’t have been able to play like that. The accutane was hard for him, but so worth it. He did have dry lips, but went through a ton of chapstick to help that. Sunburn wasn’t bad – he was outside at football practice all the time and didn’t really notice a change there. The biggest side effect for him was his moods – he said he felt like he was on edge all the time. He never had any problems because of it, but did say he just felt different. He is now 16, and the scars/marks on his back are getting less and less noticable. Yes, the side effects are scary, but they have to tell you the worst. For us, accutane was a blessing.
    I have been reading your blog for about a year and just wanted to tell you our story to help you decide what to do. I have about 35 pounds to lose, and you are helping inspire me to finally do it.

    1. Thanks for your comment and story. The more positives I hear about accutane, the more appealing it sounds. I’ve just been focusing on the negatives.

      Thanks for reading my blog. It’s nice to hear from readers who are getting inspired to lose weight. How are you going about to lose the 35 pounds?

    1. That’s good that the antibiotics helped. I’ve been taking them for 3 weeks now and see an improvement. Not a cure, but the acne is smaller and less “cystic” than it was before. Unfortunately, I also scar very easily so even if the acne goes away, the scars are pretty bad.

      1. Oh yeah. I have exactly those scars. At one point I thought about getting them lasered away, but the plastic surgeon I talked to said I’d for months have to wear bandages and then look a lot like a ripe tomato.

        BTW, it’s interesting that your problems got really bad only in your twens. Was there something that changed at that time? My girlfriend had really bad acne when she used one specific birth control pill.
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        1. Oh, that sounds awful! I have not looked in to laser treatment but I have thought about it from time to time. That sounds so painful to me….

          Not sure what happened. I don’t know if there was a hormonal change, or the birth control or something else. While I was losing my weight the acne was REALLY really bad. I don’t know if there is a correlation between the two.

  15. I had the same acne concerns before my wedding. I took an antibiotic and used 2 topical medications from the dermatologist and my face was very clear for the wedding. Give it time! I would also suggest to avoid the Accutane. I’ve had many friends who have taken it and it works, but one of my friends got Crohns disease from taking Accutane. She ended up having surgery and eventually got a settlement from the manufacturer, but I would definitely say to avoid it if you can.

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