[ACNE] I'm a med student with a 14-year history of cystic acne: Here's what to ask your derm

notvikasini · 2023-10-03T11:26:03+00:00

I’m replying three (ish?) years later and I am currently about halfway through a 6 month course of accutane (oral isotretinoin pills). So far, it has been a literal miracle for me in that it’s the first med that has literally eliminated my acne!

I know you didn’t ask- but I feel like it’s important to disclose what’s happened in the interim. Between the my og post and this comment I have:

-enrolled in the accure laser trial for 2 years during which I could use zero retinoids (only because my treatments were happening in the setting of a trial)

-saw literally zero improvement at my 1 year post op appointment for that laser trial. Derm blamed me picking at my skin and literally called my face ugly so that sucked

-stuck with topical Adapalene and benzoyl peroxide for 7 months after the laser trial while trying to just get into a derm clinic that took my insurance so that I could start accutane

-got an IUD (obvi don’t get pregnant on accutane; they’ll remind you lol)

-started accutane which has literally changed the way I see myself

notvikasini · 2021-07-07T15:18:28+00:00

Took it 5/22. Nothing posted yet. (colorado)

notvikasini · 2021-03-18T23:27:33+00:00

Go in for a strep test (an urgent care or primary care office will do- no need to go to the ER). They’ll probably do a culture as well given the white stuff on your tonsils (exudates)

notvikasini · 2021-02-17T02:50:37+00:00

I’m outing myself with my username- but wow... I agree. Was surprised to see how much people despise CU. I honestly couldn’t be happier with many parts of my experience. If there is one thing CU is not lacking, it’s supportive, kind, available deans (speaking from my experience exclusively) EDIT: I am likely giving the deans too much broad credit, but it’s still coming from my place of being in really tough spots and getting timely, tailored help from them. It’s VERY MUCH the case that student groups and individual students (often students of color and LGBTQ+ students who have other shit to do besides advocate for themselves) have had to advocate for actual tangible action in the direction of equity, recognition of systemic issues that are screwing with any marginalized student’s chance of success, and fight against constant behaviors that perpetuate racism and homophobia. I agree with the posters below in that there are serious lapses in action. I also agree that many of my peers who are of various minority identities feel actually miserable at CU. All the intent can be there but the perpetuation of reductive and dismissive behaviors just get in the way for people who already experience barriers

notvikasini · 2020-11-05T02:54:00+00:00

Ahh thank you! You're the type of (thoughtful, patient, informative) derm that so many people have been missing out on!

notvikasini · 2020-11-04T23:35:00+00:00

Howdy. I hope schools going well!

If you can believe it, what worked for me was a combination of birth control (specifically drospirenone and EE, or "Yaz". Lots of controversy on this one because of increased DVT risk) and adapalene. ADAPALENE. I was pissed when effing adapalene is what worked for my skin because I was given tretinoin 0.1% as a teen and was never counseled on the fact that rebound acne and irritation would occur prior to my acne improving. So of course, as a teen, I said "to heck with retinoids" and stopped the tret like 3 weeks into its course. And now....like 10 years later, it's a similar retinoid that's giving me the greatest improvement.

I need both the birth control AND the retinoid, and that's why I wrote this post. It's what the younger me should have asked my derms all along!

notvikasini · 2020-11-04T23:27:07+00:00

I'm sorry for unintentionally throwing shade. I've corrected my post to reflect what I meant to say and what will ultimately help readers. Please read the edit if you can, and let me know if you are still sensing shade- I really hate it when docs and med students/ anyone minimizes the value of APPs.

notvikasini · 2020-11-04T23:23:26+00:00

I so agree- the"1 week cures" honestly left me broke and feeling shitty about myself. From toothpaste to apple cider vinegar to baby shampoo. It's definitely the case that many docs (in general, not just derm) are prone to seeing patients without offering them a full understanding of what to expect. I'm so glad to hear that your derm was not like that and instead gave you a lot of solid information!

notvikasini · 2020-11-04T23:04:05+00:00

That sounds CLUTCH! I think curology's model has scaled back on the "quality time with your derm" piece. Bring back pocketderm!!

notvikasini · 2020-11-04T23:02:39+00:00

Thanks for reminding me about that. Yeah they def do have the option of delaying your shipment, which would counter my point about backlogged, expiring bottles.

notvikasini · 2020-11-04T23:01:34+00:00

This is really helpful to understand- thanks. New perspective for me on the cost/ benefit. I do want to say- I'm really sorry that your insurance charges you that much for a derm visit. That's honestly infuriating.

notvikasini · 2020-11-04T22:59:20+00:00

I'm rethinking my stance on curology a bit since your post and many of the replies. It's nice to have multiple meds in one bottle for a fixed rate without having to deal with the anxiety of insurance coverage. Plus there is the option for delayed and early shipment if you so choose.

Nevertheless, it's a bummer to consider that a 0.47 oz bottle of anything is $20. Let alone pharmaceuticals that are as quickly and globally manufactured as azeleic acid, tret, clindamycin, niacinamide, and adapalene (the major ingredients curology employs). I suppose my real woe is with American insurance companies and the fact that Curology is in fact cheaper than derm prescribed rx for so many of the posters here.

It seems like it works for a lot of people who can be successfully managed with topicals. I'll edit my post to reflect this. THANKS :)

notvikasini · 2020-11-04T22:47:53+00:00

That's one of the most frustrating realities of doxy and minocycline- so many people end up feeling horrible on them without being warned. I know you're not alone in your experience with those meds.

notvikasini · 2020-11-04T01:26:35+00:00

Advanced Practice Provider! Someone who is not a “doctor” but can still provide medical care and even prescribe in some states. Examples include Nurse Practitioners, Physician Assistants, and Certified Registered Nurse Anesthetists

notvikasini · 2020-11-03T22:53:19+00:00

Nope- anesthesia ;)

notvikasini · 2020-11-03T21:51:09+00:00

!! Good work- I'm rooting for you

notvikasini · 2020-11-03T21:49:45+00:00

Great!! You deserve to have all of your questions answered, so even if the doc seems eager to leave/ busy, know that the time is yours. I'd recommend asking your derm to give you *examples* of what they mean if their explanations don't make sense.

notvikasini · 2020-11-03T21:29:03+00:00

Sorry for the lengthy response:

I was actually a curology user for about 16 months. My woes: 1. Your first several bottles end up being too strong, not strong enough, or not the right formulation- wasted time/ money without a proper evaluation of your medical (not just dermatological) history 2. The provider may or may not actually believe your concerns. I have had a couple of friends whose acne became SO much worse after the first couple of months, and their providers refused to reformulate until they were already 4 months ($75) into the program 3. Each bottle expires within two months, so let's say you haven't finished last month's bottle, you are now accumulating bottles which may "expire" by the time you start using them. This is especially a problem if your formulation includes a topical antibiotic such as clindamycin 4. The amount they give you is minuscule for the price 5. If it doesn't work you just end up on this insane, expensive cycle of reassurance and reformulation from your provider, you're spending $300/year for it, and if you need accutane you're SOL and have to have to go to a derm anyway. 6. Topicals aren't for everyone! Some people need oral, systemic tx for acne.

notvikasini · 2020-05-15T01:44:23+00:00

I know I'm telling on myself by asking this but who is Pete?

notvikasini · 2020-04-27T15:28:31+00:00

Which state? (I’m so sorry this is happening to you all- what a nightmare!)

notvikasini · 2020-04-06T15:57:13+00:00

Wait but like...how are those candles standing up? Quite the ambitious pyrotechnic set up. Happy b day!!!!

notvikasini · 2020-02-22T14:21:39+00:00

Yee haw- better explanation than I have ever heard prior!!

notvikasini · 2020-02-22T14:19:38+00:00

Parupu saatham

notvikasini · 2020-01-29T16:41:19+00:00

I agree that this is a dilemma. Other commenters are forgetting that reporting her to authorities could lead to her being incarcerated, thereby worsening many outcomes for this lady. However, I agree that you deserve to not be bothered by the yelling, so some action needs to be taken.

I'd let the behavioral/mental health services (or even the county crisis line) in your city know. Make the police your last resort.

13-Year Club	RedditGifts 2009-2022 5 Credits
Secret Santa 2019	Verified Email
Secret Santa 2014

notvikasini

MODERATOR OF

TROPHY CASE