Follow Claire's journey as she attempts to get rid of her cystic acne. Was
she able to find a cure?
January 26, 2012 by Claire Hapke, as told to Jane Chung
Every morning, I look into the mirror, and my heart drops. Staring back at me
is a 25-year-old woman whose face is covered in bright red pimples and
inflamed cysts. Even though it's been years, I still cringe at the sight of my
skin ... and then I force myself to wash my face and get dressed, even when I
feel like crawling back into bed and hiding under the covers.
No, I'm not being over-dramatic. I have cystic acne, and if you've got it I bet
you can relate. If you don't, just know that it's a severe form of acne where
you get painful and inflamed cysts filled with pus (fun, right?). In high school, it
felt like I was the only girl who knew what it was like having real acne. All of
my girlfriends had clear skin, so it pissed me off when they complained about
one tiny zit. I would think, "Really? Do you want to compare faces? Because
we can. I'll win. Every. Time."
I tried everything to get rid of it. Oral medication just made me feel bloated
and hormonal. Proactiv didn't get rid of a single pimple. The ONLY time my
acne got better was when I started Acutane (a pill-version of retinoid, with very
risky side effects). The forehead acne disappeared, but nothing happened to
the pimples around my mouth and chin.
After I was done with Acutane, I started taking Spironolactone (an antiandrogen that helps regulate hormones) in addition to birth control pills. This
helped with the acne around my mouth, but not much. That's when I decided I
didn't want to be taking pills for the rest of my life. I was sick of filling my body
with meds, and felt so frustrated I still had daily breakouts. For the last two
years, my current "regimen" has been washing my face with a salicylic acid
cleanser. And that's it.
My boyfriend, Ben, tells me he loves me no matter what my skin looks like.
But I'll admit, sometimes I doubt that. And either way, I know I won't really feel
good about myself until my acne is gone. It's time to do something about it.
My last-ditch effort is a big one. I'll be working with Dr. Ava Shamban, owner
of the Laser Institute-Dermatology in Santa Monica, Calif., to try to cure my
acne once and for all -- and I'll be sharing every step of the way with you. Why
Shamban? She's the celebrity dermatologist on "Extreme Makeover" (and
author of "Heal Your Skin"), and lucky for me she gives women those same
treatments off-camera too. I'm willing to do anything to have her treat me -even if it means taking pictures of my bad skin and putting them on the
Internet sans Photoshop. Desperate? Maybe just a bit.
Keep reading to see what happens next in the journey to cure my cystic acne
and stick around for the end, when I share how you can do (almost) the same
thing at home.
Called out by the pro
As soon as Shamban sees my face, she calls me out, saying I've neglected
my skin. I'm embarrassed, and I can feel my face turning red -- which probably
makes my acne look even worse. And in that moment, I feel like an ugly,
hormonal teenager again. What's wrong with me? Why am I still dealing with
this problem? But she's right. By only using cleanser, I have been lazy with my
Shamban tells me my acne is mainly hormonal. She calls it "red and active"
acne, with a lot of indented scars beneath the fresh acne. Usually oral acne
medication combined with birth control helps keep hormonal acne under
control, Shamban says. But when I tell her I've already tried that, she puts me
on an extensive four-step treatment plan, which includes everything from
topical creams to laser treatments.
Buh-bye, laziness
Phase one of Shamban's plan: Oral and topical medication. She prescribes
three different at-home topical creams for my skin: Finacea, Aczone, and
Acanya. Finacea decreases the production of keratin, a natural protein in your
skin that can lead to the development of acne. Aczone's main ingredient is
Dapsone, which is an anti-infective to help prevent infections in the cysts.
Acanya is a topical antibiotic that kills acne-causing bacteria. Shamban also
gives me an oral prescription of Spironolactone, which is the same pill I
stopped taking two years ago.
I know I said I was done with meds, but I'm so fed up with the way my skin
looks. Plus, I remember that Spironolactone sort of worked for me in the past,
and Shamban thinks there's a good chance I'll get better results when using it
with these topical creams.
Shamban also gives me a strict, four-step regimen to stick to: Wash,
Medicate, Moisturize, Protect. Not easy for a lazy girl like me. Usually, if I'm
already in bed and realize I forgot to wash my face, I think, "Screw it, I'm just
going to sleep." Wish me luck.
Least relaxing facial ever
Two weeks later, I'm back at the office for phase two: A facial. My first
thought? "Sweet! Spa day!" I go in expecting to hear Enya playing and to be
handed a plush spa robe. But right when I walk in, I notice how quiet it is. Not
a good sign. I lie down on a hard table, and I'm engulfed in a stringent smell I
can only define as "medical." That's when it hits me -- this isn't about relaxing.
After exfoliating and steaming my face, Tanya Eubanks, the facialist, starts to
do extractions using her gloved fingers and a medical needle. Yep, it's as
painful as it sounds (kind of feels like she's trying to squeeze off my chin). But
the worst part is when I hear the noise of the needle pricking each cyst. It
sounds like a tiny burst of air, which might not seem bad, but I can imagine all
the gunk coming out each time, and it makes me cringe. By the time she
applies a mask to reduce redness, I've lost all feeling in my face, and I'm
thrilled I don't have to hear the needle anymore.
Extractions aren't pretty ...
My skin looks really red after the facial, but Eubanks says that will go away
after a few hours. My face feels really clean and tight, but still pretty sensitive.
On the plus side, the bumps have gone down a lot, and I feel like I have a
pretty glow. For the first time, my co-workers notice how smooth my skin
looks. I can't stop smiling the rest of the day.
Liquid nitrogen on my face?!
Once my skin calms down after the facial, I go back to the office for phase
three: A chemical peel. Eubanks says it helps stimulate the skin and push the
acne to the surface, which makes it easier to treat with lasers. I lie down on
the hard table, and have a flashback to how painful the facial was. Hopefully
this isn't as bad ...
Eubanks starts by applying retinol and salicylic acid-soaked strips across my
face. Once the strips have dried, she takes them off and begins to apply a
high-frequency light to my face. The light is both anti-bacterial and antiinflammatory, and it feels like tiny, prickly shocks on my skin. Finally, she
comes at my face with a mega-sized Q-tip covered in liquid nitrogen, which I
knock out of her hand. Liquid nitrogen on my skin? Is that even safe? She
assures me it is, but I'm not so positive when I see my skin the next morning
What's yellow and peels? (I'm not talking about a
The good thing about chemical peels? There's not that much down time. I just
need to stay out of the sun for a few hours, and Eubanks tells me to take a
break from my topical medication for several days. The bad thing? The
peeling ... OMG, the peeling.
Eubanks says my skin will be slightly yellow for 30 minutes after the peel, due
to the retinoids. That's an understatement. I walk out looking like a highlighter.
After a few hours, it starts to look like a strong sunburn and my skin smells like
alcohol. The next morning, my skin literally peels off in sheets.
Luckily, it's the weekend, so I don't have to go to work looking like this. Notso-luckily, it's Thanksgiving weekend. Which means I'm visiting my family for
the first time in weeks. And they're meeting Ben for the first time ever. When
my mom seems me, she's shocked. "What happened to your face?!" I give her
a hug and tell her what's going on, hoping it'll get her to quit staring.
Well, it gets worse. That night, I'm cuddling on the couch with Ben when I get
up for a drink. I come to a complete halt when I catch a glimpse of myself in
the mirror. My face looks like it's melting off. I run to the bathroom and ask
Ben (through the door) why he didn't say anything. "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 he's with me for
the long haul.) Once the peeling is over, I can't believe how good my skin
looks. Guess it had to get worse before it got better?
Sayonara scars
Finally, it's time for phase four of Shamban's plan: Laser treatments. This is
supposed to help with the acne scars ... also known as the bane of my
existence. Even when my skin is having a good day, it still looks red and
blotchy from the scars. In fact, it really bothers me when people say, "Your
skin looks so good today!" I know my acne scars are still there, so my skin
obviously doesn't "look good." Why lie?
And yes, I know some people cover up their scars with makeup, but I feel like
it'll make my acne worse and draw more attention to it. I just really want the
laser treatment to work, so I don't have to worry about this ever again.
Lisa Beaulieu, the acne specialist, applies a numbing ointment to my face and
makes me wear these funny-looking goggles before giving me the treatment.
She decides to use a combination of the V-Beam and Smooth Beam laser
treatments. The V-Beam laser helps with the redness and stimulates collagen
in my skin, and the Smooth Beam plumps up the indented scars. Even with
the numbing cream, the lasers feel like someone's snapping a rubber band
against my skin. Maybe she didn't put enough ointment on?
Let's amp it up
Beaulieu says my face will be swollen, or "quilt-y" as she calls it, and to expect
small, square-ish marks on my skin where the lasers hit. But it's not that bad
the first time. In fact, there are hardly any marks at all, so I wonder if it even
worked. I know my acne is pretty stubborn, but is it really stronger than a
freakin' laser? I'm inwardly cursing my skin until Beaulieu says she used the
lowest frequency for the first treatment, so I shouldn't expect much change.
Over the next month and a half, I go back three more times. She uses a
stronger frequency each time, and it gets more painful. The last one hurts like
hell, and I walk out with chipmunk cheeks. But I'm excited because that
means it's working (right?).
Save the best for last
It's time for the final phase: Photodynamic Therapy (PDT), aka the strongest
laser they've got. I'm a little scared -- Shamban calls it an "intense procedure,"
and says "absolutely no contact with the sun," for the entire weekend, unless I
want to know what it feels like for a vampire to burn. However, she says my
skin will look the best it ever has seven to 10 days after this final treatment.
That's all I need to hear.
Shannon Sher, the tech assistant, applies a topical levulinic amino acid all
over my skin. Over the next hour, the damaged skin cells absorb the
medication. Then, I stick my head into the PDT machine to expose the treated
skin to the blue laser light -- this destroys the scarred cells while leaving the
healthy cells untouched, Shamban says.
I think it's going to hurt, but it doesn't. I just feel a bit of tingling, and there's
some swelling afterwards. But right away, I notice a huge difference. My skin
looks super tan and glowing. When Ben sees me, he asks, "Did you go on an
overnight trip to Cabo without me?" This makes my day, and I don't even care
that I'm stuck at home for the rest of the weekend. I spend it on the couch with
Ben, watching all three "Lord of the Rings" movies. But I'll be honest -- most of
the time I'm not even paying attention to the screen. I just keep thinking of
what my skin will look like in a week ...
The final reveal
It's been 10 weeks since my very first consultation with Shamban, and I can't
believe how far I've come. Not just with my skin (which looks amazing), but
also with my own confidence level. When I used to look in the mirror, my acne
would be the first thing I noticed. But now, my skin isn't something I think
about all the time. It also makes it so much easier to open up to people,
because I don't assume they're just staring at my face.
Although, it turns out, they are (in a good way). This morning I notice Ben
staring at my face, and out of the blue he says, "Claire, your skin is SO clear,"
and he touches my cheek. I almost start to cry. Thinking back to my first date
with Ben last year, when I was so self-conscious of my skin, this is a huge
deal for me.
To keep my skin clear, and reduce the few remaining scars I have, Shamban
tells me to continue my at-home program of topical creams, oral medication,
and birth control pills. This isn't an easy decision, because I remember how
much I despised taking pills, and I'm definitely not planning to be on
medication forever. But it's working, so I think I'll stick with this regimen and
not give up as easily as I did before. And even though I still question why this
is something that I have to deal with and other people don't, I finally feel a little
bit of hope after seeing how much better my skin looks.
Next: See how much each treatment cost and get at-home alternatives
Cost roundup (and other tips)
I'll admit, if I didn't have a beauty editor as a friend, this wouldn't have been
cheap. Below is a breakdown:
Facial: $50 to $80
If you can't afford regular facials, give yourself a DIY facial at home with these
tips. And think about investing in a Clarisonic Mia Skin Care Cleansing
System, $103 -- it works well on smaller pimples, blackheads and minimizing
Peel: $50 to $300
If you have oily skin or severe acne, Shamban recommends getting several
peels before your first laser treatment. For a cheaper option, try using an athome chemical peel kit like IQ Natural Complete Glycolic Acid Chemical
Facial Peel Kit, $25, or a sulfur mask like DDF Sulfur Therapeutic Mask, $38.
Laser: $500 to $3,000
For most acne patients, Shamban recommends at least three laser
treatments, every two to three weeks.
Photodyamic Therapy: $800 to $3,000
For the best results, Dr. Shamban recommends that acne patients get two to
four treatments, three weeks apart.
Finally, watch the amazing Shamban answer your skin questions in this
exclusive video.