My acne has always been the thing I wished I could change about myself more than anything. To those who have never experienced real acne this may sound dramatic, but it is all consuming. You are obsessed with checking your skin: treating active acne, seeing if anything new is forming beneath the surface (and praying that it won’t), blotting excess oil, covering up spots and scars to the best of your ability with concealer, and so on. When going to bed with a bad pimple, sometimes I would wake up in the middle of the night and feel compelled to turn on the lights and “check in” on it. In the morning before getting out of bed, I’d run my hands over my face to feel if any new bumps were starting to form.
Socially, there were many occasions where I wanted to cancel plans because of a bad breakout. I remember being on an early date with my now husband in which I had a cyst forming on my forehead throughout the span of the evening – it was pulsing and itching. I tried to pull my hair forward in front of it but it was unsuccessful. Completely innocently, he literally asked me if I got bit by a mosquito. I thought to myself, “can the floor open now so I can just fall through?”
My Background
Looking at my genetics, there wasn’t much of a chance for me escaping at least some type of acne. My mom, who never had much outside of the occasional pimple growing up, naturally has very oily skin. My dad on the other hand, suffered from severe acne starting as a teenager not just on his face but down his back and arms. He eventually went on Accutane in his early 20s and saw significant improvements. It only required a second cycle of it in his late 30s to fully clear up the cystic acne on his back. The oily skin on both sides, plus my dad’s history, made for a tough combination.
When I started getting acne as a pre-teen in middle school, the first course of action was to try a series of different topicals containing the standard salicylic acid or benzoyl peroxide. But it just wasn’t enough to fight what was now turning giant whiteheads along with the first signs of painful cystic acne. My parents and I made the decision with my dermatologist when I was around 14 to go on Accutane. If it worked for my dad, it would work for me right?
Anyone who has been on Accutane knows its an absolutely brutal drug on the body. The side effects with dryness on the skin, chapped lips and muscle aches are real and painful. But with the end goal of clear skin, I was committed to going through with it all. Accutane worked for me in the beginning. For two years I had no acne and felt completely free in high school. Then, it started to come back. The dermatologist confidently recommended that like my dad, I just needed another dose of it. This time the muscle pain was so bad that I could barely finish the cycle, but once again I thought I was cured!
The Struggles of Adult Acne
I have to think the skin problems I experienced early on in college were a result of a lot of life, environment and consumption changes. My acne came back, but this time in the form of small bumps underneath the surface of my skin. I tried a few different over the counter products and skincare systems, some of which made my skin even more red and irritated. A new dermatologist I saw the summer after my freshman year got me on an antibiotic to calm down the irritation, gave me new cleansers and prescribed birth control. A lot of young women struggle with hormonal acne and birth control works well to help control it. My skin improved a little on this new regimen but it was never cured. I’ll always remember seeing a former suite-mate whom which I shared a bathroom with as a freshman when we returned to school in the fall. She exclaimed, “wow Rachel, your skin is all the same color again!” While perhaps unintentionally hurtful, it stuck with me.
As I progressed into the post-grad world and started my career, the acne was still a pain point. And I’ll be honest, there were many days I wanted to to stay home from work. A bad pimple on my face would hinder my confidence to speak up in a meeting. I’d obsess with blotting the oil on my face (which would build up by 11am) and plotted opportunities to run to the bathroom between calls to touch up a blemish. My dermatologist added Spironolactone to my regimen as many women pair it with birth control to offset hormonal acne. For me, it never made any difference to my skin and beyond that I didn’t like the way my body felt.
My Breaking Point
In 2020, I made the decision to stop taking my birth control pills. A few months later my acne was at its all time worst. No place on my face was considered off limits, but my cheeks were the worst covered with painful deep cysts. Just as one would heal, another one would pop up. It was leaving terrible marks all over my face. I did not know what to do; nothing was helping me and I did not want to go back to the drugs that were no longer agreeing with my body.
Feeling like I tried everything, I was desperate. I went down a blackhole on Instagram searching for advice and came across an account who claimed to be “The Skin Coach”. There were dozens of testimonials that claimed she cured their skin, using only natural methods. Mesmerized and hopeful, I submitted a $800 deposit to secure my spot in her next “cohort” for a 8 week acne skin coaching program.
I learned her approach was for me to order $300 worth of skincare products, vitamins and other natural remedies off her Amazon storefront and adhere to an extremely strict diet. I was to submit weekly photos showing my “progress”. When things didn’t improve, this coach asserted the only reason I wasn’t seeing results was that I must not be fully adhering to her program and that my genetics were not a factor…guilt tripping me into the idea that I was in control my skin.
My Turning Point
The terrible post-birth control acne eventually subsided, but I still had a variety of cysts, whiteheads and blackheads ongoing. My skin was accumulating more and more marks and scars. The discoloration under my skin was getting challenging to conceal under makeup. Searching for help yet again, I read about how blue light therapy can reduce the bacteria on your skin that causes acne. I decided to try a new dermatology office on a whim, and made an appointment at Chicago Cosmetic Surgery and Dermatology with, Whitney Hersh, PA-C.
Whitney was extremely honest and straight with me from the start, which made me like her instantly. She said blue light therapy wasn’t going to make the impact on my skin I was looking for, and if I wanted to try it, I was better off at buying an at-home device. Expecting her to go down the list of alternatives I had heard 100x over, she actually suggested something I had never heard of before – the AviClear Laser.
What is AviClear?
An innovation from the well established laser company Cutera, AviClear is the first of its kind FDA approved laser specific to fighting acne. AviClear targets your overactive sebaceous glands (i.e. the oil producing culprits which clog pores and produce pimples) and suppresses them, eliminating acne at the source! The treatment consists of three 1-hour laser sessions each a month a part. Not covered by insurance, AviClear does have a hefty price tag at $3000. Naturally skeptical given my history, I was not immediately sold due to the fear of wasting my money on another dead end. However after a few months of research, prayer and encouragement from my family, I decided to try it.
What is the AviClear Treatment like?
Upon arriving to the office, I was instructed to wash my face twice with Dawn dish soap to fully remove any oil. Following that, they wiped my skin down in acetone and placed water soaked gauze all over my face to rest for a few minutes prior to starting the treatment. The laser itself felt like a rubber band snapping against my face, with some areas more painful than others. Once it was over, I was pretty red, and but just avoided the sun and putting on any makeup for the rest of the day. The downtime was minimal!
After the first treatment, I noticed a change in my skin instantly. My skin was still oily, but I wasn’t needing to pull out an oil blotter until the early afternoon vs the standard 11AM. The pimples I did get were not only less frequent, but less severe and healed faster. To my delight, things only continued to improve after the second and third treatment. AviClear suggests you’ll see your full results 6 months following your final session.
It really became clear to both Whitney and I that all the hormonal treatments I had done (birth control, Spironolactone, diet changes) never worked for me because my acne was not primarily driven by hormones. My significant oil production was one thing, but it was also the type of thick and easily clogged sebum my skin secreted. After administering the laser treatment to patients with various types of acne, Whitney said my skin was the most ideal candidate for AviClear. They don’t fully know how long AviClear results will last (clinical trial patients are still experiencing clear skin 2 years out), but I’m incredibly encouraged as they are also looking to approve follow up AviClear treatments for maintenance.
Life After AviClear
While I still carry oil blotters with me, and get the occasional small pimple, it’s nothing I can’t manage. I’m slowly growing accustomed to looking at myself in the mirror in the morning to see a clear complexion. It’s natural instinct to scan my face every day for blemishes, but I am continually surprised to find nothing of interest. I’m also using a retinol to help clear turn over new skin cells and reduce my dark marks. This past Christmas, being able to take a trip to Florida to stay at my in-laws house, and come down in the morning for breakfast without putting on a full face of makeup was nearly impossible for me to comprehend. But this is my wonderful new reality.
If you are fighting acne, and feel any amount of the physical and mental pain, shame, ugliness and hopelessness I did, I encourage you to explore AviClear as an option with your dermatologist. This laser may not be the one-size-fits-all solution for everyone, but I share my story so that it may bring more awareness to it as an avenue for others struggling and searching for an answer. We all deserve to feel confident in our own skin.