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Hi folks,

While I went through my own trials and tribulations with acne years ago, now at age 51 it's no longer attacking my face, but I'm heartbroken over what it's doing to my daughter. I wanted to tell a little about her story, and then ask you folks how you think I can best help her.

First, let me make a comment about this message board - I couldn't help but notice that it has the most topics and posts of all the boards I saw listed here at HealthBoards.com. I think that says something about how many people are affected and how acne can be so much more than "just a few pimples". I apologize in advance for what will likely be a very long post, but I hope some of you can make it through.

My daughter is 19, in her second year at college, and while she's had acne since middle school, it's gotten much worse, and now she has large red cysts over much of her face. I know it bothers her, though she does her best to remain upbeat. The thing is, she's already been through so much in dealing with serious neurological and psychological issues. When she developed tics just before high school, her friends dumped her, and she became one of the outcasts.

It took us a while to figure out what was going on with her, but eventually we got a diagnosis, and managed to get her treatment that helped somewhat, and perhaps as importantly, we learned how to be more supportive, both in the environment we created at home, and in becoming her advocate at school.

When the very noticeable tics first started, we thought we were helping by urging her to try to stop them... later learning the importance of being completely accepting, providing an environment where she didn't feel she had to fight to try to suppress them, after she had struggled all day at school to hide them as best she could (which she can only partly do for so long, if at all sometimes),.

In reading some of the posts here, and from others with acne at other web sites, I see where some have expressed frustration about their parents' comments (most likely well intentioned) to wash their faces more regularly, etc. We've done that concerning her acne, too, though I must admit until the last couple of years or so, we had been much more wrapped up in getting her help for her neurological and psychological issues. Nonetheless, we were probably repeating the same mistakes in how we reacted to her acne that we did at first with her tics.

My daugther is a remarkably courageous young woman, who fought to win back her friends after they made her an outcast. She did it, but then they dumped her again... and so she found new friends, only to be dumped by them, too, as they learned how uncool it was to be friends with an outcast. Things got a little better for her during her last two years of high school, but although her "friends" treated her somewhat better, they're not real friends in my opinion, and she rarely does anything socially with them when she's home.

But, when she got to college, my wife and I were very happy to see that she made a number of friends. This year, her and five of her friends live in a suite together. They're a great group of girls, and she's doing very well with them, as well as doing very well academically.

However, she's never really dated, and I don't know how much of that is due to the tics or the acne. She did tell my wife about one time she met a boy on one of our summer vacations, and got her first (and I believe only) kiss. It's not my intention to pry into my daughter's social life, I just bring it up to give background.

The thing is, I think at this point, while she still struggles with the tics and other issues related to the neurological and psychological problems, I believe the acne is causing her more distress.

After all she's been through, it breaks my heart to see how acne is ravaging her face. A couple of years ago, I got frustrated with no progress while she was seeing this one dermatologist. As a result, she started seeing another doctor who was recommmended to us.

We all really like this doctor, and twice we saw fairly significant improvement with oral antibiotics. Unfortunately, the acne has surged back with a vengeance... and now it's the worst it's ever been. She's due to see the doctor next week (very tough to get appointments), and based on past comments, I think the doctor is leaning toward proposing Accutane. Since my daughter is now legally an adult, I know that it's her decision whether to pursue this more aggressive treatment.

However, my wife and I love her very much, and we have mixed feelings. We both would love to see her get relief from acne. It's terrible that anyone has to suffer through this, and we both feel even worse in light of everything else she's endured. But we're also concerned about the side effects of Accutane.

The previous dermatologist went right from the topical treatments to suggesting Accutane. When my wife brought a prescription for Accutane to the pharmacy a couple of years ago, the pharmacist really freaked out my wife. On top of the publicized concerns about Accutane, he raised additional concerns because of her psychological issues, and because of the medication she was already taking for both the psychological and neurological conditions. My wife was also scared about what she read and heard from other people.

I'm very concerned, too, but I can clearly see that we're not just talking about a few small pimples (not to trivialize milder cases of acne), but a pretty bad case of cystic acne. I remember how I felt about my acne, which was much milder than hers... though I'll never forget how one of the "cool kids" in my high school, who had very clear skin, made fun of me, calling me "pie", as in "pizza pie". Lucky for me, my skin cleared up somewhat in my senior year of high school, and between that, and my catching some of the girls' eyes when I grew my hair long back in the days when long hair was a big deal, I ended up having a social life in my last year of high school.

Anyway, I would fully support my daughter's decision if she decides to try Accutane. I would like to make sure she makes an informed decision, though. And my wife has suggested that perhaps one of the birth control pills that's supposed to be effective in treating acne in some cases might be something she should try. My daughter's acne definitely flares up just before she gets her period, and she tends to have very irregular cycles like her mother always did.

From what I've read, this might indicate that she'd be a good candidate for trying this approach. When I brought this up to the dermatologist a while ago, she said she doesn't use that as a treatment, but she's not opposed to it if we took her to a gynecologist. She did point out that birth control pills can have serious side effects too, so it's not like choosing a medicine that's completely safe over a horribly dangerous one (Accutane).

When my daughter was younger, we faced a similar decision concerning medication for her neurological disorder. The most effective medicine for controlling her tics often caused such horrible permanent side effects, we were afraid to put her on it. We were torn up inside, as we watched her very noticeable tics and wondered if she would have benefitted from that medication.

Eventually we got her treatment that has helped, learned enough to be more supportive, and as I stated earlier, she has adjusted fairly well, though it has been a long, rocky road. Now that she's legally an adult, she's about to face a similar decision as to whether or not to take a drug that offers dramatic improvement for the effects of acne, but could pose serious risks.

I'm trying to understand how I can best help her, in terms of advising her on this decision, and in terms of how I should best react and deal with her acne. I must admit that when I saw her the past two weekends, I found it hard to not "check out" the worsened condition of her face.

My wife told me she feels bad because when she first saw how much worse the acne had become, she reacted with some kind of comment... not intended to be hurtful, but an honest reaction to how much worse it had gotten. I managed to avoid making a comment, but as I said, I have been "checking it out".

The other thing is, I will probably be driving her to her next appointment. In the past, sometimes my daughter has gone by herself, sometime with me. When I go, I usually go in with her when she sees the doctor, but I'm wondering if I should. I guess I'll ask my daughter what she wants. I don't want to inhibit her speaking frankly with the doctor, but I'm also willing to be there for support if she wants.

I also would like to communicate my feelings and ideas to the doctor, but I find myself treading lightly in terms of what I say because I don't want to make my daughter feel any worse about the effects of the acne. As a result, I was going to write a letter to the dermatologist, but then I decided I'd try to speak to her on the phone.

So, I sit here in my office, hungry and thirsty as I wait for what I hope will be a call back from the very busy doctor. I ducked out to the rest room earlier in the day, and I missed her call. Now, I'm sitting here, getting no work done as I wait for the call. But, perhaps the silver lining is I found this site, and I'm posting this. If nothing else, writing this may help me deal with this

My daughter is just about the sweetest, kindest, most gentle, and caring person I've ever met. You should see how little kids love her. They've always accepted her, tics, acne, whatever... and she's great with them when she babysits, or when she works over the summer as a camp counselor.

Whew! I wonder if anyone made it to the end of this... and did I set some kind of record for length?

I'd love to hear any response to what I've written... either advice on the course of treatment, or advice on how I can best support my daughter emotionally, what I should or shouldn't say about acne, anything. She deserves the best, and I'd like to give it to her.

Thanks to anyone who read any or all of this,


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- A Dad who Wants2Help





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