Acne hindering depression treatment

[RyelyJames]

27 and have been battling Acne since I was 12. I have been on many prescripts and spent thousands,treated with Mino, tetra, doxy oral meds.Clindo,erythro,tazorac, retna-A and micro, gel benzole, pro active, and accutane. I was most pleased with treatment which lasted about three years of bliss.Tryed to go to my derm. Dr. and plead to try it again but to no avail. After a blood test found Effexor XR the right treatment. It has helped me so much with a new interest in life, not hiding in my home and dry heaving every time I stepped out of the house. I can talk to people now and not be afraid. I am so thankful.Right now I am using the tazorac with ivory soap and a mild toner for my face. I have 8 red-inflammed leasions on my face right now and darks scab looking reminders of the last flare(4).skin looks like I am 50,dry and wrinkly. My obbession with my face is ruining it, I try to strip the dry skin off and end up with skin tears that hurt and leave marks. I also drink lots of water, take omega 3, vit A fish liver oil, and steam my face once a week. I have whiteheads trapped as well. I just wish my derm dr. would see that I need a treatment that doesn't make it worse before it gets better and realise I might be a bit obsessive with my face, but to just help me so I can just feel better like I did those three years and stop this rollercoster ride. I feel good mentally and just want my looks and confidence to match. To be a whole person for once.

[Alan Rockoff, MD]

Your dermatologit's reluctance to treat you with Accutane again is quite understandable.  By your own description, you're clearly obsessed with your face, with a habit or rubbing and traumatizing your skin.  As long as you keep doing that, all treatments will fail, making it hard to justify a complex therapy like Accutane.  As for treatments 'making it worse before it gets better,' I rarely find that to be true even of the treatments reputed to do that, like Retin-A.  Most often, I find it to be a self-fulfilling prophecy--people convinced they're going to get wore rub themsleves until they do.  I would suggest using safe, topical treatment for whatever benefit it gives you, and seeking the psychiatric and/or behavioral help you need to deal with your obsessions.

Good luck.

Dr. Rockoff

[RyelyJames]

I am in behavior cognitive therapy and it is working, I havent picked at my face, but am still having problems. I was wondering if this 1% Tazorac gel is too much and thats why my face never seems to look moisturized and the leasion tear so easily when I try to use a wash cloth or mild face scrub to slough off the dead, dry skin. It just seems I dont know how to balance this with lotion. I use a pure mineral oil to try to moisturize my face so I can use the Bare mineral makeup thats powder to cover my red blotches with out looking so dry and flaky. Then is this causing more breakouts? I am just frustrated because I have went to school for esthetician at Aveda, studied with Dr. Fulton for my para-medical license at Midwest plastic surgery institute and now am a RN student. All this so I can understand this haunting problem. Thru my studies all I have found is so many confusing medications, cure-alls, profit seekers and just want a straight pure and simple answer not related to any of those. I work at the Mayo clinic and unfortunately know that even there some medications I have been given to try where because they were on the latest list of potential benefit thru company and hospital. Which I really do understand, unfortunately such honestly even among professionals for true simple knowledge purposes is considered taboo.

thank you