Why I Refuse to See a Dermatologist for Acne

by Auriel

Acne is the worst! Believe me I know…I’ve suffered from acne for years and it’s one of my biggest insecurities.  If you’ve ever had acne, I’m sure you can relate.

Not only is it mentally taxing, but depending on what type of acne you have, it can be physically painful as well.

Often the first place we turn for relief is the dermatologist’s office.  There you’ll likely be prescribed a combination of harsh topical creams and/or oral antibiotics.  And more often than not, these treatments do work.

For a long time creams and pills kept my acne, for the most part, in check.

In the past I was a strong advocate of seeing a dermatologist ASAP to manage acne and avoid scarring.  

However, the problem came when I decided to go off the medication.

Despite having been treated by a doctor for years, my condition was far from treated.  After slowly weaning off the meds, my acne was back like it had never left.

And guess what…it hadn’t.

What I’ve learned is that dermatologists do not cure acne.  In fact, they barely scratch the surface when it comes to addressing acne’s root cause.

My Acne Battle

For over a decade I have been in and out of dermatologists’ offices.  My first visit was around the age of 13. Back then it was just your average teenage breakouts–very minor. Maybe some blackheads and the occasional pimple, but nothing chronic at this time.

I started using prescribed creams and cleansers, which worked quite well for a bit.  But my skin eventually rebelled. In high school I transitioned to oral antibiotics–doxycycline/minocycline.  They worked wonderfully on my skin…until I went to college.

Freshman year, out of the blue, my face started breaking out like never before! For the first time I started getting severe, cystic acne. It was horrifying and horrible timing.

I stopped taking the pills and seeing my dermatologist. I blamed the medication. After all the years of treatment, my skin was significantly worse than when I started.  In hindsight it was most likely the result of stress from senior year, graduating, and preparing to leave for college.

After trying every over the counter remedy I could get my hands on, including Proactiv, my primary doctor put me on birth control.

I saw some improvements but I was tired of having my life controlled by acne. Feeling helpless, I went back to the dermatologist a year later. I started taking spironolactone–a blood pressure medication and diuretic that balances hormones and reduces oil production.

assortment of pills for acne pored out

It worked like magic! My skin and self-confidence saw rapid improvements–my face looked 90% better and that painful, cystic acne became a thing of the past. I did get breakouts now and then, it wasn’t perfect, but nothing like what I dealt with before. Spironolactone, along with the Pill kept my acne under control for a little over five years

There was one occasion when I wasn’t able to get my prescription for a week and my skin started to get inflamed all over again. It was scary! According to my dermatologist, it is completely normal for your skin to revert if you stop the medication. And she assured me that I could safely stay on it for as long as needed.

Mind you, while taking spironolactone, yearly blood work is required to monitor your blood pressure and potassium levels, as well as a pregnancy test. It can cause birth defects if taken while pregnant. How safe is it really?

I experienced quite a few side effects that eventually caused me to stop taking it:

  • Low blood pressure
  • Fatigue
  • Muscle cramps from increased blood potassium levels
  • Dry eyes

When my optometrist recommended that I stop taking both spironolactone and the pill to help relieve symptoms of dry eyes, I was terrified. I couldn’t imagine having a repeat of freshman year, when my acne was at its worst.

After doing a ton of research and weighing the pros and cons, I worked up the courage to get off the meds.

I wish I could tell you that everything was fine and my acne never came back…but it did.

Thankfully, it’s not as bad as it was in college. But it’s still a daily struggle. Despite the frustration and the stress of dealing with acne, I have no plans of seeing a dermatologist or using prescription antibiotics.  

Why I Won’t See a Dermatologist

I recently discussed my acne concerns with my current primary care doctor and he asked if I considered seeing a dermatologist or if I wanted him to write me a prescription for an oral antibiotic.  My answer was No. Here are the reasons why I refuse to go back to the dermatologist to treat acne.

Doesn’t address the root cause of acne

According to the American Academy of Dermatology (AAD), the three causes of acne are

  • Overproduction of oil (sebum) by enlarged oil glands in the skin.
  • Blockage of hair follicles by oil or dead skin cells.
  • Overgrowth of bacteria, P. acnes, inside clogged pores.

But what’s actually causing these things?

Why do I have more oil? How are my pores getting blocked?  Why is bacteria overgrowing?

Dermatologists treat acne as if it’s the cause when it’s really the effect.  It’s a sign that there’s an internal problem that you need to address.

So often dermatologists simply attribute it to genetics, write you a prescription and send you on your way.

Or they’ll say it’s hormones, write you a prescription and send you on your way.  

There’s little to no talk of why hormones are out of balance.  Things like stress, diet, gut health, inflammation, toxicity, poor liver functioning and medications all impact our hormones yet are ignored when it comes to treating acne.

I’ve been suffering from poor gut health for years and had no idea (you can read all about that here)! My acne was a symptom of this, but instead of addressing the root cause I let it go for years thinking I had solved the problem when my acne had subsided.

It’s no surprise that my acne came back because the same issues were still present underneath my clear complexion.

You can become dependent

When you have acne it can take a toll on your mental health.  I got so consumed in trying to fix it. It became an obsession that left me feeling really depressed. When you finally find what seems to be the solution, especially after trying so many things, it’s very hard to let it go.

I took pills for acne every single day for over five years with no plans of stopping because I felt like that was the only way to keep my skin clear. I was dependent on the medication not only to manage my skin, but to manage my self-esteem and my self-worth.  And that’s not healthy.

Even when I found out that the medication was having a negative effect on my health, it was hard for me to let it go.

I don’t want to feel like I need a medication for acne, a condition that is not life threatening, at the expense of my overall health and wellbeing.  

Side effects

I discussed some of the side effects that I experienced on spironolactone, but there are side effects for every drug even the topical creams. Chemicals like retinoids and benzoyl peroxide strip your skin causing it to produce more oil and can cause premature aging of the skin.

Oral antibiotics for acne have a long list of side effects, including upset stomach, nausea, sun sensitivity, yeast infection and more. The other problem with oral antibiotics is that your body will likely become resistant to them over time, leaving you back where you started.

We now know that the use of antibiotics of all kinds disrupt the gut microbiome.  Poor gut health has been linked to inflammation, digestive conditions like IBS, leaky gut, and crohn’s disease, autoimmune disease, mood disorders, skin conditions (like acne), and more. Long term use of antibiotics like those prescribed for acne are directly affecting the gut.

A short term solution

Acne isn’t just a random occurrence, it’s your body’s cry for help. Whatever’s going on inside, good or bad, will show up on your skin.  So when you don’t address that root issue, acne is never going to go away, no matter how many creams or pills you use.

Prescribed treatments are attractive because they are easy (just pop a pill or put on some cream) and often faster. But they are a short term fix and may be doing more harm than good.  I want to get off the roller coaster ride and take the time and effort to heal permanently.

I believe that my body can heal without prescription chemicals. I’m willing to be gentle and patient with myself, do my own research, listen to my body, and find a more holistic remedy that addresses the deeper issue that acne is just a symptom of.

I don’t expect everyone to take the same approach as me. And I don’t think there’s anything wrong with seeing a dermatologist. It worked for me in the past and I’m thankful that I was able to find an effective solution when I needed it the most.  

However, I’m no longer focused on just treating acne. I’m working on healing fully from the inside out.

What’s your opinion about acne and the best ways to treat it?

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Jess March 17, 2019 - 11:46 pm

Great read! I am currently going through the same exact situation… However I am 3 weeks into the spironolactone…. I want to say I am seeing a lil results and hopeful to see more…. I agree with combating this with a healthy gut…. I decided to re dedicated my fitness life…. What more perfect.time, while starting the meds.. Hoping to see great results…. Thanks for this great read!

Auriel March 18, 2019 - 12:18 am

Thanks so much for your comment Jess! Glad you enjoyed it! I had pretty good results on spironolactone when I was taking it. It does take some time to kick in fully, maybe 4-6 weeks for me. Definitely work on your gut while taking it, cause antibiotics can really throw off your gut health. Probiotics and fermented foods are great for that. Thanks again for reading and best of luck!

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