Over the past year I have spent more hours than I care to admit in the offices of various New York City dermatologists trying to cure my acne. I have used nearly every prescription acne remedy available, altered my diet, and followed all of the usual clear skin rules. I've tried obscure remedies too, recommended by other beauty editors and friends. None of it works for me -- or works as well as I would like. It almost feels as though each new treatment has challenged my pimples to adapt and evolve into some kind of acne superstrain.
According to a study featured on the American Academy of Dermatology’s website, acne affects more than 50 percent of women between the ages of 20-29 and more than 25 percent of women between the ages of 40-49. So where do we turn after exhausting our options?
"Typically, people have been through all of the usual stuff and even a lot of the alternative stuff and may have gotten some benefit but not enough," says Dr. Grossbart. "They’re ready to try something that’s frankly more involved, more labor intensive, more expensive, and takes doing much more than the dermatologist who’s got a new cream or a new procedure."
"One of the key components of treatment is focused psychotherapy and looking at how the person’s skin fits into the fabric of their life doing a detailed timeline analysis and detective work around which sorts of things push the acne button for them," Dr. Grossbart explained at the start of our session.
For patients like me who can't visit Dr. Grossbart at his Boston office, he offers to talk via Skype. Treatment typically requires 10-20 sessions, but I wanted to see what I could achieve in just one. I start by detailing my history with acne.
J: Well, it used to be that it fluctuated in and out of clear skin and then bouts of acne, but now in the past year or so, it’s just been acne. So I haven’t had any clear skin time recently, and now what it seems to be, whenever I change up one of my prescriptions, that’s when it again gets worse. It seems to just build on itself the more I treat it.
Dr. Grossbart: OK, I know what you do for a living. What’s your life circumstances, your relationships, your family..?
Most of my time is taken up with writing. It’s definitely an all-consuming thing, writing for online doesn’t stop. I enjoy it, it’s all I’ve ever wanted to do, but there’s not much of a separation between resting and working. It’s not the kind of job where you go to work, you leave, and it’s over.
What is your romantic status at the moment?
In terms of relationship history?
I was in a 6-year relationship that ended in September. I didn’t really have acne during that relationship, but I don’t know if that’s connected.
Well, my antenna is waving in the wind. So no acne, minimal acne during the relationship. Relationship ends, acne goes wild.
Your skin as a loyal part of your mind/body complex, may well be saying, “Hey, we need to protect her from getting hurt.” We can make her a workaholic, that’ll help. If she never gets away from work, she’s less likely to end up with some other prick. And number two, if her skin looks far from its best, she’s gonna be out there feeling less confident, less attractive, etc., so that’s gonna keep her out of trouble.
When this sort of mechanism is going on underneath, the most high-tech, otherwise effective medical treatment won’t touch it. These sorts of sight dynamics can put the brakes on everything -- massive doses of Accutane, the heavy guns of dermatologists, maybe its not gonna fight skin that’s saying, “Hey we’ve gotta protect her.”
Dr. Grossbart's theory certainly resonates. I look back at pictures taken during my 6-year relationship and see only spotless skin. He recommends a range of techniques to combat my acne and reclaim my pimple-free relationship skin, namely learning how to go into a state of focused concentration. It’s a form of mediation, relaxation and self-hypnosis, as a way to buffer skin from stress.
"There was a study run in Texas, where they had people using their usual benzoyl peroxide as a control group, and then they had people using the benzoyl peroxide and the imaging techniques in conjunction, and found that people got a lot better results out of same medication when combining it with the imaging," explains Dr. Grossbart.
When our session ends, I don't schedule another one. Dr. Grossbart's approach to acne treatment intrigues me, but meditation isn't something I'm able or willing to incorporate into my life.
Instead, I return to my dermatologist Dr. Anne Chapas who Olivia jokingly refers to as my therapist. She adjusts the dosage on one of my four acne medications and I hope -- as I always do -- it will be the antidote that finally erases the pimples Dr. Grossbart believes are protecting me from getting close to someone new.
Follow Julie on Twitter @JR_Schott.