This Is How Much It Costs To Have Cystic Acne In Chicago

Welcome to Beauty Diaries, where we’re tracking how much money people actually spend on their beauty routines. Whether it’s rooted in self-care or self-expression, they explain, in their own words, why it’s worth every damn penny.
Today: A school counselor in Chicago breaks down the yearly cost of treating her cystic acne.
Age: 27
Occupation: High School Counselor
Location: Chicago, IL
Salary: $140,000. My husband and I have 100% combined finances. We got married just weeks after we completed graduate school, therefore neither of us had any money to our name. In order to survive, we needed to combine forces. We look at money as “ours” versus mine and his. Unfortunately, he sees every beauty-related expense and asks about each one! When it comes to my acne, however, he is pretty understanding about costs since he has seen me go through the trials and tribulations of what works for my skin over the course of our nine-year relationship.
Rent: $3,100/month
Insurance: $480/month
I had acne from the moment I hit puberty at 12 years old. My mom was on Accutane as a teen and has dealt with acne her entire life, so she was especially sympathetic. She took me to a dermatologist right away who gave me topical creams that I started using nightly. At this time, my acne was very surface level — lots of small little pimples, mostly on my forehead. I continued to struggle with acne all through my teens and into my 20s, but it wasn’t always constant or the same type. I found that my acne usually responded to new medication fairly quickly but would always get somewhat “desensitized” to the product and eventually come back, leading me to search for something new. My dermatologist eventually put me on birth control at 14 which seemed to really help for a good 10 years.
Then, on the day I turned 24, cystic acne welcomed itself into my life. Growing up, I had a cystic pimple or two, but this was completely different. Every single pimple I had was on my chin, specifically on the sides directly under the corners of my mouth. There was a time during 2015 and 2016 that I always had an extremely large cystic pimple on my chin, and if one wasn’t visible, it was brewing just beneath the surface. Each pimple would last three to four weeks and as soon as I could tame that beast, another one would pop up in its place. It was a long cycle of embarrassingly large and painful cysts that I believe were completely hormone-related due to their location on my face.
Since I had been going to dermatologists for so long, I assumed that they would always have a quick fix for me. Not quite. I tried three different derms, who all continued to give me the same acne prescriptions that worked in my teens, but had little to no effect on my adult acne. Each time I switched doctors, I told them the medications no longer worked for me, and each time they told me I had to be using them incorrectly and to try one more time. I have come to dislike going to the dermatologist because I feel like I'm never given enough time to fully explain my situation before being hurried out so they can take the next patient.
Ultimately, my gynecologist put me on 50mg of spironolactone. We have a relationship outside of the office, and I was able to call her and vent about my bad luck with other topical medications and treatments. I typically get a 90-day supply with each refill and my insurance fully recovers it. I can say with full confidence that this medication has been a miracle worker for my skin. I was seeing a derm two to four times a year since I was 12, typically having to pay a $50 copay. Since starting spironolactone, I haven’t been back for my acne. $105 for 90 days, covered by insurance. $0
Morning Routine:
I use the Clarisonic Mia 2 Skin Cleansing System ($169) and First Aid Beauty Facial Cleanser ($20) while in the shower to wash my face. Immediately after getting out, I put on First Aid Beauty’s Hydrating Serum ($36) and Coconut Smoothie Priming Moisturizer ($28) because I do my makeup fairly soon after. One of my main problems was always that my skin was very dry, however I couldn’t find a product that wouldn’t worsen my acne. I was lucky enough to get sample sizes of all the First Aid Beauty products for a birthday gift and they immediately worked for me. I get the moisturization I needed without the breakouts.
My one qualm with FAB is that they make their products in such small sizes. I typically go through the face wash, serum, and primer within 90 days. I also bought replacement brushes for the Clarisonic ($44).
Total: $549/year
I feel like I have tried every foundation out there, but I've ultimately settled on Clinique Beyond Perfecting Foundation + Concealer ($28) for a couple of reasons: It blends well when I have dry spots from topical treatments, it comes in my shade (I'm very pale), and it doesn't cause breakouts. One bottle usually lasts me about nine months.
I have also mastered the acne-masking technique of color-correcting. A light green spot treatment concealer is one of my saviors for hiding a large, aggressive pimple. The Sephora Collection Bright Future Color Correction in Green is $14 and I haven't had to replace it yet since I use such a small amount.
My favorite standby concealer that I have been using since high school is Benefit Cosmetics Boi-ing Industrial Strength Concealer ($20). A pot lasts me about a year.
Total: $90/year
Night Routine:
My night routine is fairly similar to my morning. I use Cetaphil wipes ($12 for two-pack) before my cleanser because I've found they're one of the only wipes that remove both makeup and dirt. I use the First Aid Beauty serum again at night, followed by Cerave moisturizing cream ($10) for heavier hydration. If I have a pimple, I use Mario Badescu Drying Lotion ($17) to spot treat.
One ounce of the Mario Badescu lotion typically lasts me a good year or two (or until I spill it) and the Cerave tub is huge and lasts well over a year. I buy the Cetaphil wipes in a two-pack every month.
Total: $171/year
Special Occasion:
I typically don’t get facials because my skin does not react well to the products used, but I got three chemical acne peels every two weeks leading up to my wedding. Each was $150, but my insurance paid for $80 and I had to pay $70 out of pocket.
I also got one cystic pimple on my chin injected with corticosteroids — it was gone within six hours. $20
Total: $230
Yearly Total: $1,040
My skin is doing great after a full year of consistent use of spironolactone — I cannot not emphasize just how much I love this drug. There is one side effect that is fairly annoying, but to me, it's worth it for clear skin: I have to pee all the time. I've talked with friends who are also on this medication and we joke that we have the “Spiro Pees.” When I first started taking it, I had to get up in the night a couple of times to use the bathroom, but it's not as frequent anymore.
However, if I forget to take my spironolactone for one day, a cystic pimple immediately pops up on my chin. I am a slave to the spiro! Still, after finding the right medication and products to use on my skin, I am so relieved to finally be on the right track.
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