I Popped Pills For Clearer Skin

Photographed by Tory Rust.
I remember certain things about puberty vividly, like shaving my armpits for the first time while my family waited downstairs impatiently before a trip to Florida. I remember my mother talking me through tampon insertion from behind the door of my bathroom, since I refused to let her in. But, for the life of me, I cannot remember my first zit. The inflamed red dots that scattered across my forehead and chin have always been a part of my life, like the perfectly round birth mark on the inner corner of my right eye. I have always had acne, and it's always been pretty bad. Or, at least, I thought it was bad.
In my teen years, I tried every possible regimen, from Stridex pads to Proactiv. When I was 18, I even convinced my mother to let me go on birth control to keep the zits at bay. But nothing ever worked for very long, and eventually, I just accepted my acne as a part of me. I stocked up on hella foundation, and figured it would go away once my hormones weren't as crazy-active.
Then, one day, I woke up and I realized that I was 25 and still had shitty skin. And I was fed up with it. So I made an appointment with Sejal Shah, MD, whom I now consider my skin fairy godmother because she was 100% no-bullshit. "I'm fucking sick of having acne," I told her in her office on that first day. She replied: "Well, I can give you a topical. But if you really want to get serious, I can give you an antibiotic." I looked the good doctor straight in the eyes and said, "I'll take the drugs, please and thank you."
Adjusting To Doxy
Dr. Shah wrote me a script for doxycycline, a medication that would come to dominate my conversations for the next few months. "We prescribe doxy to patients who have inflammatory acne, meaning red bumps, pus-filled bumps, and cystic bumps," she said. "It's an antibiotic, but it also helps with inflammation, which is why we prescribe it to these patients." (Fun fact: They also prescribe it to people with chlamydia.) Considering the fact that my chin was littered with little, white, pus-filled bumps, I'd say I was a good contender. Along with doxy, she prescribed me a topical retinol to use three times a week at night.
The first couple of weeks were hell. I'd wake up every morning, expecting my skin to look better, but the zits persisted, and even got a little worse. The pinnacle of terror came during this photo shoot for the site. I took one look at my pictures, and felt my stomach drop. I begged my photo editor to photoshop my skin so I didn't have to be on the Internet looking like a teenager.
When I got back to my desk, I burst into panicked tears. "It's not working," I exclaimed to Phil, our former senior editor, through sobs. "My skin is getting worse and worse." He looked me in the eyes and delivered a no-holds-barred truth bomb that I still love him for. "You need to relax and remember this is a process," he said. "You're healing. Your skin is healing." He was right. There were still zits on my face, but every day it was getting a little better. (I have to say, thankfully, wine saw me through it all: Since doxy is an antibiotic, you're not really supposed to drink while you're on it, so I initially gave up booze...until I remembered how much I love wine. Thank god Dr. Shah told me it was fine.)
As the weeks wore on, I became hyper-aware of my skin. I took a good look at my skin-care regimen, and stripped it down to the basics. Now, I just use cleansing balm, serum, and night cream in the evenings; and an exfoliant, the same serum, and face oil in the mornings. That stuck.
After two months, Dr. Shah suggested I switch to a lower dosage. "Most people do a full 12 weeks, and I cut their dosage halfway through," she explained. My skin had cleared up considerably in that time — my skin-tone was more even, and I was able to walk out of the house in just sunscreen and concealer, which was pretty life-changing. But since I still had a few breakouts on my back, I balked. "Maybe just one more month on full-dosage?" I half-pleaded. She relented, and I refilled my prescription.
Side Effects
That night, I popped my pill right before bed and fell asleep. Five hours later, I awoke to a hellish sensation under my sternum. It felt like the pill had lodged there and was radiating heat. "I'm dying!" I yelled to my empty studio apartment. "I'm fucking dying!" I was not, in fact, dying. I did, in fact, have some gnarly acid reflux — something I'd never experienced before. Turns out, doxycycline can cause heartburn if not taken immediately after a meal — or if you lay down within an hour of taking a pill.
"I think the most concerning side effect, however, is that it can make you photosensitive," Dr. Shah later said. I saw some of that, too. No matter how much SPF 50+ I slathered on, I still managed to turn a lovely shade of pink if I spent too much time in the sun (or forgot to reapply every hour, on the hour). So, during my cycle of doxy, Cool Mint Tums and Avène SPF 50 became my constant companions.
But I am happy to report that my skin has never looked better. I feel more confident about myself than I have in ages. If I do break out (and I can count on one hand the number of zits that have cropped up since I started the meds), the blemish is gone within a day. I've also come to worship my skin-care regimen. I'm not rushing through it or just relying on makeup wipes to take off my face at night. It's a ritual. It's what will keep my skin clear after I stop taking the drugs — which I'm planning to make a life mission.
Dr. Shah sees me phasing out the drugs in the next few months, and it remains to be seen whether my acne will come back after I'm done. "It varies person to person," she said. "Some have the occasional recurrence, and they have to go back on the drugs for a short time. But the goal is not to be on an antibiotic forever. If, after a few tries, it doesn't work, other routes will be explored." I, however, am confident that my skin will stay clear. With my newfound regimen, and the retinol I'll continue to stay on, I'm in a pretty good place.
Would I suggest doxy to someone else? In the immortal words of Mr. Big, "abso-fucking-lutely." I may not remember when I got my first zit, but I will never forget the moment I decided to get off my butt and do something about it.

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