I know, you thought we were talking about my acne and now we’re talking about joints and Pilates. This whole thing is an admittedly circuitous way of explaining why at fourteen, I really should have been going to other doctors, but a dermatologist was ultimately the doctor I went to because vanity always won out over health. That said, doctors couldn’t even do much given my self-sabotaging impulses. It’s always been hard for me to go to a dentist, dermatologist, or even therapist because I used to be way more concerned with impressing them than with getting help from them. I remember spending a hilariously long time putting makeup on to go to the dermatologist—the exact person to whom I should have been revealing rather than concealing my facial carnage. I walked in, full face of Wet n Wild with a whisper of Urban Decay eye shadow. As soon as the dermatologist saw me, he quipped, “Oh, you’re going to need to go on Accutane.” In case you don’t know, Accutane is a medication for acne. I was so dysmorphic that I actually thought the centimeter of viscous beige goop was rendering my pimples invisible. This guy totally shattered my denial that three-dollar foundation didn’t instantly erase my flaws like a Snapchat filter.
Once I was prescribed Accutane, I finally felt I had a cure for my insecurity and fear of going outside. The doctor’s office gave me a thick stack of paperwork to sign, which is never a good, well, sign. I was then told I had to get a pregnancy test in order to secure the pills. I was fourteen, wasn’t it obvious that I wasn’t pregnant? Don’t answer that. I went to some other office to get a pregnancy test. The only sex I had really had at this point was the “sex” on the random cruise and in my head with Ethan Hawke, so I wasn’t particularly nervous about being pregnant. Once this was officially confirmed, I was given a second prescription—for birth control, which you have to take simultaneously with Accutane. Not gonna lie, I found it endearing that this medication came with a chaser. It got less endearing when I found out why.
When I picked up the package for my miracle drug at the pharmacy, I expected some kind of pretty, glittery pink box, since that’s usually how the pharmaceutical industry panders to females, but not this one. When I took the package out of the bag, a chill went down my spine. Accutane comes in little booklets, and on the back of each pill is a drawing of a pregnant woman with a red line through it, as if taking this drug while pregnant would cause both mother and child to immediately burst into flames. It didn’t just have one picture of a pregnant woman crossed out; there was one on every little pill satchel, so there’s like thirty crossed-out pregnant ladies. It was as if the pharmaceutical company hired Damien Hirst to design its packaging.
I also saw somewhere in the warnings that you can’t donate blood while you’re taking the medication. That one just felt mean. I had never given blood before, but I still felt robbed that I couldn’t if I wanted to. It felt rude to tell someone that they can’t help other people because they’re too full of poison. Also, if my blood is too dangerous to put in someone else’s body, shouldn’t I maybe not have it in my body? Or maybe somebody should be donating blood to me while I’m consuming this venomous toxin? I got that feeling you have when you get an X-ray and the nurse quickly scurries out of the room to avoid the radiation behind what seems to be bulletproof glass, while you just sit there like a moron getting zapped by it.
The crossed-out dead babies vibe on the packaging should have been a red flag. I mean, the package is literally all red, so it even looked like a tiny cardboard red flag. It was very red, but so was my face, and I couldn’t stand looking at it anymore. I took one of the pills, then started casually perusing the pamphlet of side effects. Usually side effects can fit on the side of the bottle or your laptop screen when you Google them, but this one had so many, it needed its own publishing company. I was new to medication at that point, so I naively read all the side effects, as if they had any bearing on whether or not I’d take the drug. It was sort of like reading a service agreement before clicking “agree.” You’d never have any decent apps if you actually read all the fine print.
The side effects of this drug are borderline violent: joint pain, bone pain, back pain, drowsiness, blurred vision, nervousness, dizziness, headaches, sleep problems, and crying spells. That said, these were all problems I had had before I started taking Accutane, so I figured it might actually be good to finally have an excuse for them.
But there were some that were harder to stomach. Rectal bleeding, for example. Ah, well, I reasoned, I guess I’d rather have a bloody ass than a bloody face.
Hearing loss was also on the list of side effects. That one’s pretty alarming now, but back then I figured that most of what I heard at fourteen was either the word “no” or stuff about y = mx + b, so losing my hearing might actually be a welcome relief.
Another one that didn’t faze me was “changes in your fingernails and toenails.” I had already lost a toenail from running too much, and if my fingernails got jacked up, I figured it was nothing my signature mid-nineties French manicure couldn’t obscure. I basically justified taking the medication by figuring out how to hide any of the impending side effects or rationalizing that I already lived with half of them.
I was told that my skin would get dry for a couple of months, which was already happening due to my scorched earth approach to facial imperfections, but nobody prepared me for the giant sheets of skin that started to fall off my face during school. I’d scratch my face during class and skin would flake off like pasty Post-it notes. I was so embarrassed that I would surreptitiously put them in my pocket, carrying around pieces of my molting face in my pants.
After I had been taking the medication for a month, my headaches got worse and so did my skin. With Accutane it’s one of those “it gets worse before it gets better” deals. For some reason, I feel like you only hear this adage in the medical industry. You never hear a waiter say, “The spaghetti tastes like actual shit at first, but just keep chewing and I promise it will grow on you . . .” or a diet product about which they promise that “after you gain fifty pounds, you’ll be thin as a rail!” It just feels like if it gets worse before it gets better, the product isn’t ready and they should maybe circle back to the drawing board and let us know when it’s actually ready for public consumption. When I brought this to my dermatologist’s attention, he said, “Look, doctors do the best we can with the information we have.” I guess this is why doctors call what they do a “practice” and not “the championships.”