Woman With Acne Shares Incredible Two-Year Journey: ‘Taken So Much Joy’

Acne is the most common skin condition in the United States and its effects can be devastating. However, successful treatment can be hard to come by.

“I have had problems with my skin for as long as I can remember,” Pien van de Haar, 18, from the Netherlands, told Newsweek. “When I was around 13, I started getting pimples. It was not very extreme but my classmates regularly commented on my skin. By 16, my acne had become extreme. My skin was constantly inflamed and red. I was in so much pain and I was covered in scars. When people looked at me, they saw my acne before they saw me.”

She said: “I often got unsolicited, unhelpful advice, such as ‘wash your skin’ or ‘put cream on it.’ My mental health got worse as my skin got worse. I had gone to the doctor and was prescribed several things—ointments, gels, antibiotics. Nothing helped. I was unhappy.”

Acne affects up to 50 million Americans a year, according to the American Academy of Dermatology, and is often the first thing people notice about a person’s appearance. In a study published in the Medical Journal of Malaysia, 76.1 percent of respondents reported that acne was the first thing they noticed when looking at images of people, compared to 24.8 percent noticing that the skin was clear first.

In a brave decision, van de Haar decided to document her journey with acne on TikTok, taking a short video of her skin every day for two years.

“I started filming the TikTok videos on November 22, 2021, when the inflammation of my skin was at its worst,” she said. “That was the day I started taking isotretinoin, known by its brand name Roaccutane. I just wanted to capture my progress. I hoped that from there things would get better.”

Describing it as a “last resort” van de Haar tried everything else before she was eventually prescribed Roaccutane.

“I wasted so much time and money on skincare before I finally went to my doctor, who prescribed various things including Differin gel (which contains adapalene), Tretinoin cream and Erythromycin tablets, none of which worked. I was eventually sent to a dermatologist, who started me on my Roaccutane journey on November 22, 2021.”

Isotretinoin is a retinoid drug that is part of the same family as vitamin A and is the strongest treatment available for acne. “There is nothing else in the world that comes close to being this effective for severe acne,” according to the American Osteopathic College of Dermatology (AOCD).

It inhibits the production of sebum, the oily substance produced by the skin. It also reduces the production of keratin, the outer layer of the skin which can block pores, reports the British Association of Dermatologists (BAD).

Due to its potency and potentially extreme side effects, including evidence for mood changes and a wide range of physical effects, doctors prescribe it with great care, and regular blood tests are necessary. Isotretinoin can cause severe birth defects, so if women are not on birth control, they will also need to have regular pregnancy tests.

Less than one percent of people of Roaccutane report feelings of depression and thoughts of suicide, according to the AOCD. Roaccutane “has been reported to cause depression and thoughts of suicide, though a recent study has not shown any correlation,” AOCD reports.

“I was informed about the dangers of Roaccutane from the first appointment,” said van der Haar. “My dermatologist told me about the requirements (good blood values and not being pregnant) and I was informed about the side effects.”

After 480 pills, van der Haar completed her prescription in October 2022.

“Dry skin, rashes, dry and chapped lips, fragile and red skin prone to burning in the sun, back pain, headaches, muscle pain, drowsiness, nosebleeds, sore throat and nose, whole body itching and a worsening of my acne were all symptoms I experienced at first,” shared van der Haar.

“Take Vaseline with you everywhere you go, wash your pillowcase often, keep your skin moisturized and wear sunscreen every day,” she advised anyone thinking of taking the medication.

Despite the side effects, the medication did clear van der Haar’s skin.

“After completing the medication treatment, my face was soft and clear (a little scarring was visible),” she said. “I was so relieved. I was confident and happy.”

Roaccutane is successful in clearing the acne of approximately half of those who take it, according to the AOCD, “so that they never need to do anything else for acne. In the first few weeks of treatment.”

Sadly, van der Haar was in the unsuccessful half of Roaccutane patients, and a few months after finishing her prescription, her acne returned.

“Acne has taken so much joy from me,” she said. “I spent so much time and money trying to get beautiful skin. Now that my acne is coming back, it feels more and more hopeless. Every day, several times a day I think about my skin.

“Because of my bad skin, I avoid being in photos. I only feel pretty with make-up on. I’ve spent a long time being angry at my parents for giving birth to me with this problem, and I have cried a lot. I am always jealous of people with clear skin.”

She said: “For those struggling with acne, I know it’s unfair. I know you don’t always feel confident. But you are so beautiful. Try what you can to improve your skin because it will help, but know that you are beautiful on the inside and if you treat those around you with love, people will see your beauty too.”

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