The Hardest Acne Case in 40 Years – And How I Finally Won (With My Sanity Intact)
Let me tell you about the most impossible acne case of my career. And I don’t say that lightly. I’ve seen breakouts that looked like modern art. I’ve seen pimples so aggressive they should have their own zip code. But this one? This one was special.
She was a teenager in distress, and when I say she had tried everything, I mean everything. If there was a new treatment, she had already been on it. If there was a famous dermatologist on Park, Madison, or Fifth, she had been in their office. If someone in NYC was whispering about a new acne cure in a back alley, she had probably tried that too.
The list of treatments? Chemical peels. Lasers. Topical steroids. Antibiotics. Injections. Light therapy. Diet changes. Prayer. She might have even rubbed a rabbit’s foot on her face at one point. But her acne just sat there like a smug little villain, laughing in the face of medical science.
Now, I take pride in my thorough history-taking—I don’t just ask, “What have you used?” I interrogate like a detective in a 1950s crime movie. I even start sentences with, “Now tell me the truth…” And yet, despite all that, something was missing.
I put her on my best regimen. I expected results. And, sure enough, she got 50% better. Her mother was thrilled. But I don’t do halfway dermatology. I don’t want kind of clear—I want clear like a freshly Windexed window.
So I went back to the case file. Something wasn’t adding up. And then, weeks later, the truth slipped out like a plot twist in a bad soap opera.
She had been on tetracycline for YEARS.
I almost fell off my chair. The mother, lovely as she was, forgot to tell me. Just a tiny little detail—like saying, “Oh, by the way, she’s been drinking the same antibiotic like morning coffee since middle school.” No big deal!
Well, that changed everything. The acne wasn’t just stubborn. It was antibiotic-resistant. The bacteria were basically Arnold Schwarzenegger in Terminator 2.
So I did something I almost never do. And when I say never, I mean I can count on my fingers how many times I’ve done it in 40 years. I pulled out my last-resort weapon: Bactrim.
Now, let me be clear: Bactrim is no joke. It can have serious side effects—kidney issues, allergic reactions, sensitivity to the sun. It’s like a loan from the mob—you only take it if you have no other options, and you better respect it. But in rare cases, like this one, when all else fails, it works.
And, sure enough, it worked like magic. Within weeks, her skin finally surrendered. The breakouts retreated. It was like the Berlin Wall coming down—but for acne.
Fast forward 20 years. She’s back in my office—but this time, she’s got a husband, kids, a whole life. And guess what? No acne. Not on her, not on her kids. She brings her whole family to me now, and every time she sees me, she laughs and says, “Remember when I was your hardest case?”
Oh, I remember.
And to this day, I still count on my fingers how many times I’ve prescribed Bactrim. Because when it comes to acne, you fight smart—and if you’re lucky, you win.
|
| DR GARY JAYNE ROTHFELD |
