First-World Problems: My Trip to the Dermatologist

Perhaps it’s a vanity that comes with being 30-something. I’ve noticed some scarring (hyper-pigmentation) on my chin and neck from years of cystic acne. It only flares up once every few months, and when it does, it’s painful. What I went to see the dermatologist about, a week ago, was to get a cream to make these scars a little less noticeable.

I hadn’t been to this particular dermatologists office before. The last time I saw a dermatologist, it was to get an annual mole screening, since I’ve been taught to keep an eye on them. I’ve not been to a dermatologist for cosmetic reasons since I was a teenager, and I don’t remember getting anything that particularly worked.

From the moment I stepped into the waiting room, I felt inadequate. Surrounding me were ads, brochures, lists of options for letting me know that though SOME women were OK with wrinkles, brown spots, discoloration, etc, I didn’t have to be. WHAT A RELIEF! Wait – I think I was OK with some of these things before… HUH? I could tell that this was going to be an interesting visit.

The dermatologist, who talked to me as if she had just slammed 3 cups of coffee (or was hypomanic, or on amphetamines), went down a list of possible medications to give me to solve my problem (which she identified as the cystic acne, which is an every 4 month problem, not the scarring, which is more every day). The options ranged from systemic antibiotics, a heart medication that suppresses androgen hormones (with possible nasty side-effects), another medication that is proven to cause fetal abnormalities and requires 2 clear pregnancy tests over about 6 weeks to be prescribed (I could buy a gun faster than I could get prescribed this medication), and finally, Retin-A, which causes drying, some sun sensitivity, but to many is the holy grail for its anti-aging and acne-curing properties.

None of these addressed my scarring – but I found out, at the end, that I could get a free consultation with a nurse on cosmetic laser treatment, which, I’m told, is expensive.

I thought to myself – do I want to take anything systemically that has potentially more risks than benefits? I am not disfigured. My acne scarring is barely noticeable to others.

These are first world problems.

There are Americans like Heidi Montag who risk their lives for cosmetic procedures. While the risks may be not as great for some of these systemic medications used to control acne, I find it odd to be so cavalier about the risks when the problem seems to be more of an emotional one than a physical one.

I will concede that there are dermatological issues of the first world where the benefits of treatment may outweigh the risks (I know that psoriasis, for instance, can be painful, though the treatments can also have many physical risks.)

When we talk about health care reform, I think we have to talk about the choices we make between necessary and unnecessary treatment. Just because we have a medication available for it, doesn’t make it a disease (hypotrichosis of eyelashes?!) Big Pharma is an enormous industry. Frankly, so are neutraceuticals. We are over-treated. To quote the Dr. Bronner’s Peppermint Soap bottle:

Enjoy only 2 cosmetics, enough sleep & Dr. Bronner’s ‘Magic Soap’ to clean body-mind-soul-spirit instantly uniting One!

I don’t endorse Dr. Bronner’s soap quite so much, however, truly – enough sleep will do wonders. I do, however, like the idea that maybe we worry enough as it is. Maybe we’re good enough, as is. Maybe all we need is a nice bath, good amount of sleep, and just living our lives.

Walking into the dermatologists office was just like turning on the TV. Someone was trying to sell me something, and they were doing it by making me aware of an inadequacy I didn’t know I had, and offering a solution to that. It’s like how “halitosis” was invented to sell Listerine. A friend of mine described her current field of study (pharmocology) as the study of signaling pathways in the body. The idea is to find a pathway, patent and sell it to a company to make a medication based on that pathway. It’s got to be good for something, right?

Maybe we have it all wrong. Instead of searching for the solutions to problems we don’t know we have, maybe it’s time just try to enjoy the limited time we have on this earth without falling prey to the commercial anxiety.