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 Category:  Biographical Non-Fiction
  Posted: November 27, 2019      Views: 68

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Mom of three, grandma of one, literary enthusiast.

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Warning: The author has noted that this contains the highest level of language.
This work has reached the exceptional level
My experience with a disfiguring skin condition
"Face" by pit viper

For most of my life, I have been pretty. Not beautiful; beauty is in the bones. An elegance of the bones in the face and a length and grace of the bones in the body. Beauty is complicated. Pretty is simple. Beauty can be confusing, hard to look at, even as it compels one's gaze. Pretty is easy on the eyes. Pretty is shiny hair, symmetrical features, white even teeth, and smooth skin. I was glad to be pretty, and never really aspired to beauty. I understood it was not in the cards for me.

Aging- a subject about which much has been written- was not particularly difficult for me, because as I entered my forties I continued to look a decade younger than my chronological age. This is down to genetics; I certainly can't claim any credit for it, as my lifestyle has never been the healthiest. Even after the birth of my youngest child at age forty, closely followed by the desertion of my husband for a woman half my age, I continued to draw confidence and comfort from the familiar image I saw in the mirror: a small, pretty woman, pale and slim, with sleek dark hair and a smooth, unlined face. I was old enough to be my son's grandmother- in fact, I had a grandchild older than him- but the world didn't see that when they looked at me. I anticipated a slow, graceful slide into middle age. I made no special effort with my appearance. I assumed I would always be pleasant to look at, that I would always look good "for my age", whatever that age happened to be. Life had not taught me to expect anything different.

Then, shortly after my forty-fifth birthday, something changed. The change was as abrupt as it was unwelcome. I woke up one morning and observed what I believed to be a rash, an allergic reaction, that had erupted overnight, scattering angry red bumps- pimples!- across my formerly smooth pale cheeks. I was disturbed by this, but not overly so. I had other things going on. I was working two jobs, over sixty hours a week, in an attempt to support myself and my son in a city with one of the highest costs of living in the country. I wasn't dating. There was no one who would care about a few pimples on my face, no one but me. And I assumed that, given their abrupt onset, they'd go away quickly. Probably just stress. I slathered them with concealer and went to work.

They did not go away. Over the next few weeks, they got worse. They covered my cheeks, my forehead, my chin, shiny and red, swollen and painful. I cut out one product after another, trying to figure out what I was allergic to. I was embarrassed to go out in public, but I didn't have a choice: I had to work. I told myself nobody cared, but it wasn't true: I saw a difference in how customers treated me. They responded less to my small pleasantries. Their eyes glanced off my face, recoiled from it. They did not smile. They hurried away. I, without realizing it, became more brusque and businesslike. What the hell, I thought. I'm not here to make them smile. I'm here to sell them a goddamn sandwich. I avoided their eyes, so that I didn't have to see them avoiding mine, or worse: see them sneaking glances at my skin, glances full of curiosity, or pity, or revulsion.

I did not have medical insurance. I had lost it when my husband divorced me. I could not afford to go to a doctor, but as my condition worsened week by week, I finally bit the bullet and went anyway, paying in cash. By the time I got to the doctor, there was not a centimeter of skin left on my face that was unblemished. I had counted over one hundred lesions on my face the previous night, before I gave up counting altogether. I could no longer even attempt to disguise them with makeup. It was too painful to put it on. It hurt to move my face.

The doctor wasted no time in diagnosing me: it was Type 2 Rosacea. I was confused. I'd heard of Rosacea, but thought it had to do with rosy cheeks, not these grotesque, oozing pustules. The doctor explained that this was a less-common presentation, a subtype called papulopustular rosacea. He assumed I'd been living with it for years, given its advanced presentation. I insisted that my skin had been smooth as cream just a couple of months ago. No, I'd never had dry skin. No, my skin had never been particularly sensitive. No, I had never blushed or flushed easily. I'd always just been pale. Pale and smooth. Until one morning I woke up, and didn't know the person reflected in the mirror anymore.

The doctor prescribed an antibiotic ointment to be used twice a day. The ointment, in my uninsured state, cost one hundred and sixty dollars a month. I asked my employer for extra hours to help cover the expense.
The prescription ointment at first seemed promising. These lesions, unlike the occasional pimple I'd experienced in my teens, did not follow a predictable cycle where they dried up and went away after a few days. They stayed, or sometimes they seemed to go away but then returned in the exact same spot, twice as angry and painful as before. My entire face, by now, was as red and swollen and lumpy as if I'd collided with a hornets' nest. But with the ointment, the lesions began to dry up a little. The doctor said it could take up to eight weeks to see any significant result.

I shelled out money, I applied ointment religiously. A month went by. Two months. Three months. It was hard to tell if there was significant improvement. Some days, my face was less painful. Occasionally, I saw a patch of clear skin through the festering mass of pustules. But it seemed to me that this only highlighted how bad the rest of my skin was. I resigned myself to the fact that this was as good as it was going to get. There is no cure for Rosacea. It is chronic, and generally progressive. There is only "managing" it. I supposed that was what I was doing: managing it. I optimistically decided that there had been perhaps a 30% improvement since I began the medication. My skin still looked very blemished, like a teenager with the worse kind of acne. But perhaps I didn't actually look diseased anymore... given the looks I'd noticed on the faces of some of my customers at work, I suspected that some of them thought I was contagious, that they didn't want me handling their food. Maybe they thought I was a methamphetamine addict. That's what I would've thought, before, about someone who looked like me. I was clearly too old for a ravaging case of adolescent acne.

I settled into my new life, my new face. I never truly accepted it. I changed. I became less outgoing, less talkative. I never met people's eyes anymore. I tended my face scrupulously, but I did so with my eyes unfocused. I did not want to see the ugly stranger in the mirror. My vision of the future changed. I no longer thought about dating, remarrying. As shallow as it sounds, I did not think I would want any man who would accept me the way I looked now. When I was forced to interact with my ex-husband, I believed I could detect profound relief in his expression: relief that he'd escaped from me before i transformed into this hideous monster. in the face of his young wife- acne-scarred herself, and not nearly as pretty as I had once been- I saw nothing but fascinated disgust.

I threw myself into mothering; out of all the world, only my small son didn't seem to care about the condition of my face. He was too young to be embarrassed by the way I looked. To him, I was just "mommy". He once stroked my cheek and asked me if my "ouchies hurt". My eyes filled with tears. I could not explain to him how much they hurt.

I saw the world differently. When I watched a movie, I could no longer identify with the characters, their trials and travails. They had clear skin. They didn't have to face the world looking like monsters every day. What could possibly be so bad about their lives?

I tried various things, remedies I read about on the internet. I bought manuka honey at the health food store, thirty-five dollars for a small jar, and slathered it on my face, making a sticky mess. I put straight tea tree oil on my skin, causing mild chemical burns. I took probiotics, which caused me to run to the bathroom every five minutes. I'm a born skeptic, and had little faith in any of these alleged "alternative remedies", but I still felt compelled to try them: conventional medicine had failed me by only helping a tiny bit. I could not let go of hope that someday, I'd stumble across something that helped more. This had come on so suddenly, truly overnight, without any warning, that even after a year it was difficult to let go of the idea that it would simply disappear overnight, that someday I'd wake up pretty again, that one morning I'd look in the mirror and see not this red, lumpy-faced apparition but my former self, like an old familiar friend who's been away too long.

Then, eighteen months after my diagnosis, that day came. I was in the drugstore, waiting to fill a prescription at the pharmacy, a prescription for antibiotics for my son's strep throat. My eyes fell upon a display of non-prescription skin cream, an over-the counter ointment that cost eight dollars a tube. I will not say the name of it here, lest this entire story sound like some sort of long-winded advertisement, but the name rhymed with "Rosacea" and the box featured an illustration of a woman's face that looked a lot like mine.

I bought it on a whim. I had little faith that it would work when all the other "alternative" treatments had failed, when even the prescription I was still paying nearly two hundred dollars a month for did so little. But I bought it, and I used it- it was evil smelling, like pure sulfur, although my little boy kindly insisted it smelled like "Play doh"- and the next day, my face was better. Like truly, significantly improved. i thought I was imagining it, but in a remarkably short time- two weeks, three weeks- the lesions dried up and went away, leaving new, pink, raw skin where they had been. I threw out what was left of my nearly-useless prescription ointment and ran back to the drugstore to stock up on multiple tubes of this inexplicably effective eight-dollar cream, terrified they'd stop making it. At first, new pimples erupted to take the place of the old ones, but this new cream dried them up overnight, and before long, no more new pimples came. The pinkness where the old lesions had been gradually faded, and I realized, miraculously enough, that my skin was smooth again. Although it resembles acne, papulopustular rosacea is a very different disease entity, and one huge difference is that unlike acne, rosacea lesions do not generally leave scars.

It has been a few months now since I discovered my rosacea "cure" (although conventional medicine insists rosacea is chronic, I consider myself cured). All of the lesions have gone away, and no new ones have come to take their place. The pink marks they left behind have faded away, and my skin is uniformly smooth and pale once again: the same face I wore for the first 45 years of my life. You cannot tell I ever had rosacea.

But I am not the same person. I do not look at myself or others the same way. My year-and-a-half as an "ugly" person- i mean, a truly objectively physically ugly person- has changed me. I realize now the unearned privilege I've enjoyed throughout my life, all the ways that being conventionally "pretty" made things easier for me. All the times in my life that strangers were kind to me... I realize now that they wouldn't have been, if I had been ugly. I know this because once i became ugly, they were no longer kind. I never, ever would have recognized this, if my prettiness hadn't been temporarily taken away. I like to think the experience has made me more compassionate- I understand too well the isolation and disenfranchisement that individuals can experience when their physical appearance does not conform to societal standards of attractiveness, even if this is through no fault of their own.

I no longer wear makeup every day. I want people to see my natural skin. I am proud of my natural skin, not only because it is smooth and pretty, but because I lost it and then gained it back. Why would i want to hide it under a bunch of makeup now? I'm even proud of the wrinkle developing by the left side of my mouth- my first. It is a smile line. I like to think it makes me look wise and kind.

I will conclude by merely stating that Rosacea is a little-understood disease that affects millions of Americans, generally in early middle-age, but the symptoms vary widely from person to person. For many, it is merely a matter of flushed cheeks. I suffered from a less-common type, and my case was more severe than many will ever become (as i said, the doctor who saw me just weeks after onset assumed I'd been suffering for years). Different treatments work for different people (or not; some cases apparently resist all treatment). I've read reviews of the eight-dollar ointment that miraculously "cured" me (or at least sent me into a seemingly permanent remission). For some, it apparently doesn't work at all. The expensive prescription i used apparently helps some people more than it helped me. I would simply encourage anyone suffering from rosacea not to give up hope, not to stop trying new things. There may be something out there that will work. Many people have overcome the symptoms of rosacea, but the treatments they've used to do so are as varied as the disease presentation itself.

The lesson I've drawn from the experience is simply this: be kind. If someone is ugly, if they have some condition or deformity that disgusts you, that hurts your eyes to look at... remember that inside they are as human as you are, and their condition no doubt disgusts them too. You can still be kind. We must all be kind. Refraining from overt cruelty is not kindness. Smile, make eye contact, remark about the weather, wish someone a happy weekend, and mean it. These little politenesses, these social niceties, these pleasantries make life easier and more manageable, and the loss of them makes one feel profoundly rejected and reviled, even in the absence of overtly unkind behavior. The way we look on the outside is important- I've learned this the hard way, having lost and then regained a face that the world deems acceptable- but what is more important is what we do. I choose to be kind. I will go out of my way to be kind, and I hope it will make some small difference in someone's life. Eye contact and a smile can go a long way toward making someone feel less alone. I hope everyone reading this remembers to be kind, as well. Have a wonderful day.

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