_I've been an ITG reader pretty much since the beginning, and while I'm in love with the idea of a simple routine (especially from reading about other people's products and stories here), I've had severe acne for most of my life. There was this huge disconnect for me between 'keeping it natural' with a simplified routine, and at the same time trying to cover all the spots on my face with heavy makeup. I've spent the last year trying to finally get my skin to a good place, and it's been a serious battle. Accutane is the only thing that's worked for me. I'm not a writer, but I wanted to share this story, mostly because Accutane has a terrible reputation (the side effects are severe—the drug has been fingered as the cause of several instances of suicide). For people like me, the options are to either deal with the acne and use tons of makeup to cover its marks, or take this drug and hope that nothing bad will happen.

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—Lauryn Goldberg

I've had acne for 12 years, which pretty much makes me an expert. It started out gradually when I was 13, and by the time I was 17, I was taking Accutane and wearing as much foundation, concealer, and powder as I could to cover the painful (physically , emotionally) bumps on my face. Everyone said what was happening was normal, but nothing my dermatologist prescribed worked. Years went by with very little change. I started to believe that I would never have great skin and decided that no one should ever see me without makeup.

Accutane was the last resort, but it is also the only thing that worked. I didn't see results until month four, and continued to take it for the full six-month time frame until I saw completely blemish-free skin. I battled the extremely drying side-effects by investing in night cream and staying inside to avoid the sun. By prom time my senior year, my skin looked great. I remember being so excited about doing a smoky eye—when you have acne, makeup is not about enhancing your features, it's about getting your face to a neutral place. A clear, skin-colored, matte place. You focus on covering the blemishes, and not attracting too much attention to what lies beneath. I was so stoked about not having to worry about my skin for once so that I could focus on something else.

I had the occasional breakout during my college years, but by my third year, my acne had gone from the occasional spot to so severe that I found myself again wearing loads of makeup to cover it all up. Somehow, I was back at square one.

Before, I rushed to the dermatologist demanding pills and creams, but at this point I wanted to try a more natural approach. I threw all of my old products out and worked on simplifying my routine with gentle cleansers, organic makeup, and skin masks. I saw some slight improvement, but not enough. I came to understand that when you have adult acne, people look at your skin and assume that you have skin problems because you're 'doing something wrong.' For most people struggling with acne, it's much bigger than having the right cleanser or how often you get facials. Hormones, stress, and genetics all play a role and it takes a lot of trial and error to find a successful fix.

Around the time of my 23rd birthday, I had this realization that I had been struggling with acne for 10 years, and worries about my skin were weighing on me every day. Each morning I would inhale deeply, preparing myself to look in the mirror. And after initial inspection, I'd strategize about how to cover and conceal what was happening on my face. It was not just acne; I'd had pimples for so long that my skin was starting to scar on my cheeks. It didn't make sense that I was using tons of makeup to cover all the pimples on my face, while trying to be 'good' to my skin with a minimal-as-possible skincare routine. So I had circled back to that last-resort point. I didn't want to wear makeup anymore, I wanted clear skin.

I lobbied hard for Accutane from my dermatologist. We had a lengthy discussion about how Accutane had changed from when I took it eight years prior. First off, it's no longer called Accutane; what I took is called Absorica. Absorica and Accutane are essentially the same drug, with a minor change. Previously, taking Accutane meant having to consume a large number of calories for the drug to work properly. However, the new-and-improved drug absorbs into your system regardless of how much you eat (hence the name). There were still the required blood work, as with Accutane; along with birth control; monthly visits to my dermatologists documenting my process; and online quizzes (about my mental health and sexual activity). It was a lot to consider. Accutane gets a bad rap, so while I'd tried it before, I was still apprehensive to go another round with the new drug. Side effects include all the fun stuff: depressed mood, blurred vision, joint pain, severe blistering, and rectal bleeding. And that's the short list.

I was on Absorica for five months. The side effects that I'd experienced at 17 with Accutane were manageable, but this time around, they were quite bothersome. I invested heavily in Vaseline and Chapstick, because my lips became dry and cracked within moments of not having a protective layer of moisture. I started using Lancôme Bienfait Multi-Vital Night cream on my face during the day, and by the fourth month, I was putting straight Vaseline on my skin as a nighttime moisturizer—sexy, right? Even with all of this moisture, I constantly had a dry white line around my mouth.

The skin on the rest of my body required a twice-daily coat of Eucerin Intensive Repair Very Dry Skin Lotion to avoid feeling itchy and dry. Absorica made my skin paper-thin, meaning the tiniest impact would cut or scrape my arms, hands, and legs. And then scab over. Fabrics that never bothered me before were suddenly unbearable against my super-sensitive skin.

I took Absorica during the summer, so I couldn't stay outside very long as the risk of sunburn is high and can be damaging. I loaded up on SPF 100 sunblock when I did venture out, and even spent a week in the Caribbean wearing a long-sleeve rash guard with my bikini, complete with baseball hat and SPF lip balm.

When I went to see my dermatologist after the second month, his first comment was that my makeup looked bad and recommended that I switch to liquid foundation. That afternoon, I picked up some Tarte Amazonian Clay 12-Hour Full Coverage Foundation, which worked much better. I stuck with Touche Éclat to cover my acne scars.

Around the third month, I quickly noticed my face transform from a red, blotchy mess to smooth and pimple-free (even if it was extremely dry). Instead of mentally preparing myself for what I was going to see in the mirror each morning, I was racing to get a peek. My face!— I had not seen my skin so clear in years. I was suddenly thinking, 'Maybe I should grow out my eyebrows?!' and considering blush and bronzer possibilities.

After those five months, I'd had enough of the side effects. My complexion had improved drastically, and I was ready to be done. My dermatologist shook my hand and told me that I'd done a great job, and he was proud of me. I teared up when he said that.

I've been off Absorica for six months now, and I wear considerably less makeup than before. Sometimes I spend whole weekends without it. But what's really strange about this entire experience is that most people haven't noticed a difference. A friend of mine recently said to me that she always sees me the same—that once people have an image of you, it kind of sticks. I have to wait six months to go through any laser treatments to remove the scars on my cheeks. Right after I finished Absorica, I was running the laser idea by my dad and he told me, “You know, you don't have to remove every small spot on your body.” He's right. Some scars might still fade, or maybe I'll laser them off, but what's important for me is to appreciate how far my skin has come and the hurdles I jumped over to get to this point. I won't take clear—or mostly clear—skin for granted.

—Lauryn Goldberg

Lauryn is a producer and art director based in Brooklyn, New York. Follow her on Twitter @lauryngoldberg. Photos by Noa Griffel.