Good day Dr. I’m a black 15 year old and I live in South Africa. Last year, I was diagnosed with PCOS and I’m currently taking Spironolactone. My insulin levels have been stable for the last 2 months. I also have facial hair due to the aforementioned PCOS. I had my first laser hair removal session a month ago. I have many skin problems which I will outline below. I have very dark joints and my face and neck are at least 3 shades darker than the rest of my body. Basically, I have an uneven skin tone all over. (My belly is a shade darker than my chest and my back and bum are 3 shades darker too). There is no consistency to my complexion. I have seen several dermatologists (11 to be exact) in the past two years and none have helped with my condition in the slightest. I have been prescribed hydroquinone at different percentages (4% to 6%) but it has not helped. I don’t think I have ochronosis because I did not use the HQ cream for more than 3 months at a time and my skin has not I have even sought the help of a dermatologist online who advised a 0.5 percent retinol product which did nothing for my pigmentation although it made my skin softer. My uneven skin tone is my main concern. My second biggest skin concern is my stretch marks. I have had them since I was 9 and I fear I may never be able to get rid of them. I have had a few carboxytherapy treatments but they did nothing. They cover a considerable amount of my body. The ones on my hips, bum and arms are very thick, raised and dark. Almost like a hypertrophic scars. The ones on my inner thighs are pitted. I also have chicken pox scars on my whole body which are not pitted but are dark. I have had these since 2014. I have been depressed because of these skin issues and I have not had even one friend in 5 years because of this. I left school in June and I hate my life. I spend my days in my bed just looking for treatments for my ailments. I have been teased severely. I have not worn a swimsuit in three years! I have not worn a skirt in two years. Please help me. I cannot even attend my brother's soccer matches. I haven’t left the house in 6 months. Not even to the grocery store. I have been admitted to a mental hospital twice in the past year for suicide attempts. I wish for a better quality of life. I am tired. I desperately need it for myself and my family. Please help me in any way you can. Any advice would be helpful. Thank you for taking time to read this long message.
First… thank you so much for reaching out. It’s really hard when serious skin issues are getting truly in the way of living a full life. Our skin is SO visible. Other people forget that it’s tough to hide and many start feeling isolated. Please don’t give up here!!! There is hope and the chance to change your situation. Your mental health is the most important thing! Solutions first lie in getting your depression treated! If you don’t have one, please find a great, really great psychologist or other mental health professional who can see you at least weekly. You have so much to be proud of. You’ve navigated, more than many grownups, a complicated health care system. You are resourceful and articulate, and you have a voice that’s clear in your writing, and could help others. You are 15, and your hormones, personality and brain are still evolving…. a lot. And you have a purpose in this world, you just don’t quite know it yet. Please reach out to others… both to help those with similar problems… and to get help.
Here are some ideas:
- Can you find a skin centered support group online where you can converse and share stories and experiences?
- Is there a University center with maybe more diagnostic capability where you could be seen and have a group of dermatologists help you. Sometimes they call this Dermatology Grand Rounds. I know you have PCOS, but that doesn’t mean another diagnosis might not have been missed.
- Can you look at other family members? Do any others in your family have these issues? If so, a genetics clinic may be helpful.
- Please find a good therapist! He/she may be able to help you find a support group too.
- Look for ways to help others with skin conditions or other problems. You are clearly intelligent and resourceful. You can help others with those qualities.
Everyone’s’ heart goes out to you and wishes you well. Please write back and let us know how you are doing in a few months! None of us need to be perfect in any way. These challenges you are facing, when you overcome them, will give you a special place in the universe, and a special empathy for others. That’s priceless.
I hope this helps,
Dr. I
