updates: the acne, the client apology, and more

Here are updates from four people who had their letters answered here in the past.

1. Could my acne be keeping me from getting a job? (first update here)

I can’t say much without giving too many potentially identifying details, but I learned that our turnover is absolutely insane. We have lost several people already this year, which added to my stress as it completely changed my role. I did finally get to see my GP and he prescribed me some ointment…which costs 100 dollars with insurance. I absolutely can’t afford that right now, especially with other potential health pitfalls on the horizon. Maybe in a few months I can revisit that.

The progress I had made with my skincare routine is gone. My acne is actually worse than it was before due to the stress. My face hurts from it, and it’s been noticed and commented on. It’s completely embarrassing.

I wish I had a better update. I’m taking steps to gain licenses I need, so maybe I’ll be in a better spot soon enough. Thanks again for all the kind words and advice from before!

2. Should I be recording this work as overtime? (#4 at the link)

I wrote about my habit of working 30 minutes to an hour a few nights a week even though I was non-exempt. I think it was mostly that I was pretty busy and often stressed at work and it was kind of an indulgence to let myself do some tasks while relaxing in bed rather than in the middle of a busy day. But your answer and the comments helped me realize that it didn’t make sense to do work I wasn’t putting on my timesheet. I also realized that a better way to deal with stress would be to leave work at work and try not worry about it. Now the most work I do at home is really quick 3 or 4 minute to-do lists just to get work thoughts off my mind before sleep.

I also wanted to note that I was mistaken in my description of my organization’s overtime pay. I said we could take overtime time and use it as comp time later and you pointed out that was illegal unless the comp time was used within the same work week. I double-checked our handbook and it does say the comp time has to be used within the work week. I never exercised that option so I misremembered. I didn’t want to incorrectly throw my anonymous employer under the bus.

Thanks for answering my question, Alison. Your blog has been a tremendous help through graduating college and landing my first job. Happy holidays!

3. My boss made my coworker apologize to a client

So just an update! In the months since the letter, my boss got more and more wonky–for instance, she decided she needed to be on *any* external email I sent out, regardless of the content or project. Another example–that coworker (Arya) that my boss made apologize? My boss made Arya attend a remedial writing seminar ( e.g., “how to write a letter”) despite the fact that she has a graduate degree and is appropriate and polished in her professional communication. (The seminar instructor was flabbergasted that Arya was asked to attend, after reading her in-class work.) It’s clear to me that exerting control on little things–like emails–is how she tries to stay relevant and “manage” work.

I interviewed for a position with an agency I’d been working on projects with occasionally and was offered the job. I’ve been in that position a month, and it’s awesome. Great to be in an organization where good ideas and good people are supported.

4 I don’t think I want to come back from maternity leave (#3 at the link)

Well, I had my baby, and I’m now a stay-at-home parent for the time being. It’s not ideal and I feel like I’m going a little crazy sometimes, but is the best choice for our family right now.

Something I didn’t mention in my original post is that I also have a preschooler who was also in full-time time. My husband and I did the math, and having two children in daycare would actually result in a net loss of income. Even given that fact, we could have made it work, but I didn’t feel like the sacrifices were worth it because my job wasn’t a great fit and it was making me pretty miserable outside of work: it was a struggle getting anything done at home and I barely spent any time with my kid on weekdays. I just couldn’t justify having two kids in care almost 10 hours a day so I could spend that time doing work I disliked and wasn’t necessarily aligned with my career goals.

Even so, I ended up waffling about going back for most of my maternity leave but as my return date got closer my anxiety levels were creeping up higher and higher. I finally called my HR rep and explained the situation and that I didn’t really want to return. Because of my org’s strict guidelines about interacting with employees who are on FMLA, I was not able to speak to my manager directly, and had to submit my resignation letter to my boss via email. I had spoken to her about the fact that there was a strong possibility I wouldn’t return before I left, but I still feel like I kind of burned that bridge, unfortunately.

I don’t want to stay at home forever, but I’m really enjoying the opportunity to spend so much extra time with my baby. I worked full time after my first was born, so this is a new experience for me. I’m also working hard at maintaining and cultivating professional connections to put myself in a good place for when I want to return to the workforce. I’m actively looking for some small freelancing gigs, but I’m taking my time to look for opportunities that fit with my schedule and constraints.

This experience has also allowed me to really clarify what my values are: I really do value time with my family over more money, and I would rather take work that is less prestigious if it allows me more flexibility.

Overall, I think I’m making the best of things, and I know staying at home isn’t forever, but I’m happy with it for now.

{ 120 comments… read them below }

  1. The Foreign Octopus*

    Thanks for all these updates, Alison. They were a nice surprise.

    And thanks to the OPs who wrote in as well!

  2. Jill*

    OP #1, call your Dr and let her know you can’t afford the cream and she can probably help you out. It’s very likely she can prescribe something else that’s cheaper, and some samples, or has a discount card from the drugmaker. Don’t just give up!

    1. yasmara*

      The insurance cost of the cream prescribed by my dermatologist was something like $255 with insurance for a 1-month supply. With the manufacturer discount card? $35. And I discovered that the “1 month” supply is really more like 6 months for the way I use it.

      1. AMT*

        I work in a hospital. It’s super common for us to have coupons available to uninsured or underinsured patients. There are also prescription discount cards/apps like GoodRx that might provide better savings than your insurance does.

    2. MsMaryMary*

      I was also going to suggest trying to get samples from your doctor. In my experience, it’s very common to get samples for dermatologic drugs.

      You can also try the website GoodRx.com. It’s a great resource for finding lower cost prescriptions, whether it’s through coupons or discounts or going to a cheaper pharmacy.

      Good luck, OP! I’ve struggled with my skin for a long time and I very much sympathize with your situation.

    3. Green*

      SECONDED. Yes, please tell your doctor that you cannot afford the medicine! Also, search for the drug or the drugmaker and “patient assistance program” or “co-pay assistance.”

      If there is nothing less expensive, you can also specifically ask for samples so that you can see if the product works for you before spending money.

    4. Azzy*

      Or try Accutane. It’s known to work when nothing else does. I’m not sure about the cost of it in the USA, but it’s much cheap here where I’m in Europe.

      1. Gen*

        OP please be sure to check all the side effects of any medication you’re offered for your skin, some (like Accutane) can have psychiatric side effects and if you’re already feeling low and stressed about non-skin stuff you might decide that’s not a risk you’re willing to take. I wish you all the best and I hope you can get into a better place with everything soon!

        1. Triplestep*

          I was also going to suggest accutane with similar caveats. My son finally went on it as a last resort after having struggled with painful breakouts which started in his early twenties. (Great skin all through the teen years, go figure.) I was really nervous after all I’d read about the side effects, but it did work well for him with only the basic physical accompanying issues. (Dry lips and skin). For it to really work, he did have to stay on it longer than his doctor first predicted, but once he was done with his treatment you’d never even know he’d had the problem skin.

          Good luck; I’m glad you wrote back in. Please keep us posted.

          1. Bigglesworth*

            Accurate worked well for my sister (she was starting to have cystic acne). However, my husband was also on accurate for cystic acne and ended up having liver issues and had to be taken off of it.

        2. copy run start*

          I’m currently trying Accutane because being 30+ with acne is just not acceptable…. though I long since gave up on concealer and medicated creams and washes because it just irritated my skin more. (My normal routine is a gentle cleanser and then moisturize with petroleum jelly. Anything more and my skin goes into rage mode.)

          I am in the US. I was only given Accutane on condition that I continue my weekly therapy visits (history of issues). Also, if you are female, you have to submit to a monthly pregnancy test at the doctor’s office and pledge not to become pregnant and to use two methods of birth control (i.e. pill + condoms) or pledge abstinence via a monthly website, in addition to monthly doctor’s visits. There are apparently very severe birth defects that can occur with it. And that’s not an exhaustive list of things you must bear in mind. It’s a serious commitment.

          Personally, I have not experienced any psychiatric side effects. But oh god, the dryness is awful. I caved and bought a humidifer for my home because of daily nosebleeds. And my stomach does NOT like Accutane, so I’ve gained a bit from chugging milk and eating fattening things with it (it is absorbed better with fat or something).

          It is also hideously expensive out of pocket, ~$300 for 30 days of generic at my local pharmacy. Luckily my insurance covers ALL generics at a low copay (insert evil cackle here!) or there’s no way I’d be able to afford it. OP, you might be able to view your insurance formulary online and do some research to see if there’s a similar drug that would be covered better for you.

          I suppose my point is to underscore that it may work (no results here yet), but it is not a drug to be taken lightly and definitely not right for many people.

          1. copy run start*

            Addendum — I had my tubes tied and am on birth control (due to periods) and they STILL make me do the stupid pregnancy test. I don’t think there’s a way to get out of it if you still have female reproductive gear.

          2. Merry Holidays*

            Whew… well that’s kind of scary. I think I read that somewhere before regarding the pregnancy/birth defects thing. How’s it working for you as far as clearing up your skin problems?

            I try not to complain when I get the random annoying pimple because I’ve always been fortunate to not deal with problem skin and I really wish there was a simple fix for people who do. It’s just one of those things I wonder about “Why does this happen?!” when I wonder about all the various things our creator(s)? imposed upon us. Ha.

      2. Nic*

        I wanted to jump in as somebody who was on two rounds of Accutane as a teen. It did wonders for my acne. It also left me with an addiction to lip balm that over a decade later I am still struggling with.

        I did not have the depression side effect and it never had negative effects on my liver ( monthly liver function tests were also required) or the depression issues.

        However I had friends who were on it at the same time as I was for whom it dried out their skin so badly that it cracked and peeled.

        I definitely recommend it, but go in with open eyes. That is not a medication to mess with.

      3. lychee*

        OP I dont know if you are a woman, but if you are – please ask your doc about spirolactane. It was the only one that worked for my hormonal acne (mid-30s female)

        1. Paula*

          Yes, I second this, I was also going to ask if your doctor did a hormonal workup. Sometimes birth control pills can help with acne. I guess I am assuming here that you are female?

    5. CAndy*

      Scotland here, I could walk into my GP’s surgery on Wednesday and get any medication I need for free.
      Socialised health care is evil though isn’t it…

      1. Persephoneunderground*

        *sigh* so jealous. My friend in Australia says their health insurance tax is only 1.5% of her income. I pay about 10% of mine for my insurance, and can only afford that because my husband makes much more money than me, but as a couple it’s still a much higher percentage than she pays. Oh, and I just got denied reimbursement for some claims because I waited too long to file them- apparently there was a time limit I didn’t know about. Agh! Sorry, don’t mean to derail, just venting. Please no one get off topic because of me!

    6. Kerr*

      Yes, ask if there’s a generic or just another cream entirely that you can try! My dermatologist prescribed a cream, and the pharmacy said it would be $120 or something equally ridiculous. I had the dermatologist’s office approve a generic prescription, which was still pricey but not THAT pricey.

      In the end, it was the second or third prescription that worked, and I was annoyed that the dermatologist hadn’t suggested it first. It was less harsh, and only $35-50 with insurance, plus it a) actually worked, and b) lasted so much longer than the expensive, tiny jar.

      Definitely ask your doctor if there are other options!

    7. Julia*

      And just in case that does not work (I hope it does), brands like The Ordinary make chemical peels and retinols for pretty cheap (like around 10$) these days. Even if they don’t work for you, you’re not out much money.

    8. Persephoneunderground*

      Jill has it right- go back to your doctor, or even just call the office and talk to a nurse about if there’s a generic similar drug the doctor could prescribe instead. Don’t give up!

      I see there are a lot of specific drugs being recommended, but you really shouldn’t try them on your own. You could bring in a list to ask the doctor about, but don’t let that make them think you are specifically asking for these drugs, just that they were suggested as ideas that might work, but that what you’re looking for is something that you can afford and relieves your painful acne, on your list or not.

      I think doctors often get the wrong idea about that sort of thing- take “what about x?” as “I want x”. I remember a dermatologist asking what brand lotion I used and I didn’t really care but managed to remember that I mostly used lubriderm and eucerin, so that’s what I said, so they made a point of recommending another eucerin product, as if I had said I would only use that brand/ wanted that brand (it seemed to be about my perceived comfort, not because it had worked for me before particularly well). I was younger and kinda confused why they thought I cared- I mean, I’m not a doctor, they’re supposed to tell me what is best to use.

    9. Kuododi*

      I have posted before if OP is in US the big box stores such as Sam’s and Costco are significantly cheaper for out of pocket meds and don’t require a membership to use the pharmacy. (ie- my anti nausea meds retail for 150 at local pharmacy and 21 at Costco.). Best wishes!!!

  3. Disappointed with society*

    That’s so disappointing about #4: it’s the same old story playing out again. Daycare is so expensive that the family saves money if the mom doesn’t work, so she stays home. Then when she decides she wants to work again, her skills will be out of date and there will be a gap on her resume, and if she is able to get a job it will be a lower paying one than she would have had if she had continued working. Like good for her for getting out of a job that wasn’t a good fit for her, but this reads like the beginning of every story where the woman ends up staying at home for the rest of her life. Hopefully this LW is able to break the pattern and go back to work in a meaningful job.

    1. MommaCat*

      One way to help this is to get some schooling or volunteer work in the meantime; obviously it would need to be either a night class or online, or otherwise at a time when the OP’s spouse can pick up the slack. That way there’s something to fill the gap.

    2. le sigh*

      I felt the same disappointment! I understand she was the one miserable with her job, but did the father look into staying home or finding a higher paying one? Is he as bothered as her that he can’t get as much done on weekdays and doesn’t see his kids? Hopefully society will have a better view of working mothers when she’s looking to get back into the work force, but I don’t have much hope. I also hope her husband recognizes and appreciates how much she sacrificed for the family.

      1. Say what, now?*

        Let’s not assume anything about the father. It’s possible that he was very willing to stay home but what it came down to was just a matter of personal satisfaction. He maybe loves his job and she just didn’t, plus it seemed that it wasn’t even a field that she enjoyed since she said it didn’t align with her career goals.

        OP, I hope that you’re able to take the classes MommaCat suggested. Maybe you’ll be able to use the time to figure out what stokes your passions and realign your job search.

        1. MommaCat*

          This is very true. I’m transitioning to stay-at-home in the next school year because my hours are just too crazy. My husband actually gets paid less than I do (slightly), and would prefer to be the stay-at-home parent, but has fewer hours and MUCH better insurance, so sadly it made more sense for me to quit. I plan on getting a few certifications and freelancing while the kids are little (preschool and toddler, just like yours). Best of luck!

          1. MommaCat*

            And that’s another idea: freelancing, if your (OP’s) field supports it. You don’t have to list every little job; just each company, with “Various, month 20xx-month 20xx,” so it doesn’t appear as a gap. Obviously, you need two or more gigs with that company to list it like that. ;-)

            1. Merry Holidays*

              Well she did mention she is looking for freelance work, and I really hope she does this diligently in whatever capacity makes sense for her schedule. To keep her sense of self, to keep a foot planted in the work-world and to keep her resume current for whenever she is ready to go back to work full-time.

        2. Poster being honest*

          Or maybe the father is supportive of womem working, but is not willing to be a house husband? I am male, if I ever get married I would want my wife to work and would encourage day care even at a loss (stay in the workforce and you’ll eventually get a raise) — but I would not be willing to be a house husband.

    3. many bells down*

      I had this problem when I was a single parent; I literally couldn’t afford to work because daycare was so expensive. I managed to get a low-income subsidy to pay for it so I could keep my job, but honestly it might have been easier to give up my hour commute and stay home on welfare.

      1. Student*

        It makes so little sense that daycare is as expensive as it is.

        In a reasonable economic world, at that price, some of these stay-at-homes would be able (and interested in) opening up a limited daycare of their own, caring for a couple additional kids, and make as much (or more) as they would in their chosen career field. And then the price of daycare would lower to something more reasonable, where some stay-at-homes could make a tidy profit taking care of a couple extra kids and women who want to stay in their career could do so without daycare costs taking away any real decision.

        1. Detective Amy Santiago*

          Except that daycare workers deserve to be paid a decent salary since they are literally responsible for your children’s lives.

          1. Academic Addie*

            They do. But that’s not where the money goes in daycare centers. Most daycare workers make barely above minimum wage.

        2. Temperance*

          I don’t understand your thought process here. Daycare would cost less, because we’d be paying SAHMs to watch kids, but it would be “as much or more” than they would have made at a professional career?

          Daycare is expensive because of insurance. Daycare workers are not super well paid.

        3. Jiya*

          Day care, like sushi, is something I wouldn’t want to go cheap on. In an ideal world, working families would receive aid with day care costs, but for various reasons, that isn’t likely to happen on a large-enough scale to make a difference in situations like OP’s.

    4. ZarinC*

      The same thing happened to me–once we had two kids, daycare was no longer worth it. I ended up getting a part time job, taking evening & Saturday hours. I got to stay home and spend time with my kids during the day, while hubby took care of them when I had to work. No day care costs! When the youngest was ready for kindergarten I applied for and transitioned into a full time position.

    5. JamieS*

      I’m a bit torn on how I feel about it. Speaking just to OP’s specific situation and just based on the very limited information we have it sounds like it was best for her to stay home over her husband.

      However in general I don’t like this mindset I often see where the options are either both parents work or the mom stays home with little to no consideration for the dad staying home. I know some men do stay home but I believe it’s around 15-16% of stay at home parents and part of that number includes fathers who aren’t staying home by choice (can’t find work, disability, etc.) so the overwhelming majority of SAHPs are still mothers.

      Although, just as an aside, I am curious what percent of families with a SAHP chose the parent with the lower income/income potential to stay home. Even though income is just one factor I think that’d help give us a bit of a better understanding of how much the discrepancy between the number of SAHMs and SAHDs is due to economic factors and how much is due to societal expectations of mother’s and father’s child rearing responsibilities.

      1. Close Bracket*

        I would *love* to see this data. When you start digging into many gendered patterns, what you find is heterosexual couples with identical but gender reversed situation where somehow it still made perfect sense for their individual situation for the woman to [insert gendered pattern here].

        The data might be skewed by the relative scarcity of couples where the woman was the higher earner pre-baby.

      2. ZK*

        I stayed home because my husband made better money than I did and had amazing benefits, plus a two hour commute just didn’t make sense for both of us to do. Once our daughter was out of diapers, I went back to work part time, and we put her in daycare 2 days a week, mostly for socialization. After a while I went back to work full time and my husband actually did the SAHD thing for a few years.

        1. King Friday XIII*

          We did pretty much exactly the same thing you did to start with, except I stayed home to start with and my wife went back to work after maternity leave. We both loved the arrangement, and I did some freelancing and then transitioned into a career I’m much, much happier in.

      3. Specialk9*

        I wouldn’t be able to be that vulnerable and trusting, to put my self sufficiency in the hands of a partner with a 50% chance of success. But lots of women do, including women I respect… but I just couldn’t risk it. I’m really glad OP is keeping her resume updated with freelancing gigs.

    6. neverjaunty*

      I think it’s less about the cost of daycare than about the math being the “good enough reason” for the OP to make a choice that she really wanted to make anyway (and rightly so, if it’s better for her mental health and for her family). In the US, anyway, there is still this lingering idea that women are always making a wrong choice unless they have some objective reason like the cost of daycare to explain it.

      And speaking as someone who has been an SAHP in the past, so many times I heard people say the same thing – that they “did the math” and it made financial sense for a parent (almost always mom) to stay home. But by doing the math they mean, take mom’s salary and subtract daycare, and then that’s the number. They almost never looked at other costs of staying home, like additional health insurance or life insurance to cover the breadwinner, or the opportunity costs and loss over time of having one person out of the workforce. If you pointed this out, they’d get flustered and say well, this was the best choice for our family. Which, hey, definitely do whatever works best for all of you – but fake math and devaluing women’s financial contributions shouldn’t be the fig leaf for a decision that isn’t really about money?

      1. Ilf*

        +1 re: “doing the math”. I really doubt anyone is comparing actualized future income streams in both scenarios.

        1. ket*

          I’m a mathematician, so I did sort of do the math — and that’s why I’m staying in a lower-paying, flexible position with a good commute, good title, and amazing benefits, and dad is taking a day a week of FMLA to stay with the kid. We only pay for 2-3 days of child care a week (because I teach in the evening so can shift work to a limited subset of “business” hours) and both parents stay sane. My career is definitely not on the fast path right now but it’s in a good eddy where I can get some work done that will set me up for future big leaps.

      2. Jerry Vandesic*

        Good points. It’s also very important to look at “the math” over the long run and not simply look at things today. Being out of the job market will impact a person’s earnings over their lifetime, so you need to factor not just today’s income but the total income over the next twenty years. It might very well make long term financial sense to take a loss this year on daycare if the long term financial impact is positive. I wince when I hear statements like “daycare would actually result in a net loss of income” since it usually means looking at things just over the short term.

        1. Turquoisecow*

          Ok, but depending on their financial situation, they may not be able to plan out long-term. It’s like the idea that if you buy more expensive shoes now, you will save money long-term because you won’t have to keep paying for cheap shoes every few months or so. But if you literally don’t have the money for expensive shoes, you can’t do that.

          Daycare and childcare costs are similar – yes it might make better long term sense for OP to keep working, but right now they have less income and she has less time with her kids and she hates the job anyway. And if we’re talking long-term effects, what about the kids? Is it not better for her to have this one-on-one time with her kids, rather than leaving them with daycare workers all the time? Staying in a job she hates will also make her grumpy and unhappy and undoubtedly effect the way she interacts with her kids. And spouse!

          1. Jerry Vandesic*

            Those are absolutely things to consider, but they need to be considered over the long term. Is leaving a job you dislike worth lower (or no) income for ten years? For some it will be, but it needs to be an informed decision.

            Simply saying that the cost of daycare would wipe out the income from a job is limited, short term thinking. Much better to say that the cost to your long term career is X times the cost of day care, but that you are OK with making that tradeoff.

          2. Coywolf*

            I definitely agree with you. I’m very confused as to why nobody else seems to be considering the benefits to the children that having a full time parent home would have… isn’t that the whole point of being a parent? Doing what’s best for your children?

            1. Xk*

              Yeah but not all parents are all that good at it! Or don’t do as well with young children. Knowing your limitations is an overlooked quality in parenting.

          3. Jynna*

            One of the many reasons I don’t have kids is because my husband and I couldn’t afford it. Daycare in our area costs more per year than I make per year. We can’t survive on my husband’s salary alone. Therefore, we can’t afford kids.

      3. nonegiven*

        I imagine the cost of adding the other parent to the working one’s insurance is a factor, too, or just which job can provide the better insurance plan.

        There also may be families where both are working because one had the better pay and the other has the better insurance and paying for daycare may take most of the smallest salary but that is the job with the better insurance.

    7. Stopyouarenthelping*

      You are a lot more negative about it than she is. She said she is enjoying spending more time with her baby and that the job wasn’t a good fit anyway. The best daycare in the world would not help with that.

    8. OP4*

      Yeah, I’m disappointed, too. Never in my wildest dreams did I think I would end up as a stay-at-home parent. I grew up in a household where my mom made significantly more than my dad did, and I think my greatest fear is that my children won’t absorb the same messages about egalitarian divisions of labor that I did. Fortunately, my husband understands the sacrifices we’re making in terms of my career and we are working on a plan to keep me engaged in my field, including with freelance work and scoping out part-time options.

      Some points of clarification: I am in a field that notoriously underpaid, and my husband works in a very high-paying, high-demand field. A few months before I had the baby, he got an new job that almost doubled his salary and replaced my salary entirely, but gave him a one-hour commute each way. This is his dream job and a huge career move for him. Previously, he was able to walk to work and was responsible for getting my older kid to school every morning, and we split the kiddo’s sick days and doctor’s appointments about 60/40, with my husband doing a bit more than me. In prior years, he had a lot more flexibility than I did, and spent all that extra time with our kiddo while I was putting in long, irregular hours.

      To be perfectly honest, the thing that our family suffers from the most is time poverty: neither of the jobs we held right before our baby was born were very flexible or let us work from home. We were routinely out of the house (with our older child in daycare) almost 10 hours a day, and it was an incredible struggle to get dinner ready, get our kid to bed at a reasonable hour, and feel like we were spending any time together at all. My husband and I both complained of constantly feeling rushed and overwhelmed, and our child was really suffering from the lack of time we had together. This whole situation has clarified the fact that time is just as important to us as money, and I’m glad our kids can get that time from at least one parent right now, as opposed to neither.

      1. Specialk9*

        Sounds like you have been very thoughtful about both the mechanics of the current situation, as well as potential implications for you. I like that you’re thinking about messaging your kids will perceive, that’s important and kudos for considering it.

    9. West Coast Reader*

      Let’s not talk about how “disappointed” we are with a woman’s choice about being a SAHM.

      We, as women, always feel guilty that we aren’t doing enough. If we are a SAHM, we feel guilty that we aren’t trailblazing career women. If we choose to work, we feel guilty that we aren’t spending more time with our kids. It’s a catch-22 situation.

      I know what you mean about the whole pattern being played out, because I wish it’s different too. However, it’s not helpful to make women feel bad about being a good parent and doing what’s best for their family.

      1. Specialk9*

        Except the post is specifically “disappointed with society”. Because even if you want to be a SAHP, it shouldn’t be this hard and full of huge short term struggles and huge long term penalties. It’s disappointing that’s it’s 20 flipping 17 and we haven’t figured out how to take the burden off of families (though mostly women still) so that we can have health productive members of society who are supported in their life stages.

        Yes indeed, SO disappointed in our SOCIETY.

        1. Specialk9*

          And by “we haven’t figured it out”, I mean have every model and instruction possible but somehow it’s all just impossible. (Seriously, how are we the only world superpower?)

    10. whyo*

      YES YES YES, What is the “right choice for your family right now” could hurt your career and earning power for the rest of your life and end up being the wrong, REALLY wrong, choice in the long run. So many women don’t realize this until it is waaay too late.

  4. fcgiorda*

    Acne: differin is over the counter now and has made a huge difference for me. The target Cartwheel app sometimes has a coupon for it (it does now, for 25% off) and I have also seen it go on sale at Amazon. It’s the only thing that has ever made a difference for me.

    1. specialK*

      I second the recommendation for otc Differin! It works great for me and a tube lasts forever. You do have to use it consistently for a few weeks before you see results but once you get there it’s amazing!

      1. Madame X*

        Was she using sunscreen as well? Retinols make the skin more photosensitive but a good sunscreen (at least SPF 30) can counteract that effect.

        1. Julia*

          Yeah, you absolutely cannot use retinol (or AHAs etc.) without using sunscreen every day, in the required amount (half a teaspoon or so for face alone?) or you will make your skin worse in the long run.

  5. Intel Analyst Shell*

    OP#1 I just wanna say I feel your pain. I’m almost 30 and have worse skin than I did in the middle of puberty. Cystic acne is hell. I found out I had a pretty severe hormonal imbalance due to PCOS so getting on hormonal birth control helped a lot but I’m still fighting the acne fight. Virtual hugs and good luck!

    1. Kj*

      Yes to checking for PCOS- it is pretty common and causes adult acne. The treatments can be birth control or metformin and your doc can tell you what os best for you if you have PCOS. Also, if you intend to have a family, it is nice to know before you try to get pregnant.

      1. Adelyade83*

        I used acutane when I got adult acne. It was amazing. I had good insurance so I’m not sure what cost would be like without that

    2. Safetykats*

      I second that hormonal birth control can help, and should not be terrible expensive.

      Another thing that can be a big help is changing your diet. You don’t say whether you’ve looked at the possibility of a food allergy, but I have a friend whose adult acne is completely related to a dairy allergy. Apparently this is not that uncommon. Eliminating all dairy in your diet is kind of difficult, but if you start with the obvious dairy and see some relief it would be worth trying. You can get food allergy testing, but obviously that will coat something.

      1. Dairy Free*

        I had the same issue with dairy. I completely got rid of it and my acne cleared up right away. I was able to reintroduce it and can eat it again without any problems, but it took a few years to get to this point.

        1. Indie*

          I have a stress related skin condition and Hanna Sillitoe’s diet recommendations worked for me in a drastic way. Stress affects the gut’s digestion and the skin then steps in as an elimination organ. In my case it was psoriasis but Hanna cured her own acne/ eczema/psoriasis. She agrees dairy had the biggest impact on the acne side.

    3. lalalindz22*

      Just seconding the comments to OP1, that acne as an adult truly sucks. I’m 30 now, and only now has my acne subsided somewhat. I take birth control for it, I avoid dairy, eat relatively healthy, and for 6 months now have been using a new topical cream that is prescription, called Aczone. It’s meant for adults with acne and is less harsh than some of the others. But I really did try everything save for Accutane, and even did a different prescription pill in my teens. My dermatologist also specified a certain face wash, which I use once a day. I actually found my face is less irritated when I only wash once a day, and then use really gentle creams. It took a really long time to find what works for me and everyone is different! Might I suggest some skincare blogs as well, like the subreddit Skincare Addiction, I learned some good stuff there too!

  6. coffeeandpearls*

    May I offer some unsolicited acne advice from a fellow long-time severe acne sufferer? Ask your doc to test your thyroid. After I was diagnosed with a thyroid condition and started taking an Rx , my hormones became much more balanced and my skin improved A LOT! Your acne might be different, of course, but it’s a common cause of acne that isn’t commonly tested for by GPs. Plus, the Rx is so common, it’s super cheap.

    1. Samesame*

      Same here! Acne improved drastically once my thyroid condition was diagnosed and treated. Also, avoiding gluten and reducing sugar made a huge difference w my adult onset acne.

  7. Dz*

    OP #1, I really feel for you with the acne. I saw in the comments of your first letter some people suggested a pill called spironolactone (aka aldactone). One person called it a “sister drug” to accutane but I’m not sure why they said that–it’s a totally different class of drug that works a different way (blocks the excess testosterone in your system) and has few side effects at the dose you would be taking. It’s been a lifesaver for me, and it’s an old/cheap drug. If you have painful cystic acne and/or if you feel that there is any hormonal component to your breakouts, it is a GREAT option. If you have any questions, I’d be happy to answer! (Note to anyone reading, this drug isn’t an option for cis men.)

    1. Middle School Teacher*

      Spironolactone was a godsend for me. It can be a bit hard on the kidneys so use the lowest dose that’s effective for you, but otherwise it’s amazing. Now I only take it when I feel a big cyst coming on; it seems to stop it in its tracks and keeps it from getting bigger.

      One thing that also worked for me was getting cortisone shots in the big deep cysts. I know it’s not for everyone but I was lucky that I had a great relationship with my dermatologist, and he was close enough that I could just see him after work and he’d give me a quick shot.

      You have my sympathies, OP 1. I had bad skin as a teenager, then I got about five good years, then my kid to late twenties were awful. I’m so lucky I found my dermatologist, he saved my skin.

      1. irritable vowel*

        I think seeing a dermatologist is key – OP, you said you only saw your primary care doctor. Ask for a referral to a dermatologist! He or she will be better suited to treat your condition and will likely be aware of/more willing to test for conditions that could be causing your acne. (As well as having tons of free samples of medication that your primary care doctor doesn’t.)

    2. Karli*

      The same active ingredient is also in spearmint tea. I’ve been drinking 1-2 cups a day and it’s made a world of difference to my hormonal cystic acne. It’s seriously been amazing.

      Just make sure you go for spearmin tea if you try it – peppermint doesn’t have the active compound.

      1. Julia*

        I would make sure to have my hormones tested before I consume anything that messes with them.
        And spiro can have side effects as well, so OP, please proceed with caution.

  8. Anon1*

    My husband stays at home with our two kids. We have grappled with exactly this fear many times, i.e. how and if he will ever be able to re-enter the workforce. What if I end up disabled. Etc., etc.

    In reality, the first child alone was chronically ill. Despite back-up nanny service for daycare, it was not always possible to get a nanny lined up on short notice. We do not have any immediate family in the area to help out. It got to a point where we had to decide who could ‘afford’ to get fired for attendance issues. My husband eventually lost his job when we were expecting the second one, in large part because he took so many unplanned days off.

    There are some lucky people who have hung on to cushy jobs where they aren’t penalized for multiple ‘work at home’ / family sick days a month. But the reality is, that’s not us.

    We have made peace with our reality, and I am focusing on my career / income. Due to the way income tax brackets and payroll taxes are set up in the US, an increase in my income is worth more than any income we could save from his earnings

    1. Anon1*

      Meant to reply to Disappointed with Society…not sure why it ended up here!

      Anyway, #4, you know your family situation best. We are all rooting for you :)

    2. Close Bracket*

      > My husband eventually lost his job when we were expecting the second one, in large part because he took so many unplanned days off.

      I wonder how much gender contributed to this- that is, are men looked down on for staying home with sick kids the way they can be when they take paternity leave?

      I’m sorry he was let go. I’m happy for you that you are making your situation work.

    3. Specialk9*

      That utterly sucks. I’m sorry your family had need of a social safety net that let you down. That’s not right.

  9. Rae*

    #4 I loved my job but when my first was born with a medical issue it was very clear that daycare was not going to be an option. I was hesitant as it was. I’m in education so it hasn’t been hard. I tutor (paid and volunteer), freelance write and now I have picked up other freelance and consulting work. It hasn’t been hard at all to keep a part-time job and it keeps my resume full.

    In the end, I think it will work out better than I ever thought. I’ve made really good connections and the small jobs are with companies that have full-time work that I could eventual interview for. The companies have great upward mobility. I miss my job, but now with 2, daycare for a newborn and a toddler is completely unaffordable even with a decent paying job.

    1. Holly*

      Can you fill me in on where you tutor? I’m looking to do this in the future. Right now I teach high school English as a second language. I used to teach English IV. I have always taught in the public school system.

  10. Libervermis*

    Hugs if you want them, LW #1 – I’m sorry to hear your job is so stressful with such high turnover. As another adult acne sufferer I know how demoralizing and embarrassing and painful it can be, and how much it can feel like it eclipses all my accomplishments. I hope you can see that you’re also doing things like surviving a rough work environment, adapting to a totally different job, etc. You are much more than your acne! (This is a thing I literally tell myself in the mirror sometimes).

    1. OP1*

      Thank you so much – honestly I could have lived with it until people started commenting on it. But the mantra you shared is so helpful and it means a lot to hear. Thank you!

      1. Kelly*

        Hey, LW #1, I also suffered with what I thought was horrible cystic acne, and eventually after trying everything I was diagnosed with perioral dermatitis. The doctor suggested long term antibiotics, but they had seemingly no effect after months. What eventually helped me was the skin care line by Somme Institute. It’s not cheap but it has completely cleared up my skin and kept it clear for about 2 years now. I can’t say how relieved I am to not watch people wince as they come into my office anymore, my skin was so swollen and painful. I also heard about Somme on a blog so if I can help someone else, I hope this comment does just that!

      2. Detective Rosa Diaz*

        Your letter really touched me and I’m sorry you’re struggling with this. It’s awful how judgmental people can be about a medical issue like this. I second asking your doctor. If they are a good caregiver they will at least try to help with samples or alternatives.

      3. Airy*

        OP 1, I’ve been there and am so sorry you’re having to cope with such an upsetting condition. I don’t think people who haven’t had cystic acne can imagine how bad it feels to have large areas of your sensitive and constantly mobile facial skin thickened and made painful by inflammation. It was like nothing else I’ve experienced. I don’t know if it’s within your price range but in my own case I have found Clinique’s anti-blemish solutions range very effective. I mainly use the clarifying lotion and spot treatment gel while using Cetaphil cleanser and moisturising lotion (which are both effective, gentle and inexpensively available in pharmacies and supermarkets).
        However, every person’s skin is different and it’s very much worthwhile to investigate hormonal causes and allergies, since no amount of external treatment will cure a skin problem caused by something internal. I used Roaccutane (the name for accutane in New Zealand) in my 20s and while it was very much a case of “it gets worse before it gets better” (I thought of it as all the crud being expelled from the very roots of my pores, which helped me to cope with a very unpleasant breakout just after starting the medication) it was ultimately very effective.
        The most important thing I’ve learned, though, is to be gentle with my skin and soothe it – no rough scrubs, no hot water, always replacing the excess oil I remove in cleansing with moisturiser. It is so easy to get obsessed with trying to purify your skin and end up doing far too much to it and just irritating it more. I truly hope you’re able to find out what works for you and can enjoy comfortable, healthy skin in 2018.

  11. Super Nintendo Chalmers*

    OP 1: The subreddit /r/skincareaddiction has a lot of invaluable advice about your options, re: prescription acne medication. It sounds like you’d really benefit from Accutane. It also had a lot of info about non prescription options, if you’d like to explore that.

    OP 4: I highly recommend you listen to the first season of a podcast called First Day Back. It’s about a woman who’s trying to get back to work after taking six years off to raise her kids. I think it can offer some comfort, and maybe advice.

    1. Jess*

      I came to the comments to recommend /r/skincareaddiction too! It can take a bit of time, but it has been so amazingly helpful for me by clarifying the different types of acne, what remedies help for different types, etc. Acne can make you feel completely out of control, esp. when nothing you do seems to work.

      In my case, I was actively seeing a dermatologist for years and my acne didn’t respond to anything, even accutane. Long story short, it turned out I never had acne, but a fungal infection. I didn’t even know there were other possible causes for my problems, and I ended up diagnosing myself due to reddit and am now successfully treating it. Finally. After 10 years of unsuccessful acne treatment by dermatologists.

      OP1, I’m not arguing that you should consider a fungal cause—I have no idea—but just that knowledge is truly power in this situation. It really is helpful to get info yourself so you can figure out your best options & try different treatments in a systematic way rather than just continually throwing the next stronger thing at it. (And there really are treatments that can be helpful that don’t require prescriptions. But it takes a bit of knowledge to sort out what ingredients will be particularly beneficial to you.) Good luck! I truly know how you feel.

  12. Safetykats*

    OP#4 – I wouldn’t worry too much about whether you’ve burned a bridge with your old boss. If you have the means to reach out to him/her beyond the formal resignation, you might do that. However, they certainly understand the restrictions on FMLA, and that it wasn’t possible for you to resign in person. Also, I doubt it never occurred to them to wonder whether you would come back. I’ve had several pregnant women on my staff, and I work for a pretty progressive company, but there is always a discussion with HR when someone exits for maternity leave about the odds they will actually return. Obviously it’s a thing that happens, and your company surely knew that before you. It’s also not all that hard to predict who really will come back and won’t, in my experience.

    If you’re feeling like taking paid maternity leave and then not returning is somehow sketchy, and that’s why you feel like you may have burned a bridge, you shouldn’t worry about that either. The thing that qualifies you for maternity leave is the baby – not whether you return. It’s not a benefit like tuition reimbursement or a paid move, that you are obligated to work some minimum number of months to “pay back.” Your company understands that too.

    Finally, enjoy your new baby! It’s awesome that you have the ability to take time out of your career to be with your kids, and I hope it’s amazing for all of you.

  13. NVHGal*

    OP#1 – Jedi hugs from a fellow adult acne sufferer. I was diagnosed with thyroid issues early, and treated for it (runs in my family) but suffered with undiagnosed endometriosis for decades. (I didn’t know to ask about the link between thyroid and endo, and my PC / GYNs for those years apparently never put it together). I tried accutane, OTC meds, shots… It wasn’t until the endometriosis was diagnosed (I love my GYN for this) and I went on continuous hormone therapy that I saw relief … and it was life changing! Not only did I escape the near continuous menses and associated pain, but my skin cleared up and my emotional state improved as well (hormone regulation / brain chemistry and decreased anxiety over my appearance at work and in public).

    I know my solution may not be the same as yours, but I do encourage you to pursue as many options as you have the capacity to do. Finding a solution is worth it. Try to get to the root cause for your issue – accutane did not help me because it didn’t address the underlying condition. The first three versions of the pill that I tried did not work – hormone chemistry is unique for each person. It took trial and error.

    One thing that did help me manage my cystic breakouts before the beauty of the pill is
    Mario Badescu’s line of skin care products (specifically the pink “Drying Lotion”, which I would apply several times a day when I felt a cyst coming on.) I still use it, because my body sometimes wants to show me it is still in control (ha!).

    Good luck! I’m praying you’ll find solutions that help, soon!

    1. OP1*

      It’s actually interesting you mention endometriosis because the doctor has been talking to me about the possibility. I had an ovarian cyst and accompanying pain (had surgery for it when I was 16, and another one grew back), but the cyst shrunk and the doctor suggested that endo might be the cause of the pain. So that’s actually something we’re looking into! Thanks for the jedi hugs and the encouragement :)

      1. Gadfly*

        See if you can have your prolactin checked too (simple blood test.) There is an incredibly common but not looked for benign pituitary tumor that ups your prolactin and causes a lot of POCOS like symptoms. And a lot of the people on it have acne issues.

        So if the other stuff shows nothing, or just because you are doing labs anyway, it is worth remembering.

  14. Acne sucks*

    OP #1 Check the website acneeinstein. It has scientific information that really helps and it’s not expensive to apply in real life. I used to have terrible acne and now the new people I’ve met can’t believe I haven’t always had perfect skin. There’s no need to spend $100 on a cream. One ingredient that has been proven to prevent acne is benzoyl peroxide 2.5% and it’s an OTC cream you can buy at any pharmacy that costs around $10-15, I forgot. The brand doesn’t matter, as long as it’s 2.5% of the active ingredient. Seriously, try it every night.

  15. OP1*

    Hi everyone! I wanted to reply to everyone individually, but there were so many responses that I just wanted to cover them all with a broad blanket!

    Thank you all for the advice and the tips! I’m actually trying curology right now on their free trial (thanks for the rec, Alison!). For those who have suggested it, I’m actually talking with my doctor about the possibility of endometriosis. TL;DR: I had surgery for a big ovarian cyst when I was 16 and was having the same pain now, but when the little cyst I have now started to shrink and it was clear that couldn’t be the cause of the intense pain, he suggested endo as a possibility. So we’re looking into that. Might be exploratory surgery on the horizon which makes me a bit jittery.

    Accutane makes me nervous because of my own struggles with mental health and the side effects – if it comes down to it I will try it, but it’s a last resort for me for the reasons I said. I have a coverup that I really like right now which makes life a little more bearable, and the people who really matter at home don’t care how my face looks, which helps. Since sending my update, we are actually fully staffed again, which I hope makes my life a little easier moving forward!

    If things go well with curology, I’ll be sure to let you all know! Thanks again for the input, tips, and solidarity, and happy holidays!

    1. Lady Phoenix*

      I would rope in your GYN doctor if you think the issue is hormonal. That way you can discuss other options regarding medication (especially since you also have a history of mental health).

      Good luck!

    2. Karyn*

      Curology was a Godsend for me, and one of the best things Alison has ever recommended (and that says a lot!). I work in skincare at a luxury cosmetics store, but sometimes you just need a prescription-strength topical to help with your issue.

      Also, please know that it usually takes 1-2 months of Curology to really start seeing clearer skin. Your provider probably already told you this, but you can purge a LOT before you start seeing new cells appear. I had milia, which is proving to be a bit of a pain now that it’s coming to the surface. But slowly, my skin started to clear – and I had those horrible cysts, too. Keep at it, and I hope it helps you! <3

    3. Temperance*

      I have endo. The “exploratory surgery” is honestly NBD. I was uncomfortable for about a week after. It’s done via laparascopy, and wasn’t bad at all. I encourage you to reframe your thinking from the phrase “exploratory surgery” which is just scary.

  16. ha2*

    Op#4 – I doubt you’ve burned any bridges! Sounds like before you left you were clear that there was a risk you might not return. And everyone understands that having a baby can lead to changing priorities. You followed procedure for the resignation.

    No bridge burning going on.

  17. neverjaunty*

    Alison, any chance you have contact information to forward donations to OP #1? That isn’t a ton of money spread out over many people, and maybe some AAM-ers could help out?

    1. Ask a Manager* Post author

      Someone actually just emailed me about that and I connected them (with both’s permission) but I’m not really set up to do that on a wider scale, unfortunately.

    2. OP1*

      Honestly, the fact that anyone is interested in helping me with what so many people have assured me is “just cosmetic” means the world to me. You’re all unbelievably kind, and thank you so much!

      1. Close Bracket*

        It’s only “just cosmetic” if you are rich. If you are poor, it’s a class indicator that could hold you back.

        sigh. society.

  18. Aphrodite*

    OP #1, it is likely that stress is affecting your acne but I suggest that you might try something else. (I agree with the plain soap and water, by the way.) Change your pillowcase every night and make sure they are plain white 100% cotton. Buy enough so you have at least a week’s worth. This might help.

    1. TardyTardis*

      And wash the pillowcases with something mild that won’t irritate your skin. I hesitate to recommend something like Woolite, because you never know, but some experimentation with scent and dye free laundry soaps might help you to discover what works best for you–and if possible, hang them up in the sun to dry. Sunlight and fresh air (though not during pollen season, obviously) work wonders.

  19. Stopyouarenthelping*

    #1 see if you can get your expensive prescription mail order from an overseas pharmacy. I get my $200 after insurance rosacea cream for $30 including shipping from Australia. Only works for some prescriptions obviously.

    4: I always said lots of people can do my job but only I can be my kids mom. You are making a choice to provide a lifestyle and experiences that your whole family will remember forever. Do not be fearful. Or let guilt pressure you from enjoying this brief time when your children are young. Mine are about to leave and I am so glad I spent the time with them.

  20. Samiratou*

    “I did finally get to see my GP and he prescribed me some ointment…which costs 100 dollars with insurance. ”

    Was the ointment/cream adapalene (eg. Differin)? This was a miracle drug for me, and an excellent example of why the exclusivity-in-generic-formulas practice is another thing killing us in health care, but I would recommend doing it, even if it is a lot. I get the adapalene cream, which is gentler than the ointment, and the tubes last many months–I can go 6 months on one tube, as you really spread it out as much as possible. I have kind of a tiny head, but still, if it is that medication you should be able to make it last.

  21. Goya de la Mancha*

    LW #1: I feel you. I’m so sorry you’re unable to find something that works for you – which leads to more stress and makes things worse!
    I was on every cream/pill/routine under the sun while dealing with mine. I did 2 rounds of Accutane, only to have it return each time. Tried the proactiv, mary kay, arbonne, etc. etc. etc. NOTHING worked long term. It was like my body built up a resistance to all of them.
    I’m sure time has played a part, but for cheap/free, I manage mine quite well now with a routine of oil cleansing and avoiding dairy. The dairy was an accident, as I cut it out for some other allergy issues I was dealing with. Noticed my skin was a lot clearer after I had cut it out of my diet – and how my skin reacts if I consume more then small infrequent amounts. Meditation and exercise of course – to help manage the stress that seems to be making it worse. I’m sure none of these are “new” ideas” to you, I just understand what you’re feeling and hope you are able to find what works for you soon! Good Luck.

  22. I Didn’t Kill Kenny*

    Very late to the party here. Not sure if the Rx he gave you was identified in the comments.

    If it is a retinoid, like Retin A or generic tretoinin, those are also used for fine lines/wrinkles, considered a cosmetic use, and typically have a much higher copay. My doctor prescribed it specifically for acne and did an override request and my copay went wayyyy down to an amount comparable to most antibiotics.

    Use it every other day; it’s very drying. If you can put up with some peeling( like a tan peeling) you will likely find tretoinin very effective.

    Good luck!

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