A New Drug for Cystic Acne Gives Patty Fischer's Face and Spirit a Lift

Patty Fischer was the all-American girl. She came from a good family, lived in a nice neighborhood in Thornwood, N.Y., and won a coveted place on her high school cheerleading squad and a role in the school play. With lustrous blond hair to her waist, she had no problem getting dates, and she dreamed of becoming an actress. Then, at 16, Patty was stricken with a hideous and painful malady.

Like some 360,000 other Americans, she suffered from severe recalcitrant cystic acne, a disease that is often permanently disfiguring, with physical and emotional side effects. Clinically the most extreme form of acne, it makes the anguish of the usual pubescent case of the disease seem mild. It often affects not only the face but the neck, back and chest as well.

After her ailment was diagnosed, Patty and her mother, Joan, began a marathon round of visits to skin specialists. “The frustrations with dermatologists were great,” Patty remembers. “The procedure was always the same. They’d take a scalpel, squeeze the pus out, then take a needle and inject medication into the open sore. It was extremely painful. I was in pain if someone touched my face or accidentally brushed against it.”

For seven years Patty was subjected to various treatments, including a host of drugs, with side effects including nausea and fatigue, and sulfur packs that she applied. To pay her enormous medical bills, Patty took a secretarial job after graduating from high school, and her despair increased. “Along with the physical pain of the treatments, the emotional pain was always there,” she says. “I looked like a freak. People on the street made comments. I got to the point where I didn’t want to live anymore. The idea of death was always on my mind.”

In desperation, Patty began her own research. Making inquiries at teaching hospitals, she discovered an experimental treatment program at the State University of New York Downstate Medical Center in Brooklyn. Patty phoned the physician in charge, Dr. Alan Shalita, and within two weeks was examined, found to have the necessary minimum requirement of 10 cysts each measuring at least four centimeters in diameter, and was admitted to the program.

The miracle drug involved in the test is a synthetic derivative of vitamin A, developed by Swiss scientists for the Hoffmann-La Roche pharmaceutical company under the brand name Accutane. Originally projected as a possible treatment for skin cancer, Accutane has been approved as a remedy for cystic acne and is being tested for relief of several other skin disorders.

In September 1981 Patty joined a nationwide test group of 150 volunteers. She took three Accutane pills twice a day for a five-month period. For her, and more than 90 percent of the test group, the results were dramatic. “The improvement started gradually,” Patty recalls. “But by the time the test was over, I didn’t have one cyst left.”

Like most of her fellow patients, Patty suffered some side effects from Accutane. “The worst things were chapped lips, dry skin and muscle cramps, but the cramps could have been from my dancing,” she says. “Compared to the problems I had with other drugs, these problems were nonexistent.” A number of patients suffered temporary thinning of the hair, conjunctivitis, peeling skin on their feet and hands, and headaches, but all these symptoms disappeared after treatment was stopped. Accutane has caused birth defects in laboratory animals, however, and Dr. Howard Rofsky, assistant director of professional services for Hoffmann-La Roche, warns that great caution should be used by women of childbearing years who plan to take the drug.

Patty Fischer, who got her first professional acting job at the Bardovon Opera House in Poughkeepsie, N.Y. a month after she completed her Accutane therapy, is still healing. Following a nine-month stint as a singer with a traveling band, she has returned to New York to continue acting classes and plans to see Dr. Shalita to renew attempts to remove scar tissue left by her acne. “I know I’ll never have cystic acne again,” she declares confidently. “I think when people see the improvement, they realize how much I’ve changed. I used to cover my face with makeup, now I tone it down. My dream is to have a peaches-and-cream complexion like I used to.”