Facial wasting

[ShadowBlue]

I've been on Truvada and Isentress since the beginning of my journey after Atripla almost killed me.

I'm very healthy, and have maintained an undetectable viral load since about a month after staring this cocktail almost four years ago.

I'm VERY observant of my myself! The tinniest change will become evident promptly. I'm obsessed with looking in the mirror (OCD...idk) before and after doing anything or going anywhere.

I'd like to say they're acne scars, but I haven't had horrible acne since my teens, and since noticing a symmetrical indentation now under my right check bone that's slowly getting worse, matching the left one that's been progressively deepened over the years, I'm beginning to contemplate if this is a sign of facial wasting?

I'm very self-conscience of them, and it lowers my already dismal self-esteem. I fear they'll give away my status to friends and family. I'm always on edge about people finding out.... and this doesn't help.

Is this facial wasting? Should I go see a dermatologist?

[mecch]

We can't know if its facial wasting. 

Generally its not much of a problem these years and these drugs. 

The only way to get a diagnosis of facial wasting is to ask an expert doctor to examine the matter. 

You certainly are not in the right frame of mind or observation to diagnose yourself for wasting.  Since you say you are OCD about your appearance, and since you say your HIV+ status is intricately connected to your self-observation. 

I wonder if the worry about facial wasting, about appearance, and the lonliness and despair about isolation, aren't all about what you have identified - "dismal self-esteem". 

Unfortunately we are not therapists.  At least I don't know what comes first in this sort of cycle - the low self-esteem, or the beliefs and behaviours that are either feeding low self-esteem, or the result of low self-esteem. 

My experience in my life is that its a kind of vicious circle, and what works is attention to both.  That means - attention to STOPPING the beliefs and behaviors that can feed low self-esteem.   In your case, this might mean RATIONALLY getting rid of the fear of facial wasting by asking for an expert opinion and accepting the opinion given to you.  E.G. see a doc and get an answer.  If by some horrible luck, you were to be one of the rare people to get wasting (and it is still possible) - then you know the reality and step up to the challenge.  If the doc says its NOT facial wasting, you drop the obsession. 

Then you widen the attention to this general obsession with appearance.  Is it working for you? Meaning is it adding to the quality of your day, week, life, or just adding a burden.  And find ways to curtail it.

So thats beliefs and behavior.  But then, maybe with a therapist, if possible, or just calm and deep self-reflection, you try to figure out if there are root causes of the self-esteem problem, and ways to improve the situation going forward.

[darryaz]

My guess...... you're not 19 anymore and your face is starting to show it.

[buginme2]

No one really can tell you over the Internet if you have facial wasting.  However, the chances are that you don't.  Based on the content of this post and your previous thread about being lonely I'd guess that something else is going on.

Are you seeing a therapist? If not you should consider it.  It sounds like you have some things that need to be worked out.

I know you attribute your need to constantly look at yourself in the mirror to OCD.  Have you been diagnosed with OCD or are you just using that as a figure of speech?  When you look at yourself in the mirror are you getting anything from it?  Is it a boost to your self esteem or is a drag on your self esteem?

The problem it seems is that as you age, your looks are going to fade (sorry but its true).  If you are feeding your self esteem by how you look your going to get less and less utility from this practice as time goes on.  If your looks are a drag on your self esteem it's only going to amplify as you age. 

Do you have anything else that you obtain worth or validation from? Are you in school, do u have a career, a talent, art, music?

Sorry I'm rambling but I just imagine you studying the mirror looking for flaws, and if you are doing that the chances are your going to find some.

[ShadowBlue]

Sorry, I don't believe aging consists of dents in my face. There's been no trauma to the skin, and it's not just in my head. I don't have problems with dissociating from reality, and I have all my teeth in my mouth.

I'll see a dermatologist about it.

I work, and I have hobbies to keep me busy. So there's my validation, I guess.

It's more than self-esteem issues, at hand. I'm in therapy, so I'm getting the help I know I need.

Ya, I study myself in the mirror, so i know these changes were not always there.

My insurance should cover getting some fillers done, if it's determined to be early signs of facial wasting.

If not, I'll find a way, somehow to get it covered.

It's about me being happy, and if that's what it takes, then fill me up.

Thanks for the insight.

[Jeff G]

Lots of people get hollows under the cheek bones as they age ... but you didn't say how old you are so its hard to say . 

[Miss Philicia]

He's 23

[mecch]

Sorry, I don't believe aging consists of dents in my face. There's been no trauma to the skin, and it's not just in my head. I don't have problems with dissociating from reality, and I have all my teeth in my mouth.

I'll see a dermatologist about it.

I work, and I have hobbies to keep me busy. So there's my validation, I guess.

It's more than self-esteem issues, at hand. I'm in therapy, so I'm getting the help I know I need.

Ya, I study myself in the mirror, so i know these changes were not always there.

My insurance should cover getting some fillers done, if it's determined to be early signs of facial wasting.

If not, I'll find a way, somehow to get it covered.

It's about me being happy, and if that's what it takes, then fill me up.

Thanks for the insight.

Rather then worrying about the what ifs, just find out whats going on.  Go see a doctor, get a professional opinion and take it seriously.   

[LiveWithIt]

As you get older you do lose fat in your face.  If you are that concerned you can get a filler to even it out.

[Oceanbeach]

Hey Shadow,

One day, I had over 120 injections under my eyes before the Dermatologist found Medicare stopped paying.  I was dropped like a whores panties!

Last year, I went to a fund raiser in San Francisco and discovered a booth with make up tips staffed by artists.  I learned... Mac Cosmetics has a bright yellow foundation which you use to cover the dark spots and then cover that with a little powder and you are flawless...     

There is a lot of discussion topics in Lipodystrophy & Metabolic Problems where you might find answers or questions that haven't come up yet. 

[weasel]

Hey Shadow,

One day, I had over 120 injections under my eyes before the Dermatologist found Medicare stopped paying.  I was dropped like a whores panties!

Last year, I went to a fund raiser in San Francisco and discovered a booth with make up tips staffed by artists.  I learned... Mac Cosmetics has a bright yellow foundation which you use to cover the dark spots and then cover that with a little powder and you are flawless...     

There is a lot of discussion topics in Lipodystrophy & Metabolic Problems where you might find answers or questions that haven't come up yet.

  I used makeup when I was in my 20's to look  younger 

 Now I am afraid to go to the counter to look   

 My face has held up much better than my body has .......

   May be time for a Body transplant !   

   No facial wasting yet , But I am very vain .    My ass did go away thou !   

                                                                Weasel

    P.S.   Nobody that is 22 should worry about their face going awry 

[buginme2]

    P.S.   Nobody that is 22 should worry about their face going awry 

Agreed, if the changes at the age 22 bother you, wait till your 40, you'll be devastated. 

[ShadowBlue]

Agreed, if the changes at the age 22 bother you, wait till your 40, you'll be devastated.

In that case, I'll be a plastic barbie by 40 lol

[mecch]

To each his own.  You got to feel good in your skin.  Since I was a teenager, every few years I've had a friend who is anxious and terribly discontent about something about the body.  The only solutions seemed to be choices such as plastic surgery, extreme thinness, or remarkable bodybuilding.  It didn't matter that everyone involved around the person couldn't see what was so dire about the "default", and after the big "change", the person was the same old person, somehow looking pretty much the same even if a different shape. And no more or less popular, likeable or unlikeable to us.  But the "choice" could work wonders for the friend. Less successful outcomes where when it failed to solve the anxiety. One of my college friends is now early 50's barbie plastic and still battling body image issues. I guess we all do at different times in our lives, but its a matter of degree... How distracting is it.

shadowblue if you really have facial wasting, none of the above applies to you, but still you should get a medical diagnosis. 

If its some kind of body dysmorphia you might consider therapy before the knife.

[ShadowBlue]

To each his own.  You got to feel good in your skin.  Since I was a teenager, every few years I've had a friend who is anxious and terribly discontent about something about the body.  The only solutions seemed to be choices such as plastic surgery, extreme thinness, or remarkable bodybuilding.  It didn't matter that everyone involved around the person couldn't see what was so dire about the "default", and after the big "change", the person was the same old person, somehow looking pretty much the same even if a different shape. And no more or less popular, likeable or unlikeable to us.  But the "choice" could work wonders for the friend. Less successful outcomes where when it failed to solve the anxiety. One of my college friends is now early 50's barbie plastic and still battling body image issues. I guess we all do at different times in our lives, but its a matter of degree... How distracting is it.

shadowblue if you really have facial wasting, none of the above applies to you, but still you should get a medical diagnosis. 

If its some kind of body dysmorphia you might consider therapy before the knife.

It's real, I'm not imagining it. I'm going to get it checked out.

On another note, I've always had body image issues, and being diagnosed with HIV didn't help. I fear rocking the aids look, when it comes down to facial wasting. I'm not ready to, and I won't allow it to happen. I know it's rare these days, but I see it happening to me.

Also, I get reoccurring fungal red blotches all over my skin every couple of months, despite the pills my Dr. prescribes me. They do go away, but always come back with a vengeance. Again, something I didn't have to deal with before my diagnosis. It's enough being reminded of it everyday, when I take my pills. Although, that particularly doesn't bother me as much anymore because it's an automated habit, second nature.

I have anxiety issues, PTSD... all that fun stuff. I'm working on it.

[leatherman]

what do you think/believe is causing this wasting? I don't see any factors with what you've told us. You're 23 and barely been on (very current) meds for 4 yrs. You didn't mention any sort of current numbers or numbers when you started meds. (I mention this because if you're 23 and been on meds 4 yrs, then you were diagnosed around 19. That just seems sort of young to already have the numbers to be put onto medications.)

If you think you really are having this kind of issue, then you need to be taking pictures and seeing a doctor regularly to document this problem so it can be attended to.

[ShadowBlue]

what do you think/believe is causing this wasting? I don't see any factors with what you've told us. You're 23 and barely been on (very current) meds for 4 yrs. You didn't mention any sort of current numbers or numbers when you started meds. (I mention this because if you're 23 and been on meds 4 yrs, then you were diagnosed around 19. That just seems sort of young to already have the numbers to be put onto medications.)

If you think you really are having this kind of issue, then you need to be taking pictures and seeing a doctor regularly to document this problem so it can be attended to.

I don't remember precisely, but my cd4 was a few numbers off near an AIDS diagnosis, and my viral load was in the 70,000's just about, when I decided to start medications 7-8 months into discovering my HIV status almost four years ago.

Currently, I am undetectable, and have remained so for about 3 years now. Last I checked, my CD4 was in the 1,000's.

[Ann]

Shadow, I have a feeling that while you are seeing real changes, you're misinterpreting them. It sounds to me like you're experiencing normal changes that occur in the faces of young men in their early twenties.

I've known many of the lads my daughter went to school with since they were four or five. They're all now in the 25-27 age range and when they were around your age (18-24ish), many of them went through a period where their face became more mature (often quite rapidly), and that included losing "baby fat" from their cheeks. Losing the softer, rounded edges of boyhood is a normal part of becoming a man.

I think you're just growing up. Seriously. As a mum, I know these things.