to overcome accidents to as it is how you present yourself to society. I worked with a psychologist for almost one entire year and told him my innermost feelings on this event and what happens to someone relatively comfortable in life who suddenly loses confidence. I was also put on anti-depressant drugs. I consistently worked with my dermatologist, worked with the psychologist, and took the anti-depressent drugs. Finally in the fall of 1990, I started to feel better and started noticing improvement in the skin condition and started participating in life again. I appreciate the opportunity to tell my story, and I hope that it will help to protect future consumers. I certainly learned the hard way to question the media and advertising and not to jump into using a prescribed drug without proper instructions. Coming from a stable background and having held responsible positions in society, I never could have anticipated the emotional upset a situation like this could have caused, and today deeply sympathize with individuals self-conscious about all skin problems but particularly in the facial area. I am also extremely upset that this drug has caused me to lose two and one half years of normal activities in my life. I feel very strongly that drugs should be tested and researched much more thoroughly before being released to the media and society at large. Thank you. LOUIS V. COLAVECCHIO, M.D. DERMATOLOGY AND DERMATOLOGIC SURGERY 360 KINGSTOWN ROAD NARRAGANSETT, RHODE ISLAND 02882 401-789-9911 March 6, 1991 Dear Sir: Nancy Meader has been under my care since November, 1988 for skin changes associated with an irritant reaction to Retin-A Cream which she had been given and applied 4 or 5 times. When initially seen she had post-inflammatory changes involving the periorbital areas bilaterally with slightly more severe involvement on the right. These were areas to which Retin-A had been applied. Over the following months and years I have followed Ms. Meader through both the physical and psychological impact of this event. Her skin has remained extremely sensitive to an assortment of environmental factors and has periodically required topical treatment. More important has been the emotional effects that persist to the present time and which have resulted in a significant alteration in lifestyle and personality. I anticipate that these effects will require continued treatment and support for an indefinite period of time. Sincerely, Meleness dis Louis V. Colavecchio, M.D. LVC: meb This is the letter you requested summarizing my impressions of the work we did together. I began seeing you in July 1989. You came to me a year after the application of some Retin-A cream to your face which caused skin burns and distortions particularly around your eyes. You had sought help from many sources including the manufacturer but had found no similar cases nor any resolution. You described to me that your life had been radically altered by the facial distortion. You told me that you had been a happy, optimistic and outdoor-type person before the incident and that after you were embarrassed about your appearance, had withdrawn from your friends and family and all your outdoor activities. This had caused problems with your husband, who was being very patient, but who wanted to continue the activities you had mutually enjoyed. You were clearly depressed and feeling rather hopeless about ever achieving any real happiness again. You found yourself obsessing about your skin and any further deterioration that might occur.. In our work together we discussed your loss of a sense of comfort with your appearance. This loss resulted in a depression with a sense of grief and a concomitant sense of isolation. It also resulted in attempts to rectify the situation first through medical means and when that failed through psychological means. During this period the intense focus on your facial appearance took on the characteristics of an obsession. You were also dealing with a parallel process of loss in that your father was dying. This complicated your work as it was my impression that the facial distortion and your father's dying became intertwined in some aspects. We worked on separating those two issues and resolving each in different ways. You worked very hard on accepting the possibility that there would never be any medical remedy and that you would have to live with this stigmata. You began to see that you needed to take risks to begin to live a more satisfying life. The risks entailed exposing your skin to conditions that you feared might further damage it but that allowed you to do the things that you find more enjoyable. You also began seeing people who knew you before that application of the Retin-A cream. You also decided to use an anti-depressant medication as an adjunct in your goal to achieve a more fulfilling existence. At the point that we stopped working together your existence had improved a little but you were still living a life that was far less satisfying and considerably more constricted than the way you had been before the application of the Retin-A cream. Sincerely, Veter Peter J. Kosseff, Ph.D. 115 GOVERNOR STREET Providence, Rhode Island 02906 HARVEY M. BAUMANN, M.D., INC. DiploMATE of the American Board of Plastic SURGERY Plastic & Reconstructive. SURGERY January 14, 1991 Nancy G. Meader 6 Calypso Dr. Saunderstown, R1 02874 To Whom It May Concern: I have been following Ms. Nancy Meader for difficulties with her eyelids. Apparently this woman was taken in by the claims for the use of Retin A to treat wrinkles. She used the drug on her eyelids and face, and was severely burned by the drug itself. This has caused a marked thickening of the skin with a leathery type appearence to the eyes, and in fact did exactly the opposite of what the expected result should have been. As far as I know the drug was not tested for the long term use for aging and wrinkles, and the media blitz that occured shortly after the release of one small study which was unconfirmed has led to multiple problems. Hopefully a stop can be put to this. I hope this clarifies the situation. If you should have any further questions, please do not hesitate to contact my office. HMB/tlo Sincerely, Harvey M. 'Baumann, M.D. I met with Nancy Meader in the office today for evaluation of some rhytids of her lower lids. She states that these were not present prior to her brief use of Retin A in May of 1988. To my examination, there is no evidence of redundant skin of the lower lids. With animation, there is a slight asymmetry with u more pronounced crows foot on the left than the right. I do not think that this is a surgical situation at this time. I also explained to her that I do not inject Collagen to fine lines around the eyes. reassured her and suggested that she massage the area and continue her moisturizer. I also stated that these lines may continue to become more noticeable as she ages and if somewhere down the line they are more noticeable, she may then be a surgical candidate. Thank you very much for referring her to my attention. Sincerely, Walter Roettinger, M.D. WR:po |