My Year with Acne

I was one of the lucky few who never had acne in high school. If I ever did get a pimple, it

was almost exciting. I could feel grown-up bemoaning my complexion, while still safe in the knowledge that it didn't really detract from my looks. To be honest, I had no idea how people with severe acne managed to get out of bed. I already felt like such a self-conscious, insecure mess. How could I ever keep my head up if I also had to deal with that?

    Perhaps as a punishment from God for my hubris, that all changed my sophomore year of college. I didn't exactly wake up one day to a face full of pimples; the change was more subtle than that. I distinctly remember looking in the mirror one day at my summer job and thinking, Wow, my skin really sucks right now. And then not thinking much more about it, because why would I? I’d had zits before, and they had all gone away in time. 

    Well, these didn't go away. They started to multiply, mutating all across my face until every patch of skin was covered in small red studs. They weren’t grotesquely large or pus-filled or bloody - in pictures, they often didn't show up, unless you looked closely - but they were obvious when you spoke to me, and they became obvious when I looked in the mirror. They became the only thing I could see. 

It became the only thing I could think about, too. The state of my skin started to consume my every waking moment. I would get out of bed and rush to the mirror, trying to convince myself that the zits had gone down overnight. (Spoiler alert: they hadn’t.) Every conversation I had, I had a monologue running in the back of my head: are they thinking about my face? Why is their skin so much better than mine? Does it look worse when I laugh? Oh God, did their eyes just flick to my forehead? When my boyfriend at the time and I FaceTimed, I would defeat the purpose by hiding my face in gloomy lighting, my hair, pillows, all without telling him why. I was terrified that he would dump me when he saw how drastically my face had changed. 

Making matters worse was the fact that I had no idea why this was happening. I hadn’t changed my diet; I didn't have any extra stress in my life (apart from the pimples); there was no change in birth control… I had no idea what I had done to cause this, and further - since I had never had to deal with acne before - I had no idea how to fix it. Naive, then, to the complications and frustrations of treating severe acne, I slathered cheap ‘acne wash’ from Rite Aid all over my skin every night, assuming the burning meant that it was getting better. If there was even one comment online suggesting that a certain food caused breakouts, I cut it out entirely. I did everything I could not to sweat, fearful that it would exacerbate my condition. Nothing worked, and my obsession worsened with my despair. 

Finally, I plucked up the courage, and forked over the cash, to see a real dermatologist. We tried a couple of antibiotics and creams, but again, nothing worked. Eventually, after several failed trials, my dermatologist brought out the big guns: Accutane.

If you have any experience with acne, you’ve probably heard of Accutane. It’s called the “miracle drug,” and for good reason; a lot of people who take it claim that it completely cures their skin permanently (link: https://www.drugs.com/comments/isotretinoin/accutane-for-acne.html). However, there are also a lot of people who say that it was the worst decision of their life (link: https://www.honeycolony.com/article/accutane-cancer-acne/). 

Why the discrepancy? Well, it’s a very intense treatment that works by shrinking the oil glands in the skin over a six-month period (or longer). Since that’s a pretty hardcore thing to do to your body - you stop producing excess oil so your skin can clear - it can come with some gnarly side effects, like hair fallout, joint pain, dry lips, and, in some cases, damage to your mental health. Some people who have taken Accutane even report that these changes are permanent.

Suffice to say, it’s a scary drug, and I was definitely a little nervous about entering treatment. That being said, my mental health was already not great. I felt so self-conscious all the time, convinced, like many acne sufferers, that everyone was always looking at me and judging the awful state of my skin. My confidence was completely sapped, and I felt that I had no recourse but to try Accutane.

Luckily, it worked exactly like it was supposed to, and I barely experienced any side effects, which was amazing (and rare, in case you’re thinking of following my example). I couldn’t believe it; suddenly, this huge weight that I’d been carrying on my shoulders for months and months was lifted. My skin was clear again. Great, now my life can go back to normal, I remember thinking.

To be honest, though, after having had some time to reflect on the experience, I’ve realized a couple of important lessons that I want to share with anyone who is dealing with acne. 

 

Lesson #1: It doesn’t have to change your life.

 

On the inside, I felt like everything changed once my skin did. My self-esteem dipped dramatically, and I found it difficult to talk to anyone without thinking about my pimples. If I look at my life objectively, though, nothing was that different. My boyfriend still wanted to be with me; my friends still loved me; nobody treated me differently at work or school… the change was entirely in my head because acne doesn’t affect who you are. It’s just an external, superficial aspect of you that will, eventually, go away, as all zits do. It has no bearing on who you are as a person and should have no bearing on how others treat you - or how you treat yourself.    

Conversely, it wasn’t like my life was automatically perfect once it was gone. I thought that I would feel so much freer, and I did, but I still had the same internal issues that I was dealing with beforehand. This is what I will say about acne: it can be damaging, but only if you allow it to be - and people who don’t have it aren’t any more put-together than you. 

 

Lesson #2: There is not nearly enough acne representation in TV or movies.

Ever since I broke out, I found it difficult to even enjoy watching TV or films anymore, because everyone I was looking at had perfect skin. Or, if they didn't have perfect skin, it was a whole plot point, and they maybe didn't get dates because of it, or they skipped a job interview… no matter what, though, their skin was always back to normal at the end of the episode. It made me feel like such a freak once I realized that acne is such a physical taboo, especially for women, who already face so much societal pressure to look quote-unquote ‘perfect.’

Luckily, there are certain people out there pushing back against this narrative, although there needs to be more. For now, if you’re ever feeling down about your skin, you can check out social media influencer Kali Kushner (link: https://www.instagram.com/myfacestory/?hl=en), who keeps it real on Instagram about her skin struggles, and the beautiful and touching film Eighth Grade, which doesn’t airbrush away the acne of its lead actress, Elsie Fisher. There are also movements like “skin positivity” which encourage acceptance of one’s skin as is (link: https://www.allure.com/story/skin-acceptance-movement-and-me). Hopefully, these are all signs of less skin-shame on the horizon. 

 

Lesson #3: It’s damn near impossible to know why you’re getting it - but that won’t stop people from telling you why.

 

    There are so many reasons we break out. Hormones. Dirty pillowcases. Certain foods. Certain pills. Genetics. It can be incredibly frustrating trying to locate the source of your acne, and it can be even more frustrating when everyone you know is telling you how to cure it since they have no idea why you’re breaking out either. “Drink more water” is great advice - but it’s not going to clear your acne if the reason is, say, your birth control. 

    I still don’t know why my face broke out the way it did. I probably never will know. And while my skin is pimple-free, I still have a lot of scars that haven’t faded yet. I used to worry about these scars, too, but eventually, I got sick of caring. They just don’t matter.

Ride it out, my fellow acne warriors. You’re still you, and you deserve all the good things in life, regardless of the state of your skin.