Acne is a difficult subject to broach for many. Too often, people see it as a reflection of poor hygiene, a bad diet or puberty. However, just a few clicks online will show you how acne is actually experienced by the wider world, with forums on acne treatment and how to deal with it in abundance, due to the high proportion of people who suffer from it.
Unfortunately, far too many people feel the need to comment on acne. All too often, well-meaning friends and family have advised me on how to treat it, and critiqued where I’m going wrong. Questions like “Have you tried x/y/z product?” or “Do you wash your face everyday?” may seem helpful, but sound futile to someone who has had an eight-step skincare routine for 10 years. Furthermore, comments like “maybe you need a healthier diet” or “well, look at my huge zit too!” may be well-intentioned, but often hurt more than they help. Someone other than a professional dermatologist pointing out something on your skin is plain hurtful.
In a society so focused on superficial appearances, acne is seen as a mark of carelessness; a deviation from the clear-skinned norm we’re sold in every form of media around. With approximately 40 to 50 million individuals living with acne, one would think it would be more accepted by now, but it quite unfortunately is not. Just a search online for any non-retouched images of those with acne enables you to see how people view it, with comments ranging from the downright abusive to well-wishers giving unsolicited advice.
Why is it that appearance should merit comment from those who it doesn’t concern? My appearance should be solely my concern. It is about time that people realise that bodies, and all the visual worth society attributes to them, aren’t up for public comment or scrutiny.
Often, pleas for help with acne are attributed to cosmetic concern or over-sensitivity. Concerns over your appearance are often vilified, particularly, as in my experience, with regards to acne. Whilst getting rid of warts or birthmarks seems fairly accepted, wanting treatment for a painful condition, temporary as it may be in some cases, is often not societally acceptable, deemed self-absorbed or a waste of time to healthcare professionals. Indeed, I felt immense guilt at seeking treatment for something ‘superficial’ that didn’t directly threaten my health.
Though acne treatment may seem small and unimportant, for me it involved prescriptions of antibiotic after antibiotic, and cream after cream, on the promise that one might work; that I should wait the treatment out and stop wasting doctors’ time. When I finally started isotretinoin, also known as accutane or ro-accutane, I remember hearing the list of side effects, and being absolutely shocked by the trouble I was putting my otherwise good health in. Blood tests and hospital checks proceeded every month for nine months in case my liver decided to stop working as a consequence of the medication; my skin dried out so much it would crack and bleed. Though this may ordinarily have been worrying, I was so desperate for it to work that instead, I was unbothered.
And whilst topical and oral treatments may be a suitable medical plan for many (spoiler: for me, it wasn’t), there is often a failure to recognise the huge impact which acne can also have on self-perception and mental health.
Frankly, I’m in awe of anyone who can truly overlook their acne. When my skin was at its worst, I would spend days doing skin care indoors, refusing to go out because I didn’t want to be seen. This became an obsession of sorts: I grew a fringe (bad idea, trust me) to hide my forehead, and started wearing my hair down every day to hide my face, refusing to leave the house unless I had clean hair for this reason; picking at my acne became a form of self-harm, which I’d do whenever I was stressed or angry at myself, which would often be the result of picking at it; I used makeup as a shield, putting on a brave face daily to deal with life; I would scurry off to the bathroom so I could top it up, terrified that anyone would see what my skin was actually like. Unfortunately, heavy makeup was against my school’s dress code, and so every day I would dread being passed a makeup wipe, and forced to take it all off in front of my peers. Years later, this dread persists – few people see me without makeup, and it’s alway terrifying for someone to see me bare faced, and view the unhappy resident on my face.
Over time, this hugely impacted my self-esteem, leading to me turning down opportunities because I just couldn’t bear to be seen, whether my acne was at its worst or best (read: far less clear than the average person). I have no pictures of myself aged eleven to about seventeen as I made sure that my acne went undocumented. For a while I disappeared from the camera and withdrew into my shell. Without evidence of how bad it was, it seemed like less of a weakness. The paranoia and sadness of dealing with acne contributed to me feeling self-conscious all the time, and my mental health deteriorating.
Now that I’m older, and hopefully somewhat wiser, it seems ridiculous that this once had such an impact. I realise that being seen by others is a necessary part of self-presentation, and of course you’ll be judged. Thankfully, at university, my peers have not judged me for my acne. But I still feel its impact as an adult. The scars from my severe acne are there for anyone to see; a reminder that my skin still refuses to comply with beauty standards. On bad days, it’s hard to ignore the feeling that people are judging your skin, not you. The nature of being a woman especially means that society values your beauty above all else. Personally, I felt I would never be seen as ‘beautiful’, so I fell into the trap of believing I could only be smart – a false dichotomy that I’m sure many Oxbridge students are aware of. And for those who are male or male-presenting, toxic masculinity often condemns individuals from using any form of makeup, or even skincare, to help yourself feel better. The impact of acne seems to negatively impact everyone, no matter your gender.
Social media has only enhanced this. Now, pretending that you have perfect skin is all too easy with the use of filters and photoshop. Whilst this could be a positive change for acne, it would seem instead that not having perfect skin, online or not, is now inexcusable. Not conforming to this standard is damning; to many an indication of being dirty, undisciplined, unhealthy. The pressure to conform is immense, and bitter when acne is mostly out of the sufferer’s control, as it is in many cases. Bad hair cut? Don’t have the right clothes? That can be fixed. But making your acne disappear is near impossible for many.
The taboo of talking about acne is slowly being broken down. As a teenager, I didn’t dare talk about my acne, and this is the first time I’m doing so now. To speak up about how horrible it can be would be to acknowledge its presence, and for many it’s easier to pretend it’s not there, and hope that those around you will maintain that pretence with you. Due to its prevalence in teenagers, adult acne sufferers are often left feeling like they’re being judged.
Because how many of these (mostly-online) conversations about acne are truly destigmatising or empowering? Instead of treating the emotional drain which acne creates, or the social exclusion that sufferers experience, the beauty industry instead focuses on what it can sell you on the promise that you might, maybe, see an improvement. This can even be framed positively, with brands like Zitsticka and Starface making acne treatment ‘cool’. However, even such well-meaning brands make money from insecurity and social exclusion, with an impressionable demographic: acne sufferers, desperate to shake off the social taboo they literally have written all over their face, are easy targets for capitalistic schemes.
But whilst Tiktoks which advocate spending £200 on skin products abound, and acne is still seen as a marker of immaturity and puberty, it’s not all doom and gloom. Beauty bloggers and those with acne are normalising the condition, with 25,000 #freethepimple posts on Instagram at the time of writing. More and more celebrities are coming forward and admitting they struggle or have struggled with acne. Who knows? – perhaps when we come out of lockdown, the bare-faced indoor look many of us have embraced over the past few months will be here to stay. Either way, I look forward to the day I can lift my face, acne scarred and damaged as it is, to the sun.
Cover Photo: Jurien Huggins via Unsplash