February 2019

Acne was introduced to my twelve-year-old self in the form of mild adolescent spots. It came accompanied with a skin shame I would carry around for another decade - and start to shed partway through a battle with cysts more aggressive than I previously knew possible. Years spent struggling with mildly problematic skin had instilled in me a deep insecurity which intensified during the sudden onset of cystic acne early last year. My skin worsened, my self-esteem plummeted, and being out in public became an arduous task.

Visibly striking acne means turning heads while you walk down the street. It means strangers glaring at you in supermarket queues, acquaintances you run into asking what you've done to your face, and customers you serve recommending you switch to a vegan diet. The way people looked at me felt jarring. Their expressions of shock reflected my own panic at having seen my skin quickly deteriorate with no identifiable cause, and on some deeply rooted level, the looks of judgement – disgust sometimes – echoed my own feelings too.

I get the impression most could start to sympathise with the psychological impact. Everybody knows what it's like to feel self-conscious. Rarely would they consider the physical sensation. It can be very painful, and this level of inflammation on your face renders the most everyday tasks like eating and sleeping difficult. It's a constant discomfort that may take months to resolve, and a prolonged state of having your biggest insecurity on show – an insecurity met by a lot of people with a lot poor preconceptions. 

I'd been working with doctors since the onset and saw no success from treatments available through a GP. Nor with any of the lifestyle adjustments and skincare tips popularly believed to be alternative treatments. There would be no change until I was able to start a course of isotretinoin under the care of a dermatologist. Now, six months into treatment, I remain in awe of the physical relief and visible improvement this medication brings.

The emotional transformation has been astonishing too and although I'm really quite comfortable in my skin today, it wasn't so long ago I was fiercely avoiding mirrors, struggling to step out the front door, and refusing to see loved ones out of shame. Naturally my confidence has grown as my skin has recovered, but cultivating a state of self-acceptance was born out of necessity a little while before any significant physical healing would take place. 


It took me a while to understand I can be aiming for clearer skin and I can meet myself with love and compassion and kindness wherever I'm at right now. Acne is a skin condition I would never be giving other people a hard time for, in the way I had been doing with myself. It's going to be here until it's not, and I decided while I'm doing all I can to work towards the not, I don't have to be waging a war against my reflection. 

Perhaps the most empowering move though was to learn more about it, to understand I did nothing to cause it, and put to rest the many misconceptions I went into this believing to be true. I was able to see it for the temporary and treatable skin condition it is; one that says nothing about me other than the fact I currently have a temporary and treatable skin condition. One that gives no indication of my health or lifestyle, and one that is no measurement of my attractiveness or worth. While knowing this doesn't change how other people may view it, hanging onto my truth keeps me grounded through wobbly days. 

Last year was an incredibly isolating experience. I would study faces of strangers in the street and co-commuters on Monday mornings hoping to see anyone whose skin resembled my own. It is with gratitude that I can now say I connect with many people through sharing my experience online. There is a healing power in feeling less alone, and I feel driven to talking about it all in a way I know would have brightened my own darker days.

There isn't quite enough distance yet for me to not feel some sense of loss for the near-clear skin I used to hate, or for all the time I spent blaming myself for a difficult skin condition I had zero control over. But I think the antidote to feeling any kind of lack is to focus instead on what we do have, and in many ways I do feel better off - not in spite of this condition but because of it. Few things force you to confront yourself the way walking around with visible cystic acne does. For the first time since my pre-teen-self learnt having spots makes them flawed, I've untangled my self-worth from the condition of my skin. 

P Phillips 

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