At what age did you first develop acne? How long have you been suffering from acne and/or acne scars?
I am currently twenty-two years old. I’ve always had acne-prone skin, but the first time I really battled with cystic acne was about two years ago, right around my twentieth birthday. My skin cleared up for a while after seeing a dermatologist, however, my acne returned about 6 months ago- and it was back with a vengeance. After having clear skin for so long, it seemed like my skin got a hundred times worse in an instant, and I’ve had the worst cystic acne of my life since. My skin now is working very hard to heal. I have occasional painful spots, but right now my skin is mostly riddled with deep purple and red scarring.
Have you ever been depressed, suffered anxiety, low self esteem, been bullied, etc. because of the acne you suffered? Did you avoid social gatherings because of your acne?
During my moderate acne flare up when I was just entering my twentieth year, I was prepared to handle my incoming spots with an array of face washes, spot treatments, and any other products I could get my hands on. The thing I was not prepared to face was the mental and emotional struggle that came with my persisting acne.
I never was directly bullied for my skin- other than the emotional damage and bullying I did to myself. On some of my worst nights I cancelled plans, stayed home, and would stay in front of the mirror, picking myself apart because of the condition of my skin. I would go to bed feeling defeated. I asked myself why I couldn’t just be normal, and have normal skin. The first time I really struggled with acne was pivotal for me because it also marked the first time I ever struggled with anxiety. I felt isolated around everyone, even my closest friends who I have known for years. I was afraid to meet new people-afraid to talk with them as I imagined their eyes only following my red, angry spots. Within a matter of a few months, I went from being in a constant bubbly, extroverted, and excited state to one of extreme self-loathing, insecurity and isolation. It ruled my life- every interaction I had was controlled by my throbbing skin. I didn’t want to raise my hand during university lectures because I was afraid of drawing attention to myself. I was nervous to have sleepovers with my friends because I was afraid of waking up with a thousand new spots. My partner at the time cheated on me, and even that was ruled by my skin. I always wondered if that would have happened if my skin was clearer. Without realizing it, I had made my self-worth synonymous and dependent on the condition of my skin. Even after my skin healed, the emotional damage of having acne followed me for years.
Have you overcome these challenges or are you still facing them today?
When I experienced acne about 6 months ago, I felt the emotional pain once again take hold of me – just as I was starting to feel fully healed both mentally and physically. This time however, I had a completely different experience, although I cannot pinpoint exactly what has been responsible in shifting my rhetoric from one of insecurity to one of total empowerment.
One of the biggest things that has helped me make this shift is communication. When I struggled with acne the first time, I kept it in. Noone knew how insecure I was because I didn’t open up to anyone- not my partner, my friends, nor my family. I suffered in silence and internalized every single bit of pain I was experiencing. This time however, I opened up to my current partner and friends- the people who I know love and support me no matter what. It was so hard at first, as I was embarrassed to discuss something that they all obviously knew I was dealing with.
One night, my partner came outside and found me sitting on the sidewalk crying. He held me, let me cry, and when I was ready, despite my reluctance, I told him about my struggle- every hateful thing I was feeling and thinking about myself, my anxiety about talking to or meeting new people, and how acne was disrupting every facet of my life. Opening up to the right people can be extremely reaffirming- within minutes of talking I felt entirely validated in all of my suffering; I felt heard, and most importantly I felt so wholly and deeply loved despite my imperfections. I cannot stress how important a good support system is for any mental health struggle, including the struggles that come when dealing with acne. Once I opened up to one person, it was easier to talk to my friends, family, and eventually a whole group of strangers on the internet about something that once was my biggest insecurity.
How does social media affect you?
Social media is another thing that has helped me to make this shift in rhetoric. Before it was something that would reinforce my insecurity as I would scroll through Instagram and see models and my beautiful friends with perfect skin, all seemingly much happier than myself. This time, however, I stumbled upon a community that made me feel accepted, worthy, and even beautiful despite my angry skin. I truly believe that social media can be a positive and powerful tool if we use it correctly. I had let social media gain power over me. It had convinced me that I was supposed to look different than how I actually am. It convinced me I should be taller, skinnier, have a better body, and finally, have clear skin. Finding a community that celebrates differences helped to redirect this subconscious conditioning that I had undergone. It was scary at first- I wanted to make an account that depicted my journey with acne for so long before I actually committed and started my Instagram page @Emmas_Acne_journey. It was a huge leap for me- posting raw, unedited, clear photos of my skin. It was a way of gaining control over my thoughts again- a bold statement to reinforce that I am strong enough to love myself despite my skin, and I’m not going to be ashamed or embarrassed anymore. I am tired of hiding.
What steps have you taken to try and improve your acne and did they work?
When I had moderate acne, the drug spironolactone worked wonders for me. Now that my acne is back, and worse than ever, I’m on spironolactone again. This time it has worked well in lessening my active acne, but I still have new spots that come in everyday. I get suggestions all the time to try accutane, but that isn’t a route I’m willing to take- at least not yet. I have struggled for so long with mental health issues, they are prevalent in my family, and I know that accutane can often exacerbate these issues. This is an internal battle I often have with myself. Accutane, and many other acne medications, can create or worsen mental health issues and yet so many people already struggle with depression and anxiety because of their skin, appearance, and the unattainable standard of beauty that the media reinforces. This is why the acne positivity movement is so important- it redirects the focus on self love and acceptance instead of “attaining perfection”. I, along with most people in the acne positive community, still want to have clear skin, however my main focus is to have confidence and love for myself. There is another option- we no longer have to choose between hating ourselves for our appearances, or taking medications that might prove harmful to some.
On average, how much money did/do you spend per month on over-the-counter acne treatments – as well as any prescription medication for acne – and do you believe they worked/are working for you? Does your insurance cover acne/acne scar removal treatments or do you have to pay out of pocket?
A huge problem that arises when people try to treat acne is paying for medical bills. Because I’m 22, I’m still on my parent’s health insurance which is quite good. However, our dermatology related prescriptions are still considered extremely expensive. The average cost of accutane, which again I have not tried, is just under two-hundred US dollars monthly, but can be much more if an individual is uninsured. Because a lot of insurances do not cover dermatology, many people who have severe, painful cystic acne cannot afford to treat their skin.
During the last six months, when my skin started to develop acne again, I was backpacking through Europe and had stopped in Spain to volunteer at a hostel. I didn’t have travelers insurance, and I knew I desperately needed to make a dermatology appointment. After working up enough nerve and practicing how to say “I’d like to make an appointment for my acne” in spanish, I called a dermatologist who informed me that it would be one-hundred euros just to be seen. Luckily I had the support of my family, and together we paid for an appointment as well as the subsequent prescriptions.
As far as treating scars go, I haven’t looked into professional treatment. I’ve been using bio-oil twice per day, which I paid around ten USD for. This is just a fraction of what I spend monthly to take care of my skin. I also pay for Cerave or Cetaphil cleansers and moisturizers, and a spironolactone prescription, which together is quite an expense.
What are some things you wish people knew about what life is like living with acne/acne scars?
I wish that people would be more gentle when they talk to others about their appearance. When you’re living with acne and scarring, your skin is constantly on your mind. People often tell me to “Just ignore it” but I’m constantly aware of my face as my painful and throbbing spots hardly let me forget them for a second. I get unsolicited suggestions and advice about how I should be treating my skin all the time. At first, when my battle with acne started, I didn’t realize how harmful these comments were, and I took the advice eagerly because I was so desperate to get rid of my spots. However, now that I am feeling more confident, I can see these comments for what they truly are- intrusive, disrespectful, and invalidating. Firstly, it is extremely ignorant to assume that anyone who has suffered from acne wants this advice. It’s so important to understand that most people with persistent acne have tried everything- and I mean everything- diets, face washes, homemade masks, spot treatments, serums, excessive water intake, seed cycling, changing your pillowcase case every night, probiotics, facials, celery juice- and so on. It’s extremely invalidating when someone tells you to “drink more water” or “go to a dermatologist” when you’re feeling defeated because you’ve tried absolutely everything, and nothing is working. This rhetoric also implies that your skin needs to be “fixed”- it negates acceptance and acne positivity and instead perpetuates and stigma that surrounds acne. Lastly, it is absolutely unacceptable to bring up food & dieting. If someone asks me for skin advice, I have no problem divulging my choice to adopt a vegan diet, and share my skincare routine because both parties are consenting to this conversation. However, giving unsolicited advice about what foods to avoid & cut out can be extremely triggering for anyone who has suffered with their body image, weight, or disordered eating and is therefore off limits.
Did you have a dream career that you did not pursue because of your acne?
Having acne hasn’t deterred me from pursuing a certain career, instead it has been one of many factors that has pointed me in the direction of a career in healthcare. I don’t necessarily handle patients with skin issues, however having acne has taught me how to be nurturing and understanding to patients suffering with a wide variety of ailments. Although I struggled for so long, I feel now that having acne has softened me, made me more human, and has allowed me to understand that many physical conditions also take a toll on mental health and self esteem. This has allowed me to extend empathy to many others that I have encountered since I began working in the medical field in 2017.
How has acne/acne scars impacted your self-esteem overall?
Having acne has been both an emotional and physical rollercoaster ride for me. I have felt the full spectrum of emotions. At the beginning of my journey, I felt completely powerless and victimized by this condition that I seemingly have no control over. I felt bullied by my skin, and eventually I started bullying myself. I fell into a vicious, destructive cycle and my mental health plummeted. I feel like now I’m experiencing the opposite end of the spectrum- I feel empowered and confident in my bare and natural skin. However, some days I still feel insecure as negative, anxious thoughts about my skin creep in. I often tell myself that healing, not only of my physical body, but also of the emotional damage and insecurity that once crippled me, isn’t linear. I try to humanize myself and validate what I’ve gone through because often I am my own harshest critic.
Are you currently working on your emotional health? How so?
Truthfully I am always working on my emotional health. When I first suffered from anxiety and depression, I didn’t know how to handle these challenges because I never had experience with this type of mental health issue before. Now that I’ve experienced these things, I know how to recognize when my mental health is slipping, and more importantly, I know how to ask for help.
My friends have been my biggest support system in the struggle I have with mental health. Our relationship is not stunted by these hard conversations, but instead they make us much closer and solidify our bond. One of the underlying issues when facing anxiety and depression is the feeling of being utterly alone- like I said earlier, opening up to the right people can be so rewarding and even transformative for mental and emotional health & wellbeing.
Some other things that I have been actively engaged in to promote mental health is journaling or blogging. Writing about your feelings is a great way to unload while tracking your progress. When I first started journaling, my pages were filled with paragraphs highlighting my insecurity and disappointment, and now, when I look back on these entries I’m able to truly see how far I’ve come.
I’ve also learned to balance my alone time with my social time in a healthy way. This is an important thing to do if you struggle with codependency or if you’re prone to look to other people for validation, which I did when I was at my most insecure.
Lastly, I make sure that I have time to nurture myself when I need it. If I’m feeling defeated, anxious, or stressed out, I make sure that I take time to do things that make me feel whole again- journal, do a face mask, take a tub, watch movies, clean my room, create art and music, or confide in a loved one. These may seem like small actions that don’t play a huge role in mental health, but showing up for yourself makes a huge difference. It’s one of the first and most basic steps in taking care of yourself.
What are you doing with your life today? Your career, emotional health, new goals, etc?
Ah this question comes at a particularly strange time. As I’m writing this, we’re in the middle of the novel coronavirus outbreak. As I mentioned previously, I was backpacking Europe for seven months, and my final month was spent in Mexico, where my partner and I were volunteering in a tiny hostel on the beach. We’ve had to separate and go back to our families when borders began to close as the virus worsened. Right now I have about a million ideas in my head of what to do next- I want to go back to school and further my education, I want to work and save money, travel more, focus more time on creating art and music, I want to start a podcast eventually, and finally my partner and I have even loosely talked about opening up our very own hostel one day.
What advice can you give people who are currently struggling with their acne, acne scars or the emotional scars left behind?
Be vulnerable. Everyone who has suffered with acne needs to know that they are not alone, and things do get easier when you find the courage to speak up about your mental and physical battle. I guarantee that every single person who has suffered with this skin condition has felt isolated and hopeless during their worst moments.
Surround yourself with people who accept you and get involved with the acne positive community. This community has helped me to fully accept that I don’t have to be perfect to feel beautiful. It’s a place where vulnerability is encouraged and differences are celebrated. If you find that you cannot open up to friends or family, message any one of us from this amazing community. Message me. Message anyone who has decided to share their acne journey in a public space. I started my account to instill confidence in myself, but also so people who are going through the same thing would feel less alone. We have strength in numbers- an unspoken solidarity as we know exactly how eachother feel without having to vocalize anything. If you are currently struggling with your skin, no matter the state, know that I have felt exactly how you’re feeling right now. I want you to know that despite what I went through with my skin, and what I’ve continued to go through, I’ve turned my single greatest insecurity, that once crippled me, into something that empowers me- and everyone has the power to do that.