Body Image: The Acne Edition

By: Claire Allison

Edited by: Bridget Salice

I’ve noticed a great deal of body positive messages circulating through social media, focusing mainly on body shape and size, but one topic that seems untouched is acne.

This topic is very personal to me, as I have been dealing with acne for the past 11 years! I want to share my experiences with this specific aspect of body image and my journey through seeking clinical intervention. I hope you finish this article with a deeper understanding of how acne effects body image and that you are not alone if you struggle with it.

I found an incredible study published just this year titled A Qualitative Investigation of the Impact of Acne on Health-Related Quality of Life (HRQL): Development of a Conceptual Model. It reveals how acne impacts emotional functioning, social activities, social media, relationships, leisure activities, sleep, school/work, and reactions from others. Below I have provided figures from the study that give examples of how acne has impacted the participants’ lives.

Acne 1

Acne 2

After reading through this study, it all felt way too familiar. My heart hurt for these adolescents and adults, as many expressed feelings of being held captive by their condition. Here are just a few of the results that I would like to highlight in my own words:

  • Over two-thirds of participants reported acne affecting their social life, especially when interacting with strangers. They felt they were being judged or that the person was only focusing on their acne, which led many to avoid social activities.
  • Some participants reported acne impacting their ability to form new relationships. It also impacted current relationships, with friends sometimes poking fun or not understanding. Some adults even reported their significant others leaving them because of it.
  • Adolescents with acne tend to feel more supported since many of their peers have it and they feel like their condition is taken more seriously. Generally, adults with acne feel less supported and some even expressed their condition was not taken seriously by their doctor or others.

One thing I want to “clear up” (pun definitely intended), is that acne is NOT a hygiene problem. I cannot tell you the number of times people used to say to me, “Well, have you tried washing your face?” Oh wow, what a great idea, I definitely would have never thought of that…Yes, if you rarely wash your face, then there is a good chance your pores will get clogged, but it’s not always as simple as that. I used to wash my face more than 3 times a day, had such as strict morning and night routine, and was trying all of these over-the-counter face washes and treatments. Nothing worked. I felt like I was covered in a mask of red bumps and that this mask was all that people could see. It took a serious toll on my body image. It was my face, you know? It’s typically the first thing any person looks at when they see you, what they imagine when trying to remember you, what they look at when speaking to you. It was hard to feel embarrassed by it and feel the urge to cover up who I truly was.

I also don’t think people understand the level of physical pain that comes with it. My face was bumpy and sore to the touch. Sometimes it would hurt to just lay on my pillow at night. I was constantly fighting an inner battle of wanting to pick at my face – it was either walk around with some pus bumps or deal with the pain and possible bleeding and scarring from picking at them. I felt pressured to wear makeup everywhere. I would use the smooth editor feature to photoshop my breakouts or use filters for pictures. It was hard to feel like I could never just show my real face. I thought it couldn’t get any worse, but then I started my first year of junior high school. Hormonal changes, galore! Does any of this sound familiar? So how did it get better?

For my acne, I sought out clinical intervention. I scheduled my first visit with a dermatologist when I was in the 6th grade, so at age 22 my case file looks like a textbook! I went through so many different medications. Dermatologists tend to treat in three ways, or a combination of them: topical creams, pills, and face washes. Topical creams never seemed to work, and within a year of experimentation, I found that targeting the infection from the inside out (pills) gave me the most success. After a few more years of intervention, I felt like I needed something more aggressive and I found a dermatologist that was comfortable with this route and respected my wishes. I went on Accutane for two cycles. This is a more aggressive treatment option in that I had to do monthly blood draws, and either be on birth control or pledge to abstain from sex. This drug can cause serious birth defects. Side effects of this drug were dryness of skin, mouth, lips, cracking of skin (typical of most any acne treatment). I remember my skin was so dry I was literally peeling like a snake and my lips were so chapped you could not even see a definitive lip line. It was rough, but I wanted so desperately to feel smooth skin. I don’t mean to scare you, I just want to give you the reality of my situation. This medication is perfectly safe and a very common treatment option for acne. Each cycle is about 3-5 months depending on the person and most people never have to be treated for acne again. I went on it for two cycles and only have one or two breakouts at a time, a major improvement and something I am extremely content with!

I also went through a lot of growth in terms of my mental health. I am 22 and still have breakouts. I pretty much always have a few breakouts, and I can honestly say that I have maybe worn makeup 4 or 5 times in the past six months. It became one of those things where I decided I just don’t have the energy or will to keep battling with that pressure to have perfect skin. Makeup is empowering for some women. I do enjoy wearing it and getting glammed up, but I honestly prefer my natural beauty. I thought, “You know what, this is me. If people are really going to treat me differently because of a blemish on my face then screw them, their loss.” Maybe that “I don’t care” attitude comes with age, but I have to say my quality of life improved drastically when I decided to withdraw myself from that battle. Because of that, I feel like I have gained a sense of control and a part of my identity back. Oh, and TIME! The amount of time I now have to spend doing other things because I don’t feel the need to put on makeup every time, I leave the house, to screen/edit photos, go through an endless skincare routine every morning and night, go back and forth between outfits, the list goes on!

Acne is something I think we all experience to a certain degree, and yes there are people out there who have never experienced it. I hope to have shined a light on the struggles of this common condition and maybe given those people who have never had a breakout a glimpse of what living with acne is like. We all get breakouts, so why is it still judged so harshly? I think this aspect of body image deserves more attention considering the scope of people it effects. I aim to keep pushing against these societal standards of “perfect skin.” I want to help others in any way that I can when it comes to coping and feeling worthy in their own skin!

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