What They Don't Tell You About Acne

Acne is still a taboo subject. Aside from a few remarks like, “Oh I have so many blackheads,” or “Ugh, I can’t wait to pop this pimple,” people don’t really like to talk about it. Especially cystic acne.

No one talks about the physical pain that feels like pins and needles continuously stabbing your face through all hours of the day and night. No one speaks about the actual needles that sometimes need to get stuck in your face by the dermatologist because a cyst won’t go away. There is not a big community to rely on, few people to confide in who understand acne-induced depression, and the feeling of loneliness ensues.

I have found that, yes, it is draining to be self-conscious of my acne, but that wasn’t the biggest hurdle for me. I thought thinking I was ugly would be the most challenging to come by. These thoughts did occur, and they were difficult, but mentally I was more so in a bad place because of the pain.

Not only did I want to see my progress both mentally and physically, I needed to let go of these harsh views and allow myself to feel what I was going through. I didn’t have anyone in my life who had the same cystic acne experience as me. I was fortunate enough to have a few people who could somewhat understand, but it is still a very lonesome experience. Here, you will see selections from my journals where I forced myself to get my thoughts down on a page.

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August 25th

“I really, really, really thought it was going to get better and was trying my best to stay positive but it just keeps getting worse. It’s excruciatingly painful to even wear my glasses, or to wear a mask.”

September 14th

“Today was a bad skin day and I’m sad and worried about how it’s going to be in the future.”

September 15th

“I feel really, really ugly.”

September 21st

“I like the days where I feel pretty despite the acne. Today is not one of those days. Every time I get ready for the day and put on some makeup I play some music to distract myself. But today, it wasn’t much of a help.”

September 22nd

“Now, today feels completely the opposite. A little more hopeful and not feeling too down on my skin.”

September 30th

“I feel like last weekend my skin was looking pretty okay and I felt like it was progressing but this morning I woke up with a few more pimples and now going to sleep my face is in some pain.”

October 5th

“Face is doing okay, kind of happy about it for once! Back acne is pretty bad though and probably the worst it’s been in a while. You win some, you lose some, I guess.”

November 23rd

“The first time I’m logging onto a video meeting without makeup!”

December 9th

“This past week has been pretty good but now I have 5 more cysts on my chin. They’re so painful. I can’t fall asleep. Very proud of my confidence levels recently though.”

January 4th

“Although the pain is difficult, I want to try and smile through my acne progress pictures this year. Even if I’m sad. I think that can maybe help a little.”

January 15th

“When I get multiple new pimples in a day that are really painful it’s so hard to stay positive. My skin was getting better towards the end of the year so it’s really hard when it’s getting so much worse. Feeling pretty low right now.

January 18th

“I can’t take it anymore I’m just so sick of acne and my face constantly hurting I’ve been so positive recently even when it’s been so hard and it’s not even how it looks it’s just so damn painful. Now I’m mad that I wasted my whole day being sad but couldn’t pull myself out of it.”

February 1st

“Since I cut out gluten, I’ve started to be a little more hopeful. Taking notice of what my body likes and doesn't.”

February 11th

“I haven’t been writing in the past few days because I was trying to avoid thinking about how bad my acne is. I finally scheduled a dermatologist appointment and hope I can get something worked out.

February 14th

“It hurts to hear from someone else that my acne is really bad. But I’m hopeful now that I have some solutions that I’m okay with from the doctor.

February 19th

“Looked at a photo of me and thought ‘Oh, I am still pretty.’ Made me feel less heavy.”

February 27th

“Itching and burning and cannot touch my face.”

March 3rd

“Difficult skin day today, as almost every day is. It seemed to be getting better the past two days and then, of course, new acne. It’s so frustrating that I keep getting back hope and then losing it. Such an unfortunate cycle.”

March 17th

“It will be 3 more months until I see if birth control works. I will stay on the antibiotic in the meantime. My dermatologist did say my skin was improving a little bit. The big oof was the cortisone shots. Those are so painful but hopefully will help the cysts heal faster. I feel relieved.”

April 11th

“I’ve been very happy about my skin for the past few days. I’m proud that I ultimately mustered up the courage to go to the dermatologist because it has improved since the first visit. It’s only been about two full months and I finally feel like my skin is going in the right direction.”

April 18th

“I am beginning to get really happy about my skin, but nervous of what will come once I’m off the antibiotic. Shouldn’t worry about that now though.”

May 1st

“I get pretty anxious about being happy about my skin because I am worried about it returning, but if I’m happy I should just try and hold onto that feeling instead. Right? My skin isn’t perfect. I have acne, and scars, and texture, but I’m beginning to become more confident. Embrace the happiness.”

June 19th

“Haven’t journaled in a while. That means acne isn’t taking up as much space in my mind. Mental health has been improving as the pain decreases.

July 12th

“Officially stopping the antibiotic. Nervous but happy.”

August 4th

“I’ve been taking fewer skin selfies and obsessing less over my skin. It’s easier to do when I’m not constantly in pain. Today I looked back and was proud of how I’ve lifted myself out of the acne-depression days. I was crying once a day, sometimes more. Every time I looked in a mirror, I would stare. My mental health, as noted before has been improving. That is so much more important to me than having a smooth face.”

August 24th

“Struggling to cope with some new acne. The fear that it will come back is overwhelming and I can’t control this fear right now. I’ve been so happy not wearing makeup and being more confident that I just don’t want to go back to that painful place.”

August 27th

“‘This too shall pass.’ Not easy to live by but I’m putting in the work.”

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This is when my journaling got more and more about my life rather than just my acne.

Although these are only snippets from some days, there were some when I felt better, and others worse; the mindset of cystic acne is overwhelming. It felt as if my whole world revolved around my skin. I sometimes felt fortunate that I couldn’t leave my house due to the pandemic. That was a low point.

As much as I still struggle with cystic acne, I have been in a better place mentally because of some habits and practices I have stuck with. Here are a few:

1) Seeing a dermatologist. I was scared to do this because I didn’t know what they would say. I already knew I didn’t want to go on Accutane (it’s the right fit for some people, but I knew it wasn’t for me) and I was afraid there wouldn’t be any other option. I kept putting it off so that I couldn’t be told they couldn’t help. I kept putting it off because I thought “It’s fine, it will get better soon.” My skin fluctuated so much that every time I thought it was at its worst, it would start to get better. And then it would get worse than the previous time. It was a continuous cycle. Honestly, I was a little embarrassed too. I didn’t want them to think I wasn’t taking care of myself. I was doing everything I possibly could on my own.

It turns out, they don’t care. Well, the process would be much more difficult if I didn’t already have a dermatologist that wasn’t judgemental. That would be number one on the list. After seeing the doctor, I was put on antibiotics for the second time and prescribed clindamycin. There were many conversations about what would be the best for me, and we started the process of looking towards Accutane, though it was used as the last resort. Although controversial for many reasons, which is another article in itself, birth control ended up being the only thing that improved and controlled my acne. Regulating my hormones finally made a difference after over a year of searching. It’s not a cure, it’s not perfect, and it’s definitely not for everyone. However, this is my journey and what worked for me. I also recognize seeing a dermatologist isn’t financially available for many people. These are some more practices that have helped me too.

2) Along with a writing journal, I started keeping track of a food journal. I knew that gut health is important for your skin but I didn’t know where to start. Over four months, I had started to figure out what felt right for my body. Now, it’s been a year of cutting out gluten, eggs, and most dairy. I was shocked to find out that eggs can also trigger other skin conditions like eczema and psoriasis if you have a sensitivity to them. It is a lot of trial and error, but it has been a big help.

3) Not looking in a mirror close up for extended amounts of time. Each time I would look in the mirror closely, I would think, “Do I have any new pimples?” even if I had checked two minutes ago. This is something I am still trying to unlearn.

4) Understanding it’s okay to have bad days, but that I need to pull myself back up.

5) Physical exertion to release endorphins. Taking a walk, weight training, yoga, anything to get my blood pumping helped. The toxic positivity has always been frustrating for me when it comes to exercise. Sometimes the phrase, “I get to move my body today” helps, but a lot of times I need an extra push. Yes, I’m grateful for my body, but I also need to move it, especially on my bad mental health days. Find what motivates you and stick with it.

6) Stop comparing myself to others. No two bodies are the same, it's not worth it to hold onto comparisons.

7) Even if you don’t have someone who shares a similar experience, speaking to anyone who will openly listen is beneficial.

8) Distractions. On the days where I couldn’t think about anything but my painful face or back, I had to immerse myself in concentrating activities. Reading, learning, painting, and music were some of my main focuses.

As much as I hope some of this can help, I don’t have nearly all the answers. I’m still navigating everything myself. It is such an individual journey. But I have learned both acceptance and gratitude along the way, and can finally say I am confident enough to walk outside without covering the red spots. I have started to find an acne-accepting community online (the acne positivity world is finally expanding) and I am beginning to let go of the harsh thoughts I so often had.

Living with acne isn't all about the set “beauty-standard.” There is so much more to it than what you see.