I think I was on holiday in Cornwall when I got my first spot. I think I was about 12, although I might have been younger. I’m pretty sure it was on my chin, in the middle, right underneath my bottom lip.
It will always upset me that one of my clearest memories of my grandpa – who was so many brilliant things, and is totally disserviced by this one moment that’s crystallised in my brain – is of him asking me, loudly, ‘when are you going to get rid of all those spots then’?
At some point in my late teens, I noticed I had a large bump on the side of my neck, near my jawline, just underneath my ear. I asked a family friend who’s also a GP (and who’s always the best at calmly dealing with my ‘am I a freak?’ medical questions) what it was. He had a quick look and told me it was a raised gland. ‘Probably because of your acne.’
It hurt my feelings at the time, but now I wish someone had used that word sooner, because it changed how I thought about my skin.
I knew I had spots. But spots are occasional, and part of growing up, and they go away. Acne is deserving of attention and intervention and you are allowed to take it seriously, because it will probably have serious effects on who you think you are and how you move around in the world.
That gland is still raised, by the way.
Here come some pictures.
This is what my skin looked like at the end of last year.
I’d describe my acne as consistent and moderate. It’s definitely hormonal and it’s cystic around my jaw. At school, the worst of it was on my forehead, but for most of my adult life my forehead has been clear and my cheeks, jaw/neck, and chin have suffered the most.
This is what it looks like this morning.
Mmm, sexy dressing gown.
From my perspective, this is progress. My right cheek is clear of active breakouts – what you can see in the photo is scarring. My left cheek is, okay, a battle-field right now, but I’ve just come off my period after running two packets of pills together so my skin accurately reflects how shitty my hormones have made me feel for the past week.
It also reflects that I’ve been a lifetime sufferer of mild dermatillomania, but we’ll get to that.
You might have noticed I’ve used the words ‘moderate’ and ‘mild’.
I’ve usually been able to cover my acne with makeup to a level I’ve felt happy with.
I’m reasonably confident that, if I’m wearing makeup, my acne is not always the first thing people notice about my face.
I’ve felt insecure about staying over at someone else’s house and them (and their family) seeing what my skin really looks like, but it’s not stopped me from staying over in the first place.
I have never been able to go to school or work without makeup on, but these days I can do my errands with bare skin and not mind too much if I actually bump into someone I know.
I have been complimented on my skin once by a stranger, and it was the best and most surprising thing.
I think ‘moderate’ and ‘mild’ have stopped me taking action to get rid of my acne, besides changing to Ultrabland when everyone started raving about Lush, or trying the Collection Lasting Perfection Concealer when YouTube exploded with ‘this-will-change-your-life’ reviews. (IMO: Ultrabland is fine but overhyped; the Collection concealer is absolutely everything everyone says it is).
I am not that person who has ‘tried everything’. I’ve never used a homemade facemask of manuka honey and tea tree oil and cider vinegar. I do double cleansing these days to actually get rid of my makeup, but it’s had more impact on the cleanliness of my towels than the state of my skin.
My acne is moderate, mild, and consistent. It has always been with me. I do not remember my skin without it.
This bit might need a TW for dermatillomania/skin-picking, although I’m not going to go into too much detail. You know yourself; skip if you need to.
I’ve always picked my spots. I pick my lips, chew the inside of my cheeks, and peel the skin around my nails. I sometimes pick my scalp. As a child, I was a thumb-sucker, a nose-picker, and a nail-biter.
A creeping, growing fear for me is that if my acne is ever cured, I will lose the main focus of my picking and therefore find another one.
I don’t know if what I’ve experienced is ‘real’ dermatillomania or if it’s just a natural response to having incredibly pickable things all over my face, all the time, and I am scared to find out.
One of the first things I noticed when we moved house is that we don’t have a mirror in the bathroom here. (In the old flat, we had three.) Which has meant I don’t end the day with a picking session. (There is nothing like taking your makeup off in front of a mirror that draws your attention so fully to all the places on your face that you might want to pick.)
I still pick without thinking if I have a hand free. I read a lot and I basically always have a hand on my face if I’m absorbed in a book. I sometimes specifically go and stand in front of a mirror to take my stress out on my face. But to a large extent I feel like I’ve broken a life-long routine (without really even meaning to). And if I do end up in front of a mirror, I’m a bit more conscious of why.
And yes, I am aware that picking my acne is not doing it any favours. But when your acne is consistently there, regardless of what you do/do not do about it, it’s hard to think of picking as a high stakes activity. My skin is my skin is my skin.
Just as a side-note – if you’re reading this and you’re about to advise me to change my diet, kindly fuck off.
I’m glad veganism/cutting out gluten/reducing refined sugars has helped you on a physical and spiritual level.
In a world where disordered eating is the most common mental illness that women and girls suffer from, which is now also taking its toll on men and boys, keep your meal plans to yourself, and stop peddling the pseudo-science, quasi-religious bullshit that anyone can have clear skin if they treat their body like a temple in exactly the same way that you do.
Finally, let’s talk about medication.
In 2015, I had major emergency surgery. Whilst in recovery, I was put on strong antibiotics to prevent infection. And once I was well enough to stand upright again, I noticed that my skin was better, vastly better, than it had been since I was a child.
As I came off the antibiotics, the acne came back. But for the first time, I understood that medical intervention could work for me, and that even my moderate acne was worth taking seriously, treating seriously, because the impact on my self-esteem during that brief period of clear skin had been real and important and valid.
I’ve been on and off limecycline in the three years since then, and it’s not cured me, but it’s helped massively. I’m on it right now, and I’m noticing it’s less effective this time, which has confirmed once and for all that it is not an over-reaction to do something a bit more hardcore.
So. In a few weeks I’m going to start roaccutane.
I. Am. Bricking it.
I like my face.
I’m aware some of my features are quirky and big.
I know I have a really grumpy resting face and that my nose goes crooked when I smile.
I like my face.
I used to make New Year’s Resolutions that this would be the year my skin would get better.
What I actually meant was – ‘this will be the year I stop picking my spots’. And what I didn’t understand is that it’s a bit more complicated than that.
I understand now, at the age of 27, that I can live with acne.
I understand that I’m allowed to try things to get rid of it (even the strong stuff – even though my skin isn’t ‘that bad’).
I understand that acne is not a punishment for my bad behaviour, my failures, and my fuck-ups.
I am allowed to heal.