Big Queer Pimples, or How I Learned to Love (or Tolerate) My Acne

Age thirteen hit me in a real bad way. I know we all talk about puberty like it was a slow crawl through a war zone, but I’ll gladly show you how much my scars resemble the little pits where the bombs dropped. You should have seen me in 2003, 5’7″ of righteous anger in a Catholic school uniform and striped knee socks. What gives, human biology? I couldn’t believe how hard I’d been cheated. My classmates were coming out of puberty with proper boobs that could fit into a bra, and all I’d gotten was this face, back, and chest of flaming red sores. My aunt said my body was a garden waiting for its blossoms, but I was pretty sure that somewhere along the way, we’d developed an insect problem.

My doctor said it would go away eventually. Are you washing your face, she wanted to know. Maybe it’s because you’re not washing your face well enough. Besides, you’ll outgrow it. Everyone your age has acne, but it goes away by their twenties.

My twenties? Were they for real? I couldn’t wait that long to look like a normal person. How was I going to go out in public? How was I going to get a boyfriend? The eighth grade boys ignored me or made fun of me. Were they suggesting that this was not an isolated incident, but to be an ongoing pattern in my young adulthood? I already hated and feared the rest of my weird, newly hairy body. Did they honestly expect me to put up with this shit for at least seven years?

Since no one was offering a medical solution, I decided I’d have to handle it myself. The other girls had started wearing makeup, so I figured that I should start, too. I mean, I’d already shaved my legs like a grown-up. Sort of. Okay, so I shaved them once. And okay, fine, it was only one part of my left calf, but then I nicked myself and touched the blade with my finger and it made my skin into these weird fish gill things and I had a Grade A freakout.

I asked my mom to use her makeup. And by makeup, I mean my mom’s liquid foundation. My mom is the kind of woman who doesn’t like or need makeup, so foundation was my only option. That’s one of the reasons why, to this day, I do not know the difference between eyeshadow and blush and have confused the purpose of the two on the few occasions I ever used the stuff.

My mom didn’t understand why I wanted to use makeup when I’d never shown any interest in the past, but I was determined that these big angry sores on my face were about to make a swift exit. I didn’t wear eyeliner until three years later, but you can bet your bippy I didn’t leave the house unless it was in a layer of caked-on Cover Girl liquid foundation in shade 02. I figured I was hideous without it. If I had to go out without makeup, I felt like a walking monster. As if we’re not already so overly conscious and terrified of our bodies as preteens, I was convinced that I needed to put a bag over my head to spare passersby the horror that was my facade.

I became an expert in the application of liquid foundation, and then I graduated to powder foundation. With powder foundation, I was bright orange, but suddenly being an inhuman shade was a great distraction from the distress of my acne. As you can probably guess, the foundation was actually aggravating the acne, but I figured if I just slapped more on, no one would be able to tell. And what other people could tell or not tell was the real problem for me; my own health was never a concern I registered, but a stranger’s perception of my appearance and thus my attractiveness was the kind of thing that my preteen brain determined to be a do or die situation.

The years passed, and the acne did not improve. In fact, it got decidedly worse, and I was ready to tear off my own dermis with my fingernails if it came to it. I didn’t know desperation until I had shitty skin. I went to three different dermatologists. I tried Clearasil, Neutrogena, and anything you could buy from a stand in the mall that promised teenage happiness. I tanned. I hid from the sun. I tried prescription cleansers. I tried over-the-counter lotions. I tried prescription lotions. I tried weird treatments with lights. I tried sitting under the doctor’s horrific little tool that gouged out all my pores and made me swear that if I did not survive the treatment, I would come back as a ghost and malevolently haunt their dermatology office for all eternity. I tried peels, topical appliques, special face washes, and a chemical situation that was akin to an acid bath. But I would have done anything, I would have given anything. Hundreds of dollars for this treatment? I’ll make the sacrifice. Side effects include nausea, diarrhea, and depression? Honey, I’m already depressed. Have you seen my face lately? When the doctor said that such and such a treatment was linked to health problems later in life, I didn’t even blink. I’ll hit 50 and keel over? Fine, I don’t care, get rid of these fucking pimples. I would have committed unspeakable crimes to rid myself of my acne. Unspeakable.

I was on the forums, and I read the books. When people made lists of the foods that might cause acne, I stopped eating them. Or I’d eat them all at once one night of the week, and then not at all the rest of the time, and feel very smug because I thought I’d cheated the system. By the way, never tell a teenage girl what she can and cannot eat to achieve a certain kind of appearance. I know firsthand what kind of demons start forming in her head, and those demons have no problem setting up house.

My dermatologist sent me to a gynecologist who put me on birth control. Those boobs I’d given up on waiting for? They showed up, along with five pounds in eight days and me crying in public at small children. My biggest issue has always been feeling like I don’t have control, and this was a few months of no control over anything – my weight, my emotions, my anxiety, my whole body. I got the heck off birth control, which I guess is a good thing, since the Yaz I was on is now under fire for multiple major health concerns that were not forewarned back when they were handing it out like candy. It was overprescribed in the early 2000s as a miracle drug that was going to save us all from PMS and bad acne, but now it’s a lawyer’s dream, linked with strokes and blood clots in the lungs, and said to be responsible for the deaths of 23 young women. But you know what? If you had told me the health risks when I was prescribed it at age fifteen, I still would have taken it. Because I was fifteen years old, and I couldn’t care less about the dangerous, even fatal side effects when there was the tiniest sliver of hope that I had a shot at clear skin.

By the time I was eighteen, doctors determined that my acne was undoubtedly hormonal. Except unlike everyone else who complained about a “PMS breakout” that was a single whitehead in an unnoticeable place, I had a 24/7 puss party north of my boobs. Heck, I was getting it on my upper arms by this point. My arms! How do you get acne on your arms? The chest was bad enough, but my arms? I’d lost faith in outgrowing this a long time ago, but this was a curveball I could not stomach.

i hope you all appreciate that i am putting the most unattractive picture of myself on the internet

The author in 2012, pre-vitamin treatment.

You know that cystic acne that hurts like heck and leaves a little purple sac of nasty long after it’s died? That’s my brand of acne, right there. The gross and miserable kind, the kind you would take a blowtorch to if you hadn’t already calculated that the burn scars would technically be worse than the current problem. One time, my dermatologist even said that my acne was not acne at all, but a lingering case of MRSA that I’d contracted when I was nineteen. Then she prescribed me a daily round of strong antibiotics that all but killed my ability to eat anything but starchy foods. My digestive system fought a good fight for a while, but eventually it had no choice but to surrender. My other doctor had just about diagnosed me with IBS, until she glanced at my listed current medications and did a double take. One thing I can confidently say I gained from this ordeal was a complete lack of faith in the medical community’s ability to consistently treat bad skin. We can make fake sperm and grow ears out of mice, but god forbid you have pimples, honey.

Accutane was brought up by doctors more than once, but it’s the one thing I turned down. Desperation is real, but everyone has their breaking point. My breaking point was Accutane. I’d heard horror stories, and I’d finally had enough shit happen to me where my mortality was a reality that I would face with my big girl briefs on, thank you. By this point, I’d also moved into a place in my gender expression and sexuality where my attitude towards the space on my body formerly known as a functioning human face was rapidly changing. I didn’t know if I was allowed to wear foundation now that I was identifying as butch. I know, looking back it’s the silliest and saddest thing in the world, but at the time, it was a fact I did not question. I couldn’t cover up my acne anymore. I couldn’t use that foundation, and if I did, I felt pretty darn uncomfortable with it. I was afraid it would somehow negate my fledgling identity, which was still a little sticky and shaky in its newness, and I knew a poke at just the right angle could knock the whole shebang over.

One time in college I was hanging out with a girl I really liked, and she said she thought my acne was really cute. She said it looked boyish, which she knew I was going for and which I know she found attractive. We kissed a few weeks later and I didn’t even panic when her hand brushed my face. A year later and I got an anonymous Tumblr message along the same lines. I know we’re not supposed to put too much stock in anonymous Tumblr messages or complete mental breakdowns will follow, but it really stood out to me.

I still think about what it means to be a masculine queer person, how my standards of beauty are very different from the experience I had growing up as a feminine girl who was expected to be feminine. And if I have a bad day and need to wear a little cover-up, I’ve learned that it’s not even a remote threat to who I am or how people perceive me. I know butches who wear more make-up than some femmes, and their identity isn’t in jeopardy anymore than mine is or has ever been. One of the most freeing elements in my struggle with acne was learning how queerness works to subvert mainstream beauty standards and expectations for appearance, and accepting and fueling that subversion in myself. Being queer makes me confident in myself, and that self includes a lifetime of acne.

For such a long time, I’d never thought of my acne as anything but a huge terrifying problem. It had made me see myself as lesser-than for so many years that I’d let the very fact of it be a threat to my entire identity. I thought I’d have to choose between managing my acne and being confident in who I was, because that had been my only reality since I was still a kid. I never thought I’d get to the point where my own self-cultivated happiness would outweigh the necessity of hiding my face from the world.

When I was twenty-one, I started seeing a holistic therapist in conjunction with an acupuncturist. It was the first time I’d foregone all the chemical stuff and opted for an all-natural approach. I didn’t end up continuing with acupuncture because I get pretty anxious around needles, even if they’re long and tiny and don’t hurt, but I kept going to the therapist. She told me to get myself Vitamin A and zinc supplements, and hang in there. I took six Vitamin A supplements and 2 zinc supplements after dinner, and kept it up. I did not break the regiment. And two months later, for the first time since I was thirteen years old, my acne started to clear up. I started eating healthier. I drank water like my life depended on it, which I suppose it technically does. Despite the fact that I couldn’t even believe this last ditch effort could ever work, it did. Some of the scars were even repairing themselves. I wasn’t sure which deity I was supposed to start sacrificing to, but a miracle had surely taken place on my body.

The author in 2013, after 6 months on vitamin treatment. No foundation, no cover-up, no nothin'.

The author in 2013, after 6 months on vitamin treatment. No foundation, no cover-up, no nothin’.

I will admit that it hasn’t been a straight shot to the good life. I will never be one of those people who has clear skin without having to work for it, and I have yet to see my face without at least one active pimple accompanying still-visible scars. Sometimes I miss a supplement or I eat something that sets me off, and even just the telltale redness and pain can put me back in a panicky teenage mode. Certain activities seem to make it worse, which my therapist says is a result of spurts in testosterone. Two weeks ago, I ruptured an ovarian cyst and my period went skippedy-do-da for the first time in ages. As a result, my acne came back with a raging agenda, hitting me extra hard like it was trying to make up for lost time. The cysts are so sore that it stings to have my head on a pillow at night, and my fingers are getting that familiar itch to scratch the darn things off.

The acne doesn’t get to win, though. I’m out in public, right this very second, and there’s not a lick of make-up on these cheeks. I looked at myself in the mirror and decided I was going to put on an outfit that made me feel really hot, and I was going to drive myself to that Starbucks and park my behind in a well-trafficked place no matter how much my heart was racing. And you know what? More than one girl straight up checked me out today, and it felt pretty darn validating. Heck, it felt good. I just about tingled all over, except the good tingle, not that horrible tingle after they’ve just done a chemical peel and you’re crying in front of a nurse about how you always feel so irreparably ugly. I don’t feel ugly anymore, at least not all the time. Sometimes I feel downright attractive as far as people go, which is something that preteen and teen me never thought was possible. I remember being sixteen or seventeen and thinking very firmly that if anybody ever loved me, they’d have to overlook my acne first. I wish I could sit down with preteen me and shake out my shoulders a little bit, remind myself that I am worth it in a lot of other ways, and even if the acne doesn’t ever really go away, it doesn’t have to define me. I’ve got better things to call myself, after all.

Avatar of Kate

Hard-lovin' butch made of tears, sweat, and spit, in that order. Professional lonesome polecat. Kate is living proof that you can take the hillperson out of the mountains, but she's still probably going to run back to the mountains anyway. Kate prefers the trashy to the classy, and the tender to everything else. Full-time writer, part-time lover. Heart got so big and soggy that she had to cut off all her sleeves.

Kate has written 115 articles for us.

62 Comments

  1. Thumb up 3

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    This was GREAT. I totally agree with what you said about doctors not being able to treat any kind of acne. I got my pubescent acne when I was in grade five. FIVE. I suffered right through junior high until mom broke down and bought me proactiv and it changed my life and my skin. I used to seriously laugh at those commercials until I tried it and then I thanked every god there was. I had to wean myself off of it eventually but I always try to have a bottle on hand for any flare ups. Moral of the story- this is a great piece of writing :)

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      accutane is technically a massive (and unhealthy) dose of vitamin a. which is why i was told to take a lot of vitamin a, but not an uncomfortable amount of vitamin a. there were waaaay too many red flags when i was researching accutance, but the only side effect i’ve had with vitamin a is a little more sun sensitivity and having to wear lotion every day. no digestive problems, no peeling, no hair falling out, nothing zip nada. which i am 100% okay with, because the vitamin a and zinc are doing crazy good things when every single other thing out there did pretty much nothing for me.

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        So accutane is actually one of the best treatments for cystic and scarring acne when topical treatments and oral antibiotics aren’t effective for patients. It does have certain side effects such as overall dryness and joint pains but it is one of the only treatments that can cause acne to go into remission. Acne is caused by overactivity of the oil glands in combination with infection by bacteria which is where you get the redness. Proactiv, etc. or any benzoyl peroxide, salicylic acid preparations will stop the redness but they don’t treat the predominant lesion of acne, the comedone. To fix the overactivity of the oil gland, you can use a topical retinoid. Most dermatologists recommend a combination of the two and then for more severe acne, short courses of antibiotics. For patients with cystic or scarring acne, isotretinoin/accutane dries the oil glands which is why patients on it get the dryness of the lips and inside the nose.

        One of the reasons that isotretinoin is so tightly monitored is because a Senator’s son committed suicide while he was taking Accutane so there’s a political aspect but there is no clinical study exhibiting any proven causal correlation of suicide or depression while taking the medication. Most patients are only on it for less than a year so it’s not a lifelong routine and you don’t need any other acne treatment in that time which is good for people who aren’t into the AM and PM regime that topicals require. One of the other counter indications for the medication is pregnancy since it is a synthetic vitamin A which can result in birth defects, hence the requirement for the two forms of birth control and the monthly pregnancy tests. Any formulation sold in a health food store or by a holistic practitioner is also going to be a synthetic vitamin A and is ergo a chemical so it’s a little bit misleading to state otherwise.

        Anyways, great you’ve made your peace with your complexion and found a routine that works for you! Just wanted to share what I’ve learned since I work in the derm field and we treat patients with acne on the daily so I’ve gotten to see firsthand, that acne is a problem that can be solved at least!

  2. Thumb up 2

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    If you replace acne with blackheads this article is virtually my teenage years in a nutshell. Peels, prescription pills, lotions and potions, all of which were used to no avail. I feel you Kate, maybe I should try vitamins…

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    dermatologists tell you when you’re 16 that your acne may stop when you get to your twenties. then you get to your twenties and the same dermatologist asks if you have any body acne because “a lot of people get body acne as adults.”

    dermatologists are the worst, basically.

  4. Thumb up 9

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    I think it’s a lie that we’re all fed as sad, spotty teenagers, that acne ‘goes away when you’re 20′ and it really doesn’t! I’ve found that less is more when it comes to skincare and that it’s mostly just a case of finding a product that works for you and sticking to it. The first bit is easier said than done though!

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    I feel your pain. I suffer from the same kind of acne you suffered with: the huge purple hormonal kind. I get all sorts of comments about my acne. My favorite one is : why don’t you go see a doctor about it?

    Yeah, I’ll go do that right now.

    Or “I know a cream that would work perfect for your face.”

    My personal favorite: “You know your face is really red?”

    My acne is mostly gone. Like you, I drink a lot of water and take vitamins. But I do take birth control that has been the biggest help with my acne. I guess it’s different for everyone.

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    Thank you for this article. I totally feel your pain- the multiple visits to dermatologists, the make-up, the pain, the purchasing of every new facial wash, the medication… I’m 24 and still suffering from acne, and it’s frustrating to say the least. I haven’t heard of using Vitamin A & Zinc yet, so I’ll give it a try! It looks to have done wonders for you.

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    For me, I suffered from the age of 10 until 20, nothing helped until I finally started Estrogen and Spironolactone (Hormone replacement therapy) and then like a FUCKING MIRACLE, my acne cleared up, my oiliness went away and I’ve been free and clear for a year and half! It’s been one of the unexpected side benefits of transition and it’s done my mental health a world of good!

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    I went on Accutane when I was 16. 12 years ago they hardly knew of the long term side effects of it. They knew only of the side effects that occurred while you were taking it. And although it was horrifying having giant red painful rashes all over my body, bloody lips, insane mood swings and having to use visine every 5 minutes, it was NOTHING compared to the internal digestive problems I suffer from now due to the drug. Long term side effects include IBS, Crohns, Ulcers etc etc

    However, it completely cured me of my pimples. To this day I will have at most 2 pimples on my face at one time and for the most part am completely clear. The sad thing is, acne is such a awful thing to deal with in your teens that I wish I could say I wouldn’t go on it again knowing what I know now, but I look in the mirror at my clear skin and wonder if that is actually true…

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      I went on Accutane when I was 16 or 17, and it totally, permanently cured the acne on my face, back and chest, and my oily skin. I’m 24 now, and my skin is nearly perfect, save for the occasional pimple or two when I’m on my period. It’s pretty miraculous. I never experienced any side effects whatsoever, though, at least that I know of… when did they begin to surface for you? Was it immediate or did some of them appear years later? I’m a little worried now…

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        Agreed. Accutane is 100% a cure for acne. It saved me in many ways. I felt like a new person after I came off it. I was a dancer as well so having my chest and back healed felt amazing and I finally felt comfortable on stage. Every time someone comments on my skin (which is frequent) I tell them I owe it all to Accutane.

        My symptoms while I was on it were intense, but I naturally already had extremely dry skin so most of the symptoms were because of that (cracked skin/lips etc) which the doctor warned me about. My mom still stands by the fact that I was depressed while on Accutane but I was 16 and just coming out…so I can’t say for sure that is what it was. As for my symptoms now, they started surfacing a couple years ago, so probably 7 or 8 years after coming off the drug. People get intestinal problems all the time though, so whether it is a direct effect of the drug my doctors will never really know. But there have been a lot of studies, and legal cases that attribute the two together so I can’t help but believe it might have something to do with it.

        However, I know people that have been off the drug for 15 years and still have not experienced any bad repercussions. Its not a definite thing, simply a risk you take. Like any serious drug. But like I said, I would probably do it again if I knew what I know now. It cured me.

        I wouldn’t worry my dear :) If you have gone this long AND were fine on the drug, you are probably in the clear.

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        This comes from Wikipedia, but gives you an idea on the kinds of long term side effects Accutane may cause.

        Several scientific studies have posited isotretinoin as a possible cause of Crohn’s disease and ulcerative colitis in some individuals.[63] Several trials over inflammatory bowel disease claims have been held in the United States thus far, with many of them resulting in multimillion dollar judgments against the makers of isotretinoin.[64] In 2009 Roche decided to pull Accutane off the market, claiming at the time that the move was to stem the tide of Accutane lawsuits.[65] As of January 2012, there were an additional 6,000 cases pending.[66]

  9. Thumb up 1

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    A gynecologist put me on Yaz when I was 18 to help with PCOS (which I was never actually properly diagnosed with), and told me that it would clear up my acne, help me lose a little weight, and just make me feel better overall. Not only did it not clear up my acne, but I also gained 15 pounds, my boobs grew two cup sizes (they were already DDs) putting even further strain on my already crooked spine and relatively small frame, and made me incredibly irritable. After about 6 months and a breast reduction surgery I refused to take it anymore and my acne actually cleared up pretty well and I regained my patience. I still get a few pimples here and there, but I know how to manage it now due to a very long trial and error period with numerous over the counter products and soaps.

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    You guys, please be careful about Vitamin A consumption! You CAN overdose on Vitamin A and the symptoms are terrifying. However, the thing about Vitamin A is this… There are two forms: beta-carotene and retinol. Basically, beta-carotene is the form that naturally occurs in fruits and vegetables, which your body then processes that into retinol. Retinol(also just listed as Vitamin A) is found in animals and especially liver. You can have as much beta-carotene as you want, because your body will just not process it into retinol if you don’t need any more. However, if you consume too much retinol, you will start going into toxic shock and the symptoms are things like blurred vision, loss of muscle control, vomiting, and headaches.

    So, moral of the story: Stick with fruits and vegetables or supplements that list it as “beta-carotene.” Be aware of the difference between retinol and beta-carotene and don’t just eat a bunch of liver.

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    This whole article speaks to me on so many levels. I have been struggling with my horrible skin for now 20 years (since I was eight) and have heard and tried it all. I pray every day I will someday find something that works for me, and not the same old awful “it will go away eventually” that I think we’ve all heard. I don’t know anyone else who understands how it feels, so thank you thank you thank you for writing this.

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    After ten years of saying no to and being terrified of Accutane, I finally got fed up and tried it. It worked perfectly for me, and I had no side effects whatsoever (long- or short-term), besides some dry skin while I was on the med. I guess I got lucky.

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      This is me! I was scared of it for years, tried evvvverything else. At 28 got sick of having acne for more than half my life and bit the bullet.
      I have nothing but praises. Short term side effects for me while I was taking it was the dryness, I had to have lipbalm all the time, use heavy moisturiser morn and night, but it was definitely bearable.
      On Accutane for about 4/5 months and my skin has been completely clear for 2.5 years.

      It was such a weird feeling to go outside without any makeup on the first time.

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    Oh holy shit. I can still relate to parts of this so hardcore. I have acne that seems to get worse as time goes on, & nothing has done anything to it. I’ve never had the money to try the life-threatening procedures you mentioned, but nothing OTC or prescribed made it go away. I used benzoyl peroxide, which is in Proactive, for a while, until my body had a reaction to it– it gives me a chemical burn & my eyelids puff till i can’t see.

    But. I have acne everywhere. I always feel like people think i’m being ~melodramatic~ or it’s hyperbole, but it’s not. I have acne literally everywhere, even on my earlobes & sometimes my hands. It’s on my face, my neck, my shoulders, back, all over my arms, on my breasts, on the rest of my chest, now on my stomach, my rear & accompanying area, on my legs. It started with puberty & never stopped. I remember reading stuff in teen girl magazines where it was like “OH NO I HAVE A ZIT I CANNOT SHOW MY FACE IN PUBLIC EVER AGAIN!!!!!!!” & thinking to myself, like, seriously? I have acne all over my face & i still go out.

    When it began to spread to the rest of my body, i think that’s when i stopped wearing tank tops & shorts. Not the only reason, but a major factor. It was only a few-ish years ago that i began to wear them again, because i get too damn hot in summer to wear even t-shirts. So a combination of “whatever, i don’t care” & “i’m too hot, i will die” led to me wearing certain clothes again.

    But. I never. Ever. Ever. Ev. Er. Feel attractive. Or even clean. And i shower every night. I squeeze my clogged, disgusting pores, wishing they’d just stay empty & clean & why won’t they? If it’s not acne, it’s giant pores filled with gunk. I lose track of time squeezing my pores & popping pimples, & when i finally think, “i should maybe get out of the bathroom,” i have large red blotches of skin from where i’ve been picking at myself.

    I never feel like i’m desirable. I don’t even feel flat-out wanted, ever, & a large part of that has to do with the acne. Because i feel so ugly & gross, i feel like not even my friends will want to touch me. I look at my chest & think, nobody wants to, you know, “do” somebody who has clogged pores & pimples on their tits. Nobody wants to touch someone where nearly any patch of skin is pimply or clogged. I go about my day & whatever life i have not because i’m confident & don’t care about what anyone thinks, but simply because i have to. I’ve never been invested in makeup & i don’t have the time for it, usually, so i’ve pretty much always gone without cover up. Not because “you don’t like it, suck it!!” but because i have to.

    As if we’re not already so overly conscious and terrified of our bodies as preteens, I was convinced that I needed to put a bag over my head to spare passersby the horror that was my facade.
    This is me. Like, this is so me that i read it & immediately copied it because i knew i’d mention it in my comment, because it was like you had taken the exact thought from my head & said it. Only it hasn’t gone away from preteen days, it’s only stuck around & intensified. It’s not the only reason i feel like a bag over my being would benefit humanity as a whole, but it’s a huge, huge, huge factor. How can i take someone seriously when they say i look pretty? Nice? Beautiful?! You must be fuckin joking! Do you think i don’t own mirrors? A camera? Do you think i’m so thick that i can’t tell i’m ugly? Are you lying just be nice?? Because you think you’ll help my self-esteem? I know it’s rude & hurtful to not accept compliments, & especially to feel like the person’s lying, but i can’t accept them. I can’t see any of it; i don’t believe it’s true.

    I’m sorry this is probably overshare & all it is is me babbling via type. It’s just, you know, something that’s always on my mind, because one’s own acne is this constant presence. You can never escape it. Even if it’s covered up, it’s there. You know it’s there. It impacts you so negatively, & for so long i felt like i was selfish for that, because of the whole “other people have real problems” kind of thing. It’s like you have to defend the fact that something that makes you feel ugly is something to be legitimately upset over. I honestly thought i was the only one who ever had to deal with anything like this at all. It just hit a chord, &… yeah. I hope i haven’t overstepped any bounds or anything, it just hit me &. Stuff.

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      Me too! I sort of assumed that I had passed my adolescence with maybe a couple of pimples a month, and that it was all over. Now I’m 20, and I’ve just started getting massive weeping clusters all over my chin the week before my period that last at least two weeks and leave me constantly reddened. Mostly it suck because everyone else seems to have a skin care regime sorted at this point, while I’m awkwardly swapping between products and looking even more childlike than is usual.

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    The make up thing is an interesting one. I’m in the fledgling stages of being out as ftm after many years of thinking it over, but I’m pre transition. I have super delicate skin, as do my mother and grandmother, and if I go out in the cold without some sort of makeup/light foundation type thing on, my skin is dry and raw and sore. So while make up might not be the most masc thing going, I’ve become happy enough to have my face not hurt in exchange

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      I always say it’s how you wear something that determines whether you look awesome, not what you’re wearing. If you stride out like the rock star you are and tell any haters exactly where they can shove it, I’m sure you present exactly as masculine as you want :D

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    About 15 years ago I took Accutane (or Roaccutane, as it is called here). I only suffered the usual side effects of chapped lips and sun sensitivity. After years of wasting money on lotions and magic potions, it cleared my skin within six months, for good.

    With guidance from a skin specialist, I was constantly required to have blood and liver function tests. My doctor told me point blank that if I were to get pregnant during the next two years ‘You will need an abortion’.

    My only concern with vitamin treatment is young women taking large quantities of Vitamins, with the risk of birth defects not being stressed to them, or their liver function not being monitored.

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    Thanks Kate for sharing your experiences. It was difficult for me to read this article without crying.
    I worked in Dermatology for years. I have a brother who suffers from this (and other skin stuff). And although I’m blessed with clear beautiful skin on my face, I have scars on my back from acne & also “chicken skin” on my arms. So I feel for anyone who has to go through this.
    I hated seeing people stare at my brother. And I especially hated… now I’m crying again… hearing people whisper horrible things. Even calling him a “monster.”
    My brother is not a monster or a freak. He’s just a giant panda bear with some battle scars.

    Big hugs to all you queer panda bears with battle scars!

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    Whoa, I identify so hard with this. I did get on accutane. I even lied to get on it. One of the side effects listed was suicide… it wasn’t even listed as “suicidal thoughts” just “suicide.” The doctor asked if I’d ever struggled with depression; my mom and I looked at each other, swallowed and I said “no” with my heart racing like maybe he’d look into my soul and realize the truth. Those six months I applied chapstick CONSTANTLY and had frequent nose bleeds, had to get my blood checked regularly and wasn’t sure if I was more miserable than usual but was a little terrified that I’d suddenly off myself. Ugh.

    I had acne starting in third grade- THIRD GRADE!- and was made fun of pretty viciously for years. I was pretty sure that was the first thing everyone noticed about me and was convinced I was and would always be ugly. One round of accutane did not clear my acne, which was down my arms, back and chest too. A second round was recommended but I was too scared to do it again.

    After my family moved mid-high school my mom took me to a recommended dermatologist. His waiting room was full of paintings of women in weird disjointed postures, with long legs and big lips. He promised the world; he said he was going to not only clear my acne but shrink my pores and rid me of all in-grown hairs, ever. He looked at me with relish, like I was some kind of particularly intricate puzzle placed before him that he couldn’t wait to tinker with and solve, and spoke to me like he was a used car salesman. As my mom drove me away, excited about his promises and talking about the next appointment, I started crying and told her I didn’t want to come back and I didn’t want to go to any doctor anymore for my skin. I was so tired of all those antiobiotics making me feel sick and making me burn so easy in the sun, and so tired of all those gels and creams drying out and cracking my skin. I switched to the most gentle stuff I could find, clearsil, and did nothing special and nothing acne-specific for my skin. Within months it cleared up a lot, like it was just waiting for me to be gentle to it. I still have acne, even still on my back. Probably I need to work on my diet. But it’s a LOT better. Sometimes I even get compliments on my skin, heh, which I always return by looking at the person like they have three heads. =p

    Whew, so, in short, feelings… but it’s a lot better now and I actually think I’m attractive, which teenage-me would have NEVER expected to feel.

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    I’m just starting on the dreadful adventure of finding a dermatologist and skin routine that works for my moderately acne prone skin. I find that as I leave my teens, it is actually starting to act up a bit more. I find that holistic works best for me, eating a vegan diet helps too, and I think I am starting to clear up for good.

    I love this post and really admire your confidence. Kudos to you!

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    oh my goodness, thank you for writing about something that feels so vulnerable and awkward to go through. i wish i could show this to myself as a teenager on one of those days when i cried in front of kids who said stuff like “have you ever heard of proactiv?” because it is incredibly heartening to know that there are other people ~out there~ who also have acne related insecurity, and that it’s totally normal. i am glad that you found confidence in yourself and i think that this story is super important. <3 <3

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    I am so glad I found this. I’ve been struggling with cystic acne since college. I had extremely mind acne, and my mother convinced me to use Proativ, which I am convinced threw my skin’s pH balance out of whak for eternity. One time, I had a cyst that swelled my eye shut for a week–I still have a pretty obvious scar between my eyes from it. Most people say I’m overeating when I have breakouts, but they have no idea how much pain those things cause. It feels like a tiny, pulsing monster under my skin. More than the pain is the utter embarrassment you feel when you go out–no amount of makeup can hide how hideous I feel in the middle of a breakout. It doesn’t matter how many people tell you that you look pretty today, something inside you always screams, “No, I DON’T. Can’t you see my face?!” I’ve started following a vegan diet, and I’m trying to eat mostly raw foods on it–fruits and veggies and tons of water. Also, I’ve been trying the oil-cleansing method for my face, with mild success. I don’t know if it’ll work, because I moved to Atlanta, and the pollution here is killing my skin. But I’d rather try and be healthy from the inside than have to deal with harsh, bleach-ridden creams or nausea-inducing birth control pills. Anyway, thank you SO MUCH for writing this. As terrible as this probably sounds, it is so heartening to hear from other people who have to deal with this illness. We’ll figure this out somehow. <3

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    I had bad acne too and was prescribed birth control. It worked great but the thing is, you can’t stay on it forever. I have no idea what I’m going to do when I have to stop taking it… all the acne will come back and I’ll be in my late twenties feeling like a depressed teenager again. Acne sucks.

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    Wow. I kept on nodding my head and almost weeping as I was reading this. I know it can’t be the same for everyone, but really: this was exactly how I feel.

    Only that the big, ugly, red, pus-pilled acne started appearing just as I was about to turn thirty. I’ve read about adult acne, but I never thought it would happen to me. For someone who only had a few tiny pimples as a teen, you can imagine the horror of being (on paper, at least) a grown up and starting getting concerned about pimple washes. Yes, I know what Proactive is. No, it doesn’t work for me. Yes, I’ve spent serious money on treatments and doctors. No, still got acne. Yes, I’m usually stressed and I’m trying to breathe properly and eat right and get enough sleep. But whatever I do, the acne only gets worse.

    My last hold out is Accutane. It’s called by a different name where I am. I know about the side effects, and I’m not too keen on nausea and depression. The doctor even said “not to get pregnant or active” while on it, but I’m single so I just sort of nervous laughed at her. I said no, thank you. Will just go on with the facials and try to manage the damn thing.

    I have to say I’m curious about the vitamin a + zinc combo. I’ve never tried it before, and I’m just about at the end of my rope. Someone posted about overdosing on vitamins/it not being good for the liver, so I guess we will have to proceed with caution. So what sort of vitamin and zinc do you take?

    I admire your courage though. Ever since the break outs, I have just felt unpretty. It will take me a while to get confident. But you’re putting yourself out there. And that gives me hope that I’ll get to that place someday. Hopefully soon.

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      I’m sorry. I was reading your comment and all I could think was “don’t do it!” I mean, lots of people go on it and are fine. Most aren’t. I remember my experience with it and it was HELL. It was worse than any acne I’ve ever had, and at one point almost every pore on my face was infected in some way.

      The reason Accutane is so bad for you is that it’s vitamin A delivered in concentrated doses for extended periods of time. All it does it build and build because, unlike B vitamins, it’s fat soluble. It stays with you long after you stop taking it. While on it, I had to have monthly blood tests to make sure my liver wasn’t failing.

      Talk to your doctor extensively about the side affects. It might not be as bad for you because you’re not going through puberty like I was.

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    Food, stress, and exercise habits have had the biggest effects on my skin for me. Starting in college I developed a more vegetarian diet with many more raw vegetables (thank you Cornell Dining)and I drank copious amounts of water instead of juice concentrates. Both much better for my overall health. I was exercising regularly and as long as I rinsed my face when I was sweaty I kept pimples at bay.

    College was obviously more stressful, but that mostly meant I would break out right around exams (not sleeping, not exercising, eating junk, drinking energy drinks). And within a week with some OTC meds, I would clear up again. I finally understand the signals my body is giving me about stress and taking care of myself.

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    This was awesome to read, and really helpful. Especially since I got sick this week and have a giant cold sore (on the side of my NOSE, FFS), and have been feeling especially pariah-like.

    It’s really easy to get lost in our own heads and their various problems (esthetic and non); it’s good to be reminded that we’re all dealing with some of the same shit once you get down to the emotional core of it all. Though it sucks that any of us have to deal with this level of appearance-based bullshit.

    (And practically speaking, this is another good reason for me to get back onto taking a bit of zinc – it helps my immune system, but I know that the possibility of lessening those painful cystic face invaders will help me remember to take it more than the more general “staying healthy” side will.)

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    I didn’t realize that my acne trigger was environmental until I moved from Illinois to Colorado in my mid 20′s. My skin cleared up almost immediately after moving and it seemed to be repairing itself. Here I am back in Illinois 5 years later and my acne has come back with a vengeance.

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      yeah my best friend would break out like crazy when we were in northern michigan and new york city, but when he was home in oklahoma in the summer his skin would completely clear up.

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    I got made fun of a lot in middle and high school for all my acne. It wasn’t uncommon at all for my entire face to a blanket of bumps and scars. During the worst of it, I couldn’t even stand to look in the mirror. After years of supposed natural remedies and OTC drugs she made me try, mom finally took me to a doctor. The only thing that works for me is a combo of Differin (adapalene 3%, the highest dose they have) and Acanya (clindamycin phosphate and benzoyl peroxide). Both of these are really expensive, and it’s going to be interesting paying for them in 2014 since the new insurance I have considers them both to be unnecessary, but dammit if I won’t find a way.

    Middle school me would cry if she could see the skin I have now, and the fledgling confidence I’m developing because of it. I just find it sad that I put so much emphasis on my appearance that I couldn’t see how awesome of a person I was underneath my bad skin. If I ever have a child, I hope to God I can shield them from poisonous shit like that.

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    I. Hate. Hormones. I’ve always had perfect skin, even in my teens. “Breaking out” for me is what I’d call 1-2 zits. I’ve been taking birth control since I was 13. My hair started falling out in 2011 (age 21) so I went to a doctor. He told me I probably have PCOS, but since birth control is the treatment, it was probably the stress that caused me to lose 20lbs in a couple months without trying. My hair stopped falling out and all was good.

    I’m now 23 and in September I moved back home (from LA to the Midwest) for awhile. With my mother insisting on spoonfeeding me and stockpiling sweets, I’ve gained 5 pounds. I took a vacation in mid October. I skipped my placebo birth controls to skip my period because I read it was safe. I broke out in tiny superficial clusters of zits, was moody, and bloated like none other. Naturally I was with someone I’m into, ugh. Since then, even though I went on with my BC like normal, I’ve not been quite right. I’m crying at the drop of a hat. More horrifyingly, my skin has gone INSANE for the past month. It’s almost exclusively on my chin. I’m using the same products I always have, so I don’t think it’s that. Overnight, I’ve gotten 2 cystic painful zits blooming. It’s scarring the hell out of my face. I don’t know if it’s PCOS or what, but this is horrible :( The ends of my hair are also splitting like crazy. I look like a monster.

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    I *LOVE* hearing stories like this.. so thank you! I mean, I know the struggle is very VERY real, but only because I’ve also been there. Cystic acne is its own level of Hell. I’ve also done the “I’ll wear makeup!” route and let me tell you, it’s an expensive route to take. As a woman of color, finding makeup to match my skin tone was a teaching experience. All my money earned from anywhere went directly for that purpose. Even through college and into adulthood, my skin took away every ounce of confidence I had. I perpetually wore my hair down to try to cover it, actually. But my Dr. & I finally found a antibiotic that worked and so what if I need to stay out of the sun, I’ll get Vitamin D elsewhere. And even today, if I stop using these creams, my skin breaks out and my emotions go haywire. So continue your quest! It means a lot rather than giving up or just retreating into a cocoon (I’ve also been there!).. we’ll each get to where we’re supposed to be in the end.

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    there are loads of possible treatments out there

    to a certain extent it is finding what works for you, and sticking with it long enough to get the effect. I too echo the reminder it is possible to OD on vitamin A (never eat polar bear liver!)

    it also depends on whether you get comedones (black/white heads) or cystic acne. Or both. Do you have PCOS? How old are you? Is your acne cyclical?

    Find a doc you can trust, in the UK this will be your GP initially. have a few basic baseline tests and then give your options a go!

    I personally dislike topical antibiotics due to the risk of resistance, which doesn’t seem to be such an issue with systemic. Although systemic, especially tetracyclines take 6m to have their full effect. topical adapalene and benzoyl peroxide are good, but very drying and make you sun sensitive. not a problem usually in the UK. You must not get pregnant whilst using most systemic antibiotics or adapalene.

    if the combined pill works for you, you can continue until you are 50 as long as you do not smoke and keep your weight down, obviously unless you want kids in which case stop.

    Anti androgens (such as spironolactone or dianette) may well have a part to play in PCOS if you have elevated testosterone levels

    PCOS can be difficult to diagnose in teenagers as many of the examination/ultrasound signs of PCOS are very similar to normal physiology of puberty.

    Roaccutane works for most people who take it. Not everyone. And there is a careul selection process to starting it in the UK. but suicide is a significant risk. In the UK this is dermatologist-only prescribable. It will not be offered until you have had a good 6m + trial of oral antibiotics and topical creams +/- combined pill (unless you have contra-indications to the combined pill).

    Do not lie to your doctor I beg of you. Their questions are usually based purely to find out if a treatment is safe for you (I wish I could say always, but not every doc is as fabulous as me!)

    go with natural if it works for you. but vitamins are not as safe as we thought, indeed taking multivitamins regularly may result in increased mortality rates. we do not know why

    DOI: UK GP. Not paid by any drug companies.

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    Reading this article made me cry. I wish I was 13. I started breaking out before double digits. Oh. It was small at first, but steadily got worse. It was to the point where almost every pore on my face was infected. I remember all of the visits to the dermatologist’s, chemical skin treatments to the point that I could barely touch my face it hurt so badly. After all else failed, including birth control, I went on Acutane for 6 months in 9th grade.

    They don’t really say what goes on in your body when you take that shit. I had to have a blood test monthly to make sure my liver wasn’t failing. I got nose bleeds every day where before I hadn’t had a single one. My back muscles would spasm and cramp if I tried laying down, even in bed. Overall, though, the depression was the worst. I was crazy. I remember, once, binge eating to the point of my body rejecting food and I threw up on the tile floor while trying to do math homework.

    I tried antibiotics, exercise, everything. The only thing that helped a little tiny bit was that I was in a pool every weekday for 2 hours because I was on my high school swim team. I was on birth control for years, before saying “enough” when I was 16. I quit everything except for two face creams, a natural facial cleanser I use nightly, and telling myself it’s ok.

    Thank god I’ve finally started to grow out of breakouts. To this day, I still stare at myself in the mirror and have to make a conscious decision to not wear foundation.

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