Acne Was My Whole Personality. Who Am I Without It?

“Ginger! Small! Spotty!” 

The older kids lined up to label the fresh meat on the first day of school, announcing a reductive name for each as they went. I’ll let you guess which of those descriptors was intended for me. Before that moment I hadn’t given much thought to my breakouts, which first appeared as a couple of whiteheads on my chin. Soon, though, as Mother Nature handed me and my peers our body hair and periods, she also gave me full-blown acne. 

It wasn’t long before acne started taking a mental toll on me. The majority of my friends ate chocolate and fries on a daily basis without giving a single thought to their skin the following morning, but knowing the repercussions, junk food made me anxious. Midnight snacking at sleepovers was the most stressful of all; the sugar and grease seemed to culminate in a flare-up I’d pay for in red bumps for days to come. 

Others could sleep in their eyeliner or spend their pocket money on cheap makeup and their skin would remain unchanged. My beauty routine looked very different. I made a beeline for the most clinical products the high street had to offer, placing all of my trust in stripping ingredients, like witch hazel and high-strength acids. They did nothing but I still held out hope. When skin care failed me, I thrust myself into a grunge phase. I cut a fringe to hide more spots, started buying Kerrang! magazine, and packed on thick makeup, using full-coverage foundation and vampy lipstick in a bid to draw the attention away from my skin. Makeup kept me in the loop with most of my friends, but it never felt like fun. Instead, it was more of a necessity, as were concealing filters on apps like Retrica, FaceTune, and Photo Wonder.

Eventually, I was prescribed medication by my doctor, namely mammoth pills of lymecycline: an antibiotic often used to treat acne. When that didn’t work, I was recommended the combined oral contraceptive pill, considered to be a good treatment for acne by dermatologists. Over time, my acne all but disappeared save for some hyperpigmentation — the ghosts of spots past. 

The confidence I gained in the years since leaving school was unparalleled. Stripping down the heavy makeup felt like finally affording my face the freedom it craved, but soon enough the paranoia started to set in. Though I was spot-free for the first time in years, I continued the skin habits I developed when my acne was at its worst. I closely analyzed every inch of skin in the mirror for the beginnings of a breakout, hoping to catch one before it had the chance to grow. Having gotten a taste of life with clearer skin, I felt like any presence of a zit would ruin my week. 

Initially, I believed I was afraid of the breakouts themselves; sore, red, and angry. But now, at age 22, I’ve realized that what I actually feared was the low self-esteem that always seemed to follow — and I’m not alone. Acne is the most common skin condition in the United States, affecting approximately 50 million people every year, while in the UK, approximately 95% of people aged 11 to 30 experience acne. Studies have found that acne can diminish confidence and plenty of research has linked acne to low self-esteem, depression, and body dysmorphic disorder in young people.

We’ve come a long way to dismantle outdated beauty standards surrounding skin. The skin positivity movement, for example, celebrates skin texture and calls the abundance of airbrushed faces into question. On TikTok, the hashtag #skinpositivity has an enormous 607.2 million views. There, you’ll spot influencers and beauty enthusiasts embracing their pimples, scars, and hyperpigmentation. As a result, we know what real skin — in all its uneven, textured glory — actually looks like up close. But I still compare my face to others; the people without dark marks or scars that give away their past. I’ve started to feel different, too. Having acne allowed me to carve out a specific identity. I was the person with an IDGAF appearance and an attitude to match. Acne was my entire personality, until one day, it wasn’t. 

Don’t get me wrong: Skin journeys are never linear, and I continue to have flare-ups from time to time, but when my skin is clear, I find myself carrying that same lack of confidence around with me. In all honesty, I often struggle to recognize myself in the body I’m currently in, perhaps because I’m treated differently. Now, I find myself being acknowledged in new ways, all mainly positive. It suddenly dawned on me that I am benefiting from “clear skin privilege,” whereby a person possesses advantages thanks to the condition of their skin. Those with acne scarring, for instance, are often perceived negatively in society. Similarly, a 2022 survey by skin-care brand Skin B5 found that 41% of Gen Z believe acne makes you look less professional, and 46% of those with acne reported feeling judged at work. 

Given the abundance of acne treatments I tried throughout the years, I find it difficult to align myself with those who haven’t experienced the physical and mental effects of acne, not to mention the lingering scars — again both literally and figuratively. But after years of negative comments about my skin, any compliments I have received since have felt bizarre, borderline ridiculous. Even now, I don’t think I deserve them. 

As isolating as it may seem, this is a common feeling. In fact, TikTokers have coined it “post-‘glow up’ imposter syndrome.” Recently, young women have taken to the app to discuss the idea of going from feeling unattractive in school to being told they are conventionally pretty, or that their appearance is now acceptable. Just like me, they’ve found themselves in something of an identity crisis. “Then they say you’re fishing for compliments,” observes one TikToker in the comments section underneath a viral video explaining the concept, “but u just can’t see yourself that way.” Another wrote: “I’ve never related to anything more. My bf always gets mad at me cus I never believe what he believes. I still see my seventh grade self.”

Though this may sound like a nice problem to have, it’s far from a humblebrag. If anything, I feel this way because I know firsthand just how debilitating having acne — and the anxiety that stems from it — can be. For years, acne was such a big part of my life. It shaped my character and relationships, but I’m not the only one to question who I am without it. Refinery29’s acting beauty director Jacqueline Kilikita first experienced hormonal acne at the age of 11. Her breakouts worsened around the same time she was diagnosed with polycystic ovary syndrome (PCOS). When she became a beauty editor, Kilikita suddenly had access to dermatologists, who suggested prescription skin care like tretinoin and medication such as diuretic drug spironolactone.

Now in her 30s, Kilikita's hormonal condition and skin is mostly under control. However, the change has been an emotional rollercoaster, one she didn’t expect: “Every morning, I wake up and pass my hands over my face, feeling for new spots, and each time I’m confused that there aren’t any,” says Kilikita. “I spent years painstakingly treating under-the-skin spots, whiteheads, and blackheads, and often crying myself to sleep over my skin. Society tells me I should be happier now that my acne is under control, especially considering our fixation with ‘flawless’ skin. I became the loud, confident girl at school in a bid to mask my insecurities. But when you’ve based your whole personality around your acne and it suddenly disappears, so too does a part of you. Sometimes, I look in the mirror and I don’t recognize my face. It’s perplexing.” 

Consultant dermatologist Dr. Anjali Mahto also has acne, so she understands how a skin condition like this can impact your mental health over time — even when it is no longer there. “What people seem to forget is that acne isn’t actually a cosmetic condition; it’s a medical one,” Dr. Mahto tells me. For this reason, Dr. Mahto’s clinic, Self London, has clinical  psychologist Dr. Eleanor Chatburn on hand to speak to patients about the emotional effect that acne may have on them throughout their treatment process, whether they’re at the very start or nearing the end. 

Dr. Chatburn has recognized my struggle in plenty of her patients, with many experiencing the same post-acne anxiety I have. Some experts refer to it as acne dysmorphia, a form of body dysmorphia whereby people become preoccupied with an imaginary physical issue. While Dr. Chatburn doesn’t like to use this term herself, as she feels it can give people the impression they have body dysmorphic disorder — a serious mental health condition — when this may not be the case, she tells me that sensitivity can linger on the skin long after being healed.  

Even though many of Dr. Chatburn’s patients no longer have acne, the diminished self-worth they encountered as a result can be hard to shake. “It’s difficult to make the shift from disliking your appearance to loving it in an instant,” Dr. Chatburn told me. We came to the conclusion that it’s no surprise given the spotlight social media shines on clear, often filtered skin that so many continue to search for issues, even once our acne is treated effectively. Dr. Chatburn tells me that we have trained our systems to “zone in on minor flaws” and that it’s ingrained in us to find something to fix. Perhaps this is why the “skin neutrality” movement — which encourages us to focus less on faults in our complexions, and to be at peace with our skin — is slowly but surely usurping skin positivity, the latter of which places pressure on individuals to love and celebrate the skin they’re in. 

Friends and family can’t help but point out that my skin is the clearest it’s been in years, but it’ll be a long time before I can acknowledge that myself. Acne always made me feel like the “worst” one in the room. But for all that acne has taken away from me, it has added plenty to my life as well. In fact, it has even helped me become a better person: I have empathy and compassion, especially when it comes to other people’s skin struggles. Then there’s my endless knowledge of ingredients, which has saved plenty of friends from investing in useless skin-care products. That said, getting to know who I am without my acne is a work in progress. Rather than comparing my skin to last year’s, or an Instagram influencer whose skin has been subtly filtered, I’m trying hard to love the real skin I’m in today.