Acne

The emotional side of having acne

Most of the people we spoke to talked about the emotional side of having acne. People often worried about how others would react to seeing their acne (spots and scarring) and some were concerned about treatments. 

People tended to have good and bad days with their acne – Sarah felt things were fine most of the time but “every so often there are days where I feel a bit blue about it”. Some described how their first thought in the morning was to look in the mirror to see how bad their acne was that day. Feelings about acne changed over time for most people. Even though it could get them down, many felt strongly that it wasn’t something to be embarrassed about or take over their life.

Common emotions about having acne included feeling:

•    embarrassed, awkward and self-conscious or having low self-esteem
•    frustrated and annoyed
•    scared
•    nervous
•    sad
•    stressed and irritated
•    confused
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Age and having acne

People often saw acne as a “quite normal” part of teenage life and, for some, having other friends and siblings with acne made it easier to live with. At the same time, the idea that acne is ‘just part of being a teenager’ stopped some people from getting medical help sooner and could leave them feeling unsupported. 

Those who had had acne in their pre-teens often found it a very negative emotional experience, especially when their peers didn’t have any spots at all. It made them feel isolated, lonely and jealous of other people with “perfect” skin.
Having acne could knock confidence and self-esteem at a time when the person was going through the physical and emotional changes associated with adolescence. Harriet was “quite shy” and found having acne drew unwanted attention to her. She explained that “when you’re a teenager, you already feel like everyone’s looking at you anyway. And then when you’ve actually got a definitive reason why they might be looking at you, it just makes it so much worse”.
Having acne beyond teenage years and into your 20s could be frustrating, especially when people were often told that their acne would ‘go away’ before then. Marga didn’t have many spots until the end of sixth form/start of university – she felt “frustrated” because “I thought I had passed that [point]”. Some people said they didn’t mind having acne as a teenager and Deborah hoped she would “get it out of the way”, but their feelings about this changed as they got older and their acne continued.

Some felt that it was easier to talk about acne when they were older as they felt less self-conscious. Initially, Harriet had been very worried about others seeing her scarring but was told that eventually she wouldn’t notice it and she has now stopped thinking about it. Devan became more confident about finding a solution to his acne when he left secondary school. Getting older and socialising with other adults could make a big difference.
Acne on different areas of skin 

People talked about different parts of the body affected by acne. Having acne on the face and neck tended to make people feel more self-conscious. This could mean using make-up to cover up spots and scars, avoiding photographs being taken of them and, when it was at its worst, missing social events like seeing friends. Acne on the chest and back was usually less visible than facial acne, but could make some people anxious. This included feeling self-conscious when changing for P.E. lessons (especially swimming) or showing more of their skin in the summer. A few people mentioned that they thought it was less socially acceptable to have acne on the body than on the face, but others were less worried about acne on their bodies. Naomi saw acne on other parts of the body as “just a kind of subsidiary to the face thing, like I wasn’t really that bothered”.
Scarring

It wasn’t just the acne itself but sometimes the scarring that it left behind on their face or body that can be difficult. People could feel very self-conscious about scarring even if others didn’t notice it, although scars could fade over time. It could get easier to cope with scars as time went on. Abbie said she doesn’t mind her scars now and sees them as a kind of proof that she “succeeded in my acne fight”.
Gender

A few people talked about how they thought their gender made it more or less difficult to deal with acne. Many of the young women talked about pressure to meet media stereotypes of flawless skin and to wear make-up, and some wouldn’t go out without make-up on. Most people felt that there was more peer pressure for women to hide their acne and any scarring than for men, which made female acne seem more ‘unusual’. At the same time as feeling pressure to cover up spots with make-up, some young women talked about other people’s beliefs that this was a cause of acne.

Fatima thinks acne affects her brother more than it affects her because he is more fashion conscious. Marga thinks boys and young men are at a disadvantage because it seems less socially acceptable for them to cover up their acne with make-up (which for her is a “safety net”).
Emotions associated with seeking treatment 

Talking to a GP or dermatologist could be emotionally positive (“taking back control”, “hopeful whatever they’d give me would sort it out”) or emotionally negative (“embarrassing” “awkward”, “it’s annoying admitting that you’ve like got an actual condition or a problem”). Several people spoke about feeling worried that it was too trivial a condition to see a doctor about. But for most, the doctor’s response was to take it seriously. Some people believed diet, bacteria and stress had an effect on their acne – because of this, a few felt that having acne was partly their fault. Others disagreed and were hurt that some people might see their acne as a sign of poor diet or lack of personal hygiene. You can read more about causes and triggers here.

Everyone we spoke to talked about trying many different remedies and this could be an emotional process (a “rollercoaster of emotions”). People could feel “frustrated”, “annoyed” or even “quite hopeless” when creams or medication didn’t work or made things worse. Marga found a cream that works well but feels concerned about stopping the cream because every time she does the acne comes back.

Using creams, taking oral medication, and trying alternative or home remedies could be stressful. Unwanted advice from family, friends and even strangers could be tiring. Some people worried about side effects. Some treatments can have side effects on mood too, such as isotretinoin and hormonal contraceptives.

But there could be positive emotions associated with finding something that worked, and people spoke about feeling more confident about themselves. 

Mental health in the context of acne

A few people described having acne in the context of a diagnosis of depression. Others talked about being “moody” and prone to anxiety. Many found that stress and acne fuelled one another.
Although having acne could be upsetting, most people said they didn’t seek any special emotional support such as through online or face-to-face support groups. Some said the support they had from family and friends was enough, or that they wouldn’t have felt comfortable talking about acne with other people.

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