Friendships and romantic relationship with acne

Many people spoke about how friends and partners gave them support, but a few felt isolated or found it difficult to talk to others about their acne.

Most people recognised that their acne probably seemed worse to them than it did to other people. Nevertheless, for some, having acne could make them less confident about seeing friends, meeting new people or being in relationships. Ollie felt it was ‘harder to make new friends with low self-esteem, low confidence that acne often gives people’.

When his acne was severe, Will had a close group of friends who he was comfortable with but having a girlfriend went on the back burner.

Age at interview 21

Gender Male

Age at diagnosis 14

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Eli sometimes talks to her friends about acne, but only those who have spots themselves.

Age at interview 13

Gender Female

Age at diagnosis 11

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Friendships and acne

Having friends to talk to was usually seen as a good thing: Rachael’s friends were ‘really supportive and made me feel more positive about it’. Friends who also had acne often wanted to share their experiences and get or give advice and support. Will took isotretinoin when he was younger and, since then, has talked to some friends about it. Friends sometimes asked Tom about skincare products he recommended when they saw the products in his room at home. Friends without acne could also appreciate their expertise: Harriet’s friends saw her as a ‘fount of knowledge’ about skin care in general.

Friends could also offer practical support like going along to medical appointments with the person. Emotional support was important too and friends could help make the person with acne feel they weren’t being judged. Many young people liked having someone understanding to talk to about how acne affected their confidence and mood.

Fatima talks about going to a private skin clinic with friends.

Age at interview 21

Gender Female

Age at diagnosis 12

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Having basic human contact with friends made Harriet feel like a regular person.

Age at interview 21

Gender Female

Age at diagnosis 12

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Abbie found a good group of people who she could be frank with about her acne.

Age at interview 17

Gender Female

Age at diagnosis 13

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Feeling isolated with acne

However, some suffered from low self-esteem as a result of their acne or simply didn’t want to see friends when they felt they weren’t looking their best. Some people had experienced hurtful comments and a few were bullied because of their acne. Even when people had friends who were understanding, being self-conscious about their acne made some ‘withdraw’ or ‘hide away’.

Although she used to be outgoing, Becky is very self-conscious about her acne and says it stops her from seeing friends and making new friends.

Age at interview 19

Gender Female

Age at diagnosis 16

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It could make it worse when friends who didn’t have acne, and so didn’t understand what it was like to have acne, tried to give advice. Rachael feels there’s a big difference between having just ‘the occasional spot’ and having acne. If these were friends who they were not close to, they could feel awkward and a couple of people said they preferred it if friends didn’t mention their acne.

Deborah felt isolated because friends didn’t understand what it was like to have acne. She thinks getting emotional support from friends, rather than practical advice, is really important.

Age at interview 25

Gender Female

Age at diagnosis 12

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Hester only really spoke about her acne to other friends who had acne.

Age at interview 21

Gender Female

Age at diagnosis 15

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None of Rachael’s friends had acne. It was helpful talking to them about it, but it could be frustrating too.

Age at interview 18

Gender Female

Age at diagnosis 16

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For some, talking about acne was just not something they wanted to do, whether they had close friends or not. Emma and Ish didn’t feel comfortable speaking to friends about their acne until they were in their mid to late teens.

Romantic relationships with acne

The people we interviewed ranged in age between 13 and 23 years old. Some who were older reflected back that when they first had acne in their early teens they were not looking for romantic relationships and were more interested in friendships and study.

When she was at school, Sarah was more worried about what people might think of her hair and worried she might seem less attractive because she was studious.

Age at interview 22

Gender Female

Age at diagnosis 16

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Naomi wasn’t looking for a relationship when she was in school. Now she is in university she does have a boyfriend who is very supportive.

Age at interview 22

Gender Female

Age at diagnosis 9

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People often wanted to look their best when meeting potential partners and felt that others would make judgements about them because of their acne. Eli felt that ‘boys don’t really find it [acne] attractive’.

Chris thinks it’s normal to feel self-conscious about your acne when meeting romantic interests.

Age at interview 20

Gender Male

Age at diagnosis 17

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Feeling self-conscious about their acne could affect how they interacted with others. When Nina met someone she found attractive, she felt ‘held back’ by the thought of ‘Oh but you’ve got bad skin’. Hester couldn’t keep eye contact with men when she had acne and wasn’t wearing makeup because she ‘felt guilty that they had to look at me and I’m just like a bit of an eyesore’. However, Rachael always felt like ‘quite a confident person’ and that ‘if I was wearing makeup I was OK looking’.

Alexandra is very aware about partners seeing her body acne. She prefers to date boys who don’t have completely clear skin themselves.

Age at interview 22

Gender Female

Age at diagnosis 13

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Ish felt that in a relationship you always want to show your best side and it would be embarrassing having to do his morning skin routine if he had just started dating someone.

Age at interview 22

Gender Male

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Kosta finds it okay spending time with male friends, but feels more worried around girls.

Age at interview 14

Gender Male

Age at diagnosis 13

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But not everyone was as concerned about their acne. A few people spoke about being in a relationship as a source of support. Also people could become more confident over time, or as their skin cleared up.

When she was 14 Harriet felt no one would want her because of her acne. But now she is at university she is building up her confidence and realises physical appearance isn’t the only thing people notice about you.

Age at interview 21

Gender Female

Age at diagnosis 12

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Emma is a lot more confident about meeting people since her skin cleared up after a second round of isotretinoin (Roaccutane). She is in a relationship now and says she still feel self-conscious about her skin.

Age at interview 20

Gender Female

Age at diagnosis 10

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Family life and acne

Most people turned to their parents to help them when they first noticed their acne. Parents or siblings were often the first to give advice...