This is what I’ve learned from over a decade with acne...

Over the past few years, we’ve seen acne come slowly into the spotlight, from beauty blogger Em Ford baring all on YouTube (a platform traditionally home to flawless skin tutorials) to photographer Sophie Harris-Taylor showcasing acne front and centre in her revolutionary Epidermis portrait series. Most recently, Fenty (already doing the most for representation in beauty) published an acne make-up tutorial featuring someone who actually has acne (radical, I know!), which went viral, garnering over 150,000 views. We’ve also seen a skin-positivity movement on the rise on social media, with celebrities such as Lorde, Ruby Rose and Kendall Jenner “clapping back” at insults around their skin and the hashtag #freethepimple gaining popularity on social media. It feels like acne might be the latest focus in the growing body-positivity movement, which has been responsible for opening up conversations on diversity, disability and disfigurement.

There’s a lot of misconception around acne, partly because people don’t understand it properly (acne is caused by the “slow shedding of dead skin cells combined with excess oil production”, says skincare specialist Debbie Thomas, “it has nothing to do with being unclean” and it can affect people of any age), but also partly because of the way it’s portrayed in advertising and media (if it’s even portrayed at all). Growing up, I don’t remember seeing more than a handful of characters on screen with acne – and they were almost always either a nerdy teen or a bad person, whose rotten core was illustrated by the pimples scattered across their face. Even adverts for acne treatments seemed to cast only clear-faced teens. “Oh, no, it’s the big school dance and I have a zit!” they’ll wail. It perpetuates the idea that spots are a “teen-only” condition incompatible with being a professional adult women – that it must be a sign of someone who isn’t to be taken seriously.

Two years ago, I was keeled over in a doctor’s office with a double ear infection. I’d spent an hour in A&E floored by the pain. The doctor leant back after examining my ears and proclaimed that I did have an ear infection, that he’d prescribe me some medication and, with a grimace, that I “really needed to see someone about that acne”.

I started getting spots when I was 11 or 12, along with my first period, and it very quickly turned into full-blown acne. Suffering from acne is inherently psychological as well as physical; a recent study found a strong link between acne and depression, even in mild cases, and an “intense” effect on overall quality of life for those suffering from it. When your face is so tied to your sense of identity, having scars and spots covering it can impact the way you feel about yourself in a devastating way. It’s embarrassing to admit to my acne-free friends how I spend most of my time on the Tube trying not to notice how everyone else’s skin is better than mine, or how I’ve cancelled plans before because I can’t bear to see how beautiful they look while I’m having a flare-up. Acne is not just painful emotionally, but physically, too. Exposed sores, tight skin, lumps that feel like tender bruises; I’ve had acne so severe around my mouth that I couldn’t open it to eat properly, and spots so deep and large on my forehead they’ve given me round-the-clock headaches for days.

Over the years, I’ve tried countless antibiotics, topical gels and facials, but none of them have worked on me. I was even referred by my doctor for laser treatment. It took two years of waiting in limbo before I was given my first appointment, by which time the machine was withdrawn and I never finished the course of treatment. The last-resort treatment for acne is often Roaccutane – controversial for its long list of potential side effects, including suicidal thoughts. But because of my history with depression, I was advised against taking it. In the absence of viable treatment options, one thing that has definitely helped is talking to those who can truly relate. There’s an incredible sense of solidarity in talking to other women going through the same thing.

But, for every step forward – whether that’s through celebrities shining a light on acne or through woman sharing their experiences and posting barefaced, spotty selfies – there’s invariably a barrage of ignorant comments and think pieces that pull us back again. The A&E doctor was the not the first to say something insensitive. Another GP told me it’s “better to not get the scars in the first place, isn’t it?” when I asked whether going out in the sun was bad for acne scarring.

At this point, I’ve found a skincare routine that doesn’t cause me to flare up and make-up that does a valiant job of covering my skin without making things worse – but it’s a constant balancing act. After countless GP and dermatology appointments, I’ve come to accept my journey isn’t about finding a cure, but about managing the condition. Recently, I’ve found myself wanting to let go of trying to control my skin and instead focus on trying to control the way it makes me feel about myself. Ultimately, that’s a much harder thing to accomplish – but one that is just as worthwhile.