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Acne Isn’t Skin Deep

by Claire Mullen //

Acne and Advice

As a girl who has struggled with cystic jawline acne for years, I have collected a small pile of unwarranted advice on how to “fix” my face. Society’s expectations for how women should look, coupled with general misconceptions about acne, resulted in a rather painful personal experience for me. My acne journey made me question what it means for a woman to look “presentable” and how harmful “helpful” advice can be.

Not Always Your Period

Growing up, the general notion was that my acne must have something to do with estrogen and my period. Now, there is some basis behind this. During a woman’s menstrual cycle, testosterone levels initially increase, which in turn increases sebum (the oil on your skin) production. Sebum is a breeding ground for P. acnes bacteria, and the immune system responds by sending white blood cells that eventually die and become pus. Ultimately, a pimple is formed.

Testosterone, though, isn’t the cause of hormonal acne in all women. A different hormone, insulin-like growth factor 1 (IGF-1), can also be responsible. For all people, IGF-1 spikes during adolescence and young adulthood to aid in bodily growth, maintenance, and development. Besides this, IGF-1 also leads to sebum production, and sebum leads to acne. This is part of the reason why many people suddenly develop acne in their teenage years: because of increased IGF-1. 

However, I was never told this. People only made some vague reference to “the hormones,” as if each of them had identical functions, and how to “fix” my hormones: not eat milk chocolate while on my period, drink more water, and so on. I only learned about testosterone and IGF-1’s impact on acne years into my acne journey through extensive online research. Additionally, cystic acne can be a symptom of hormonal conditions such as polycystic ovary syndrome (PCOS), so it is best to discuss acne with a general practitioner and/or dermatologist if possible. 

Ignoring the Problem 

Society’s consensus is that acne is a purely cosmetic issue, but in reality, acne digs deep into one’s personal life and mental health. No one seemed to understand what I was experiencing as a result of my acne: it hurt to wash my face, I became obsessive over changing my pillowcase, and I was adamant about never reusing a face mask in fear that it was contaminated.

I was told to “just cover it up with makeup” but this was problematic for so many reasons. Firstly, it would only irritate and infect my broken skin. Furthermore, acne is not a purely cosmetic condition, therefore it is illogical to treat it solely through a cosmetic approach. It would be nonsensical to tell someone to put concealer over a paper cut, so why would we tell a woman to put it on her acne? Come to think of it, I’ve never heard anyone tell a man to put concealer over his acne. Then again, society deems it unacceptable for men to wear makeup in any capacity. Nevertheless, for women, acne is treated as an urgent problem that must be covered up to look “presentable.” 

What to Tell Someone with Acne

If someone you know is experiencing acne, the best thing to say to them would be nothing at all. If they ask you for skincare tips, go right ahead, but in all other situations, their skin is none of your business. Just as it is rude to give unsolicited advice and commentary on how one “should” dress, style their hair, or otherwise present themselves, we must learn to refrain from commenting on another person’s skin.