By Freddie Cocker
Acne is one of those accepted conditions which society seems to shrug its collective shoulders about in a way that it doesn’t for more serious health conditions.
When some adults see teenagers living with it, the responses can range from ‘it’s alright, it builds character. It’ll go away soon’ to ‘everyone gets it at some point, its no big deal’. Thankfully, we are getting to a more informed and educated perspective on acne as a condition but it doesn’t minimise the mental health impact it has on people.
I am writing this article because I lived with cystic acne from the age of 15 years old. Unlike regular acne, Cystic acne is the most serious type of acne. It develops when cysts form deep underneath your skin. This can result from a combination of bacteria, oil, and dry skin cells that get trapped in your pores. Although anyone can develop acne, cystic acne tends to occur in people with oily skin.
From the ages of 15-17, I had acne on both my face and back and spine. Whilst it was invisible to most people on my back, the acne on my face was demoralising, immasculating and painful to live with.
It felt like living with a physical mask on that you couldn’t take off, even when you got home from school. I had no sexual experiences in secondary school and the acne probably made me think any girl was out of my league, let alone the ones I was attracted to.
At the time, my skin-picking and self-harm was still very high and not under control so I would often pick at spots around my lips, forehead and under my eyes, causing them to bleed, which isn’t nice.
During the last years of secondary school, I was still being bullied so the lack of self-esteem and self-worth I had from the bullying was exacerbated by the presence of acne as well.
When I moved to a new school for sixth-form college, I immediately untagged all the pictures on Facebook of me with acne on my face.
I was then diagnosed with acne by my GP and put on mild forms of treatment for it to start with. Anyone reading this who has had acne will know what Lymecycline is and how it is used to treat people with acne. Whilst it can have positive effects for some people, it did nothing for me. Eventually, I had to ‘prove’ to skincare consultants and dermatologists through completing this course that I was eligible to go on a drug called Roaccutane.
This drug is the strongest you can take for acne and has been the subject of some controversy in the last decade, especially for people who take it with existing mental health conditions. I am not here to discuss that, just my own personal experience of the drug and how it affected my acne and mental health.
The first time I took it aged 17 was a course of three to four months. I was told to take one pill a day immediately after meals and the results were instantaneous. Despite the drug making my face dryer than the goby desert, the spots cleared from my face by the time I had completed the treatment.
However, for some reason, probably because of the severity of the drug, I was taken off Roaccutane once my face was sorted out.
Unfortunately, this meant that the spots did not clear from my back and I lived with this for the next 10 years. Ironically, the spots were far worse on my back than my face.
So, you get a scale of how bad they were, this is what my back looked like up until February 2021…
I cannot articulate how embarrassing and at times painful these spots put me in as an adult living with acne. Waking up with blood on my pillow from when I scratched a spot half-asleep in the middle of the night or simply moved around a lot and popped the head off one was a regular occurrence.
Taking my shirt off in front of a girl in a romantic situation was fraught with anxiety. Its not exactly sexy to tell someone you’re being intimate with not to scratch or even touch your back out of fear they’ll pop a spot and cause it to bleed.
I should also add that this second treatment of Roaccutane was a lot more intense and debilitating to go through, despite its positive results. Because of the severity of the cystic acne on my back, shoulders and spine, I was told to ingest two pills at once after meals to intensify its effect, which caused the dryness to be exponentially worse.
I was even told to try three at once if I could handle it, which I did on one occasion. I was wiped out the entire evening and had to take paracetamol to get back to normal so that was a no-go afterwards.
This second Roaccutane course caused both sides of my lips to be permanently cracked for the time I was on it. My ears eventually began crusting over as well as dryness developing inside my ear lobe. My nose began to peel, I developed eczema all the way up both my arms, my hands needed constant moisturising or they’d become red raw and I had mood swings too.
In addition to all of that, the intensity of the pills made me very tired and dehydrated afterwards.
The only feeling I can compare it to is a really strong comedown after a caffeine or sugar rush. You can barely construct a thought in your head at its worst.
Despite all of that and my fear that this time around wouldn’t be enough to do the business, after a second course of Roaccutane for a longer period of seven months, this is what my back looks like now…
The difference is chalk and cheese right? One could even say miraculous. Apart from some scarring which I can live with, all spots have disappeared from my back entirely. The relief that has given me going forward is indescribable and my self-esteem is much higher as a result.
Gone are the days where I’d feel anxious before taking my shirt off at a beach or around my mates, even though I know they wouldn’t judge me for it. Hopefully with a bit of Vitamin D, even the scarring will melt away.
If you live with acne and are concerned about it, please consult your GP before taking any steps and make sure you find the right treatment for you. Roaccutane worked for me but you have to have a lot of resilience to get through it and be mentally in a good place but I know that it hasn’t helped others with cystic acne or even regular acne.
What I hope people take away from this article is just how big an impact acne can have on one’s mental health.
If you know someone who has it, especially a teenager, don’t let them suffer with it unnecessarily. Approach them or a family member with compassion and empathy, ask if they are trying to address it and if not, why?
Ultimately, the positive impact of getting rid of that acne on that person’s mental health is one hundred percent worth taking that step.
Freddie Cocker is the Founder and Editor-In-Chief of Vent.