On life with acne as a woman

When I was 23, I was elated to land my first corporate job. But I also felt out of place in the busy office complex, where everyone was older than me and wore a lot of black. I applied my make-up very carefully every morning so I would match the other women in the building, though I always flinched at my reflection when I saw us, standing side-by-side in the lift. I could see my efforts had been futile – even the soft lighting couldn’t hide the angry red bumps all over my face.

My boss confirmed my deepest fears one day, when he turned to me and said, “You don’t wear make-up, do you?” For a long, excruciating moment, I couldn’t even speak. I stammered that yes, I did. “Oh, you wear make-up sometimes,” he replied, unconvinced. “You should drink more water.”

I was shocked and humiliated. I wanted to walk out to show him how inappropriate he was being, but I also didn’t know how he would react if I did. He had my job in his hands and though I knew it would feel good to speak up and be brave,for once, I also knew the longer-term consequences wouldn’t be worth it. In the end, I stayed silent and hated myself for it, because it gave him tacit permission to keep sharing his advice, which he did several times.

Comments like this aren’t new to me. As a now 30-year-old woman who has suffered acne since she was a teenager, I get a lot of unsolicited advice from co-workers, relatives, friends, shop assistants and strangers. People who have never had to deal with severe cystic acne, but have a lot of assumptions about what causes it. Oddly, it never occurs to them to ask about the treatments I’ve already tried – the harsh skincare products that bleach my towels, or the creams that can leach into my womb, somehow, and cause birth defects in my hypothetical children. To them, the answer is much simpler – Drink more water. Eat less junk food. Wash your face.

Try harder.

In my personal experience, these comments come almost overwhelmingly from men. Most of the time, their advice is well-intentioned, but the fact that they feel entitled to pass judgement at all is yet another reminder that a woman’s body is not her own, but a focal point for public commentary. While I know men with acne receive their share of unwelcome skincare advice, it’s impossible to say they suffer the same level of scrutiny. I have never heard a man comment on another man’s appearance in public, especially in a professional context, while I have heard women criticised for everything from their shoes to their perfume. Women, as the recipients of these comments, tend to be more sensitive about men’s self-esteem, and cognizant of the power structures that prevent them from saying anything equally careless.

I would argue that the main reason women receive these comments more frequently than men is because we are conditioned to equate a woman’s desirability with her ability to lead a confident, happy and successful life. Acne is still regarded as a teenage issue, so a woman with acne can’t be desirable. She isn’t even a proper woman yet. This perception that we are juvenile, that we are somehow incapable of taking care of ourselves, seems to suggest we need immediate intervention and guidance.

It’s a belief I internalised for a long time. Even though acne is becoming increasingly common in adult women, who account for 82% of post-puberty cases, most of us still believe that acne disappears by itself with age. And if it hasn’t happened by the time we reach 20, 25 or 30, then it feels like we’re doing something wrong.

Research tells me this is actually a common misconception among female acne sufferers. In a 2014 study called ‘Understanding the Burden of Adult Female Acne’, which surveyed women between 25 and 45 with serious facial lesions, one-third of participants (38.5%) said they thought their acne would clear up by itself with time. One-third. More than half (51.9%) believed a simple over the counter face cream or cleanser could effectively clear their acne. These are women who had suffered chronic acne for years, and still didn’t think they had a medical condition.

When you consider how acne treatment is marketed, it’s hard to be surprised. Commercials and print advertisements, which are overwhelmingly targeted towards women, and usually feature an attractive young celebrity trying to get rid of a tiny pink spot on her chin, suggest that bad skin is a temporary inconvenience; a simple face wash away. We associate acne with youth, cosmetic products and cleanliness, and this has distorted our understanding of proper treatment.

The shame that women feel when they can’t control their own appearance also stops a lot of them from seeking medical help. While both genders have identified a relationship between their mental health issues and adult acne, dermatologists agree that female sufferers are more socially self-conscious than their male peers, suggesting that the stigma of bad skin is worse for women.

For me, at least, this is true: my worth as a woman feels directly tied to my skin problems. I feel more feminine on good days, and less feminine on bad ones. I see this reaction mirrored in the people around me; from the retail workers who greet me with smiles when I wear make-up and ignore me when I don’t, to the colleagues who patronisingly suggest I exercise more during flare ups. I spent years furiously self-treating because I was so sure I hadn’t mastered the beauty secrets that my female friends had, which resulted in scarring that could have been avoided. I recognise this as a mistake now, but it’s hard to overcome years of entrenched self-blame. When you have a chorus of voices telling you that you’re not doing enough to fix yourself, it starts to sound plausible.

Though my skin is better now than it’s ever been in my adult life, I’ve accepted that time isn’t a cure for my condition, but the right balance of hormone-based contraceptives and topical treatments. And after gaining experience in better workplace cultures, and being around assertive women who rail against their mistreatment, I’ve become aware of the subtle ways that misogyny manifests itself in daily life. I’ve come to realise I don’t actually have to put up with comments about my appearance – I can call them out, because they are driven by a need to police my body and make me conform to unrealistic ideals. It isn’t always easy. People are inevitably defensive, or embarrassed, when I show them something ugly in themselves. But I won’t be silent anymore. I’ll never be immune to breakouts, and I’ll have scars for the rest of my life, but I refuse to let these perceived flaws define who I am.

Image: Drew Graham


Emily Tatti is a Melbourne-based writer and editor. Her work has appeared in places like Junkee, Lip Magazine, Writers Bloc and Killings. You can find her on Twitter @narrativekind.

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