I was in fifth grade when I got my first pimple. It was small and barely noticeable, but it felt like the end of the world. Uncoincidentally a few months later, my period arrived. And then, I started middle school. This series of events launched my 11-year-old self into a downward spiral. I felt plagued by these changes to my body, wondering why I was the only kid in my class going through puberty. To cap things off, I made myself an Instagram profile. Needless to say, adding social media to the mix didn’t help my self-esteem. 

This feeling of being misunderstood dissolved upon entering high school. I eventually realized that puberty wasn’t a unique experience for me and me alone. But that’s when my long, uphill battle with acne started. 

Throughout high school, I never had a clear face, chest, nor back. As a distance runner, part of this had to do with my sweaty sports bras. But the other primary determinant of my acne was the overproduction of oil and sebum. 

I started seeing a dermatologist who prescribed almost every medication in the book: salicylic acid, benzoyl peroxide, Differin, Tazorac, Duac, Epiduo, dapsone, tretinoin, and clindamycin. When none of those worked, I switched to oral medications. This included doxycycline, minocycline, and spironolactone. When picking up these prescriptions before meeting our yearly deductible, some of these medications cost hundreds of dollars. 

After two years of trial and error, my skin finally responded to the combination of minocycline and Epiduo. But there’s one glaring problem with oral antibiotics such as minocycline: you can’t take them forever. By the end of my senior year, my dermatologist recommended weaning off of taking the antibiotic before my body became immune to it. 

Amidst my acne plights, social media began to erupt with new campaigns focusing on body positivity. Among encouraging people to challenge their own negative self-perceptions, body positive activists also argue for the diversification of media representation. I, then, started to question my constant search for a cure to my acne in the name of self-love, feeling guilty for hating my skin, as though that made me a “bad feminist.” I wanted to love myself. I also knew that even having access to a dermatologist and insurance made my problem a privileged one at best. 

So when I entered college, I told myself it wasn’t worth it to worry about my skin; that hopefully it would clear up on its own. Two weeks into the semester, my chin and cheeks were covered in cystic acne. Having had only white and black heads before, I was upset, confused, and in pain. 

During this time, my self-love was at an all time low. But the resurgence of my poor self-esteem wasn’t just because of the way my skin looked. During that entire academic year, I couldn’t apply makeup, sleep on either side of my face, or even rest my chin in my hand because the cysts were too painful. For me, self-love and cystic acne just didn’t go together, even if I had wanted them to.

After another trip to the dermatologist, they finally recommend I go on Accutane. Hearing the word aloud made me physically cringe. We’ve all heard the Accutane horror stories: the lip peeling, the monthly pregnancy tests for people with uteruses, the hair loss, the depression. Everything about Accutane seemed far from loving myself and my body. Two consultations later, I started my first month and my skin immediately got worse. This purging period made me feel far from excited and I found myself wondering if any treatment would help. 

Two months in, I started to notice some of the cysts fading away on my jawline. After two more months, my skin was practically clear. Besides having extra dry skin and constantly applying Vaseline, I experienced no other side effects. And finally, after taking Accutane twice a day for six months, after having acne since I was eleven, my skin was blemish-free. 

I eventually came to terms with the idea that self-love isn’t one size fits all. For me, self-love never has, and never will, include cystic acne. This doesn’t mean people with acne shouldn’t have self-love. And it doesn’t mean that I hated myself or my skin in the process of clearing it. It just means that acne and I aren’t compatible, from a perspective of pain, both physically and emotionally. 

I still have mild breakouts here and there. But putting cystic acne behind me has allowed me to actually practice self-love, despite a few zits. And while body positivity remains important, so is accepting that we may not necessarily love every inch of our bodies. That’s not to say that there are bodies that aren’t beautiful (because there aren’t), but rather how we view ourselves doesn’t have to be toxically positive nor fake. Only then can we really practice healthy and realistic self-love.

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