Now, I know there are plenty of people in this world with far more pressing problems than acne, both skincare-related (disfiguring scars...) and otherwise (abuse, bereavement...). However, the permanent battle against acne, spots, zits, whatever you want to call it, is so pervasive and common with pre-teens, teens and twentysomething-plusses throughout the world that it seems impossible to ignore.
I first started seeing spots on my face when I was TEN. Yes, ten. My Year 6 class photo bears the evidence for all to see. It was embarrassing enough starting secondary school with this, being barely old enough to wear any makeup to cover it, but I could at least harbour the hope that I would grow out of it by the time I was fifteen and old enough for parties and boyfriends. It didn't happen. I then set my sights on being sixteen, in the sixth form, and spot-free. No such luck; in fact, my acneic skin dogged me through sixth form and university, and now, at the age of (nearly) 24, many of the students that I teach have better skin than I do.
I suppose the possibility that I might suffer acne into adulthood was always something that I knew about, at least in a very abstract way: at fourteen, I had a science teacher named Miss Marshall, who was probably about the same age then as I am now, and she had terrible acne. I remember thinking I would just die if I was in the same situation as her when I was grown up. Now I am, and I'm not dead, and nor do I wish to be, but that doesn't stop it from being demoralising. Equally, when I was 17, I was diagnosed with polycystic ovary syndrome. As well as potentially restricting fertility (though I won't know the effects of this until I try to have children), it can also send the amount of testosterone in a woman's body haywire, sometimes causing or aggravating hirsutism and acne. Trying to get my oily and acne-ridden skin under control has therefore been a constant battle.
The plan of attack for many sufferers is three-pronged: makeup, medication, and skincare. I feel sorry for the guys when it comes to point one, as the purchase of makeup can add further embarrassment to the whole problem. Mineral makeup can help matters, and a decent concealer (mineral or no) is my absolute, number one, indispensable item. Medication and skincare are trickier areas: skincare products can appear to make skin better, only for the effects to then plateau or tail off, and there's the risk, too, of your skin becoming dependent on a particular product in order to stay clear, meaning that you haven't really treated the problem. This is why some people turn to medication, but this again can present a similar conundrum: will it send the spots packing for good, or will your skin flare up again once you come off the medication?
There are several options with regards to medical treatments: they can be topical (applied directly to the skin in the form of a cream or gel, whether bought off the shelf or prescribed by a doctor) or oral (oxytetracycline, for instance, is one of the many tablets that a professional can prescribe to treat acne from the inside). The most potent and perhaps also most famous oral treatment for acne is the prescription-only Roaccutane, which for many people is a lifesaver, sending spots packing for good. However, for others it can be a nightmare, increasing mood swings and giving sufferers painfully dry skin (including nosebleeds due to dryness inside the nasal cavity). Perhaps worse, after all of that, for some users of Roaccutane, it doesn't actually work the first time and you need to go on it again. Use of Roaccutane also needs to be monitored by a doctor as it is really only for the most serious of cases, meaning that most autonomy in terms of how you pursue your treatment is removed.
Having tried many of the topical treatments on the market, as well as a lot of the oral treatments available (including homeopathic ones), you wouldn't be the first to ask if I had tried Roaccutane yet (and if not, why not). The reasons are manifold (although I do sometimes wonder the same myself): firstly, I teach, and I cannot be doing with constant nosebleeds; secondly, I worry about some of the drug's other side effects, such as mood swings; thirdly, when I suggested this to my fiancé a few years ago he sounded like he'd have been happier if I'd said I wanted to give cocaine a try; fourthly, I do not like the thought of putting myself through all of that only to have the drug fail and for me to be back at square one; and lastly, perhaps stupidly, my skin does ultimately seem to be improving with age. My back and arms used to be covered in spots, and now they no longer are; my face and chest, while not perfect by a long way, also seem to have improved greatly (though this varies according to the treatments that I use).
Perhaps this approach is naive, and perhaps I am dicing a bit with fate to really believe that my skin will be totally clear by the time I am 30. But I do wonder sometimes if I am not totally mad to say "no thanks" to a treatment that could, in making my skin better, also boost my self-esteem, and not make me resort to airbrushing my wedding photographs. You cannot blame me, as someone who has suffered with acne for over ten years now, for feeling a little bit cheated out of my youth.
Some claim one final approach: changes in diet. I do hate the assumptions that people make about people with acne (that we do not wash or that we eat badly), and I do not think I really believe that diet makes a significant difference to skin condition. Certainly eating plenty of fruit and vegetables, and drinking lots of water, won't do your skin any harm, but as someone who has gone through a range of diets (eating meat, to turning vegetarian, to going back again, to eating so badly that I piled on a couple of stone, to eating well/normally again and losing the weight) I cannot say that I have noticed any difference to my skin in any way that would correlate with a change in diet. Even though I have not tried cutting out dairy (an approach that some swear by), I eat so little dairy anyway (don't even have milk on my cereal; tend to eat dark chocolate; have no more than a yoghurt a day and a tiny amount of cheese at weekends; don't have milky coffee or tea) that this would seem like a lot of pointless aggro.
So, naive/stupid or not, I'll just stick with my current two-pronged attack (no medication as it often messes up the oral contraceptive that I take) and hope that in conjunction with age it will do the trick eventually. At least, too, I know that my friends are real friends, and don't just love me for being one of the beautiful (read: clear-skinned) people.
Skincare
Treatments that I have found to be effective, in order of price:
-Pond's Cold Cream Cleanser, £3.99
-Liz Earle's cleanser, toner and Skin Repair Light, £21.75 for the travel kit or £40.25 for the three full-sized products
-Clinique Anti-Blemish Solutions cleanser, toner and moisturiser, £30 for the travel kit or £44 for the three full-sized products
Makeup
- Lily Lolo mineral foundation
- Bare Minerals mineral foundation
- Clinique Anti-Blemish Solutions foundation
- L'Oreal Touche Magique concealer
- No7 Quick Cover Blemish Stick concealer
Medication
Try tackling your skin with regular skincare first (see above), as well as mass market topical treatments, such as masks or tea tree oil, which is targeted at oily or acne-prone skin, before seeing a doctor. You can also try homeopathic treatments. The doctor will likely prescribe two or three different types of oral medication, in addition to prescription-only topical treatments. Only if this does not work will you be referred to a dermatologist with reference to Roaccutane. Do not attempt to self-prescribe/buy the drug off the internet as you should be monitored by a health professional during its use.
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