Growing up, I never struggled with acne. Sure, I’d get the odd pimple here and there every month, but it was never anything to lose sleep over. Then came 24. My skin started breaking out all over my jawline, and next thing I knew I was diagnosed with full blown nodulocystic acne, the most aggressive form one can possibly have (as told by my dermatologist).
Before I take you on the highs and very low lows of living with nodulocystic acne, let’s first answer the question, “What is acne?”.
*Acne is a common skin condition that occurs when a hair follicle in the skin gets blocked and fills with oil from the sebaceous glands and dead skin cells. Our skin contains millions of follicles, each containing one hair and a sebaceous gland that produces oil. When pores are blocked and this sebum builds up without being able to be released from the skin, acne forms. *
There are many different forms of acne. 6, to be precise:
Blackheads are small bumps on the skin that occur due to a blocked hair follicle that has been exposed to air, resulting in a black colour. Blackheads are a type of non-inflammatory acne and can easily be treated through professional extractions and the right skincare such as chemical exfoliants that help shed dead skin cells from the surface of your skin.
Whiteheads are also small bumps on the skin, but the difference is the hair follicle hasn’t been exposed to air, causing just a white raised bump on the skin commonly known as a comedone. This too can be treated with something as simple as introducing exfoliating acids into your skincare routine to help slough away those dead skin cells that are causing pore blockage.
Papules are tiny red bumps on the skin caused, again, by excess oil production and dead skin cells clogging the pore. Papules, however, don’t have any visible pus on the surface, and are red due to them being inflamed.
Pustules are papules, but with a pus-filled head. These can be sensitive to the touch as they are an inflammatory-type acne.
Cysts are a more severe types of acne. Cysts form deep within the skin in the dermis layer and are caused by clogged pores and an overgrowth of bacteria. Cysts are pus-filled and thus softer to the touch. Cystic acne is most common amongst those with oily skin. It is also common amongst teenagers, women, and adults with hormonal imbalances. Cystic acne generally requires more serious treatment like prescription medication from a dermatologist, as it is not treatable with skincare alone.
Nodules are also an aggressive form of acne as it can’t be cleared by over-the-counter products alone. Unlike cysts, nodules form hard bumps deep under the skin and never form a head. This kind of acne is painful to the touch and is also red/purple in colour as it is very inflamed.
So, what caused my acne?
To be frank, I still don’t have a clear explanation, and that is the honest truth about acne. The answers are never as black and white as you might think or hope for. I visited countless doctors, did so many blood tests, ultrasounds, scans, food allergy tests, the works! And nothing gave me a clear answer. The only possible cause was slightly elevated testosterone levels, but not enough to explain the severity of my acne. I have always been someone that is pedantic about hygiene and health – always drinking water throughout the day, eating clean and healthy food, avoiding processed foods and refined sugars, barely consume any dairy, and wash my face twice a day, yet for some reason my skin broke out in the most aggressive form of acne imaginable.
In hindsight, I personally think that my acne was triggered by emotional stress. I was on a work trip in Turkey back in 2018 for 3 months. The living conditions were very stressful and sent my health almost over the edge. My hair was shedding, I broke out in eczema all over my body, I gained 8kg’s in water weight due to elevated cortisol (stress hormone), and I didn’t menstruate for the entire time I was there. I came home, and immediately went to see my doctor to help get me back to good health again. It took until early 2019 for me to fully recover. I never thought that that period of my life could have been my acne trigger because my acne only developed 6-8 months after this time, but the body has interesting ways of healing.
During the early stages of my acne breakouts, I started going for frequent facials and skin treatments like microdermabrasion, micro-needling, and extractions to try and keep my skin under control, but the more treatments I went for, the worse it got. At this stage I knew absolutely nothing about skincare or acne, so I blindly trusted my beauty therapist to treat my skin, but little did I know I was aggravating it by spreading the bacteria. After a few months of tirelessly trying to get my skin under control, I gave up and decided it was time to see a dermatologist. I was hesitant to go, because I knew that I was going to be put onto Roaccutane (Isotretinoin), and I always thought that that wasn’t an option for me because I have a condition called Gilbert’s Syndrome, which in a nutshell means my liver doesn’t function properly and would therefore take strain while on the medication.
In January 2020, I went to the dermatologist, and it was the best decision that I could have made for my skin. He put me onto Roaccutane and reassured me that he had treated multiple other patients with the same liver condition with no complications throughout their treatment, so I had nothing to be worried about. The 7 months of treatment that followed were grueling. I went for more corticosteroid injections than I can count, I was on antibiotics, and even used short courses of cortisone to help treat the infection over and above using Roaccutane. Throughout this healing process, I was tested in so many ways both mentally and physically!
Lessons I have learnt through living with acne
Don’t pick your skin
Trust me, don’t do it! It will only make it worse! Picking and popping pimples causes the bacteria to spread, which could result in more breakouts as you are spreading the bacteria. It also causes post-inflammatory hyperpigmentation, which can take months to fade if using the right skincare products. When a pimple arises, it is best to use a spot treatment to target the breakout. A great option is the Thursday Plantation Blemish Gel.
Patience and consistency
Healing takes time, and a lot of it! Living with nodulocystic acne taught me to be patient and consistent throughout my healing journey. Your acne won’t clear overnight, especially if it is cystic. It is going to take time, and you need to learn to understand what your body is trying to tell you. Be patient with yourself, and consistent with your skincare, be it topical or oral.
Beauty is so much more than your outward appearance
The world tells us that we need flawless, blemish and wrinkle-free skin to be and feel beautiful. We are fed unrealistic standards of beauty from such a young age that it becomes engrained in what we think we need to be: flawless. When last did you see someone with acne skin represented in a movie? Series? Magazine advertisement? It simply doesn’t exist. But let me ask you this: when last did you see an anti-wrinkle cream advertisement? Another skincare ad of a model with flawless skin selling an acne product? A magazine cover of a woman with airbrushed skin? Probably less than an hour ago! Toxic beauty standards are so deeply entrenched in society, we have become numb to them, and have blindly accepted them as the standard.
You are stronger than you think
Yes, you are! I never believed I could get through it, but I did, and I can truly say that it has made me a stronger person. Acne teaches you perseverance and kindness, and how to truly love the person you are, for everything you are and not just what you look like.
There will be days when you just don’t have the energy to face the world and its criticism, judgement, and unsolicited advice, and that is completely okay. I had those days too. But I always tried to lift my spirits, even just for a moment, to make me realise that there is still good in every day.
Ways to lift your mood when you are feeling low
Surround yourself in nature
Being surrounded by nature can help you calm down and take your mind off your skin. Make a habit of spending time outside every day for a few hours, whether it’s reading a book under the shade of a tree, playing with your dog, or going for a stroll in the park. This will help lower your stress levels and improve your mood, even if it’s for a moment.
Start a gratitude journal
As cheesy as it may sound, gratitude journals really help to recenter your focus on the good in your life, and not the bad. Living with acne can so often cause a spiral of depressive thoughts. By writing down some things you are grateful for each day, you can start changing your perspective on your life into one that is more positive and hopeful.
Speak to someone you can trust
Having acne can easily make you feel alone because no one you spend time with can relate to what it is you’re going through. By speaking to people close to you about your journey and how it is making you feel, you can let go of those isolating thoughts and open up about your emotions, which in turn helps lighten the heavy load. You’d be surprised at how many people can relate to your struggles!
Watch a feel-good series/movie or delve into a good book
Sometimes all we need is a temporary escape from our current reality to lift our spirits! Put on your personal favourite feel-good movie or get stuck in a book that is near impossible to put down.
Do an Instagram feed clean-up
How many influencers and models do you follow that only show the best parts of their lives, wearing make up in every single post, and not having a single flaw shown in their posts? It’s time to do a deep-clean of who you follow! Sure, it’s great to see highlights from people’s lives – we all love to share the best versions of ourselves online – but that doesn’t mean the lowlights don’t exist. Following people that share real, authentic content online has helped me tremendously with overcoming my own trauma. It helped me realise that it’s okay to have bad days, it’s okay to have acne, and it’s okay to have human problems and not look like an airbrushed supermodel! The more you surround yourself with content that aligns with your values, makes you feel accepted and loved, and advocates for realness in a world filled with unattainable standards of beauty, the quicker you will learn to love every part of who you are – even the parts that the world tell you are unlovable. Some of my favourite Instagram accounts to follow are @isofiagrahn, @cydneylrj, @lounorthcote, and @oyintofe.o.
If you would like to follow the rest of my journey, you can view my Instagram page here: @moniqueschreiber.
- Healthline. 2019. Types of Acne: Pictures, Treatments, and More.
- Healthline. 2017. Acne Conglobata: Symptoms, Causes, Treatment, and More.