The Financial and Emotional Toll of Having Acne-Prone Skin

“Teen Vogue” is celebrating its annual Acne Awards this week with a series of stories on all things acne. From knowing when to pop a pimple to understanding why some people get breakouts and others don’t, we’ve got you covered. Read all of the stories here.

My older sister started breaking out at the end of elementary school. I didn’t understand why the red bumps began showing up on her face. She wasn’t doing anything different than before, but the adults around her told her to avoid “oily” foods and to stop eating chocolate. She started buying everything she could from the skin-care department at the pharmacy: OXY pads that were supposed to sting, astringents that dried out her skin, acne scrubs with bright blue microbeads in them, and four-step lotion kits.

Nothing worked. About a year or so after she started breaking out, it was my turn. My breakouts were normal; they came and went. In some of my teenage photos my face looks fine, in others you see obvious breakouts. I looked like a lot of my friends.

But no one prepared me for the different phases of breakouts. Second puberty⁠ — aka that time in your early- or mid-20s when your body and skin will change yet again ⁠— arrived and splattered my skin with amazingly stubborn acne. Instead of just breakouts here and there, my entire face was inflamed. I had everything from whiteheads to painful cystic breakouts. What used to be slightly annoying scarring became a huge problem. I had reddish-brown dots alongside active breakouts. The creams and masks that somewhat soothed my skin as a teenager did nothing for my new crop of breakouts. I was prepared for my complexion to improve after I hit college, but at 18, my breakouts became even worse. Nothing I ate, drank, or smeared on my face took away the redness or stopped new breakouts from happening.

And no one prepared me for the amount of work it took to keep up with my acne-prone skin. I knew that my skin-care routine would have to involve way more steps than it did for my clear-skinned friends, but I wasn’t prepared for all of the unsolicited advice or how much money I would shell out for skin-care products.

“Have you tried drinking more water?” a relative would often ask. I explained that I carried water with me wherever I went and that I was pretty hydrated, regardless of how hot it was outside.

“You should try avoiding dairy and red meat,” a friend advised. I told her that I had already cut out all red meat and most milk from my diet. It helped some of my breakouts, but not enough to make a huge difference.

The dawn of Instagram made everything worse. I couldn’t get through a single hangout with friends without group photos or selfies. I put a lot of effort into avoiding photos whenever my skin was breaking out, even if I was able to cover some spots with foundation or concealer. I remember cringing when a friend showed me a photo of us together.

“We look really good in this lighting!” she said. All I could see was some hormonal breakouts near my chin and the hyperpigmentation on my cheeks from previous breakouts.

My life revolved around my skin and how it made me feel. I remember waking up to a large spot on my chin and lying to a friend about being sick so that I wouldn’t have to meet her for lunch. I’ve even canceled on my current boyfriend when I had a bad breakout during the beginning of our relationship. And there were several times when I was late to work or class because I checked my outfit in the mirror before heading out the door and started crying because I noticed a new breakout forming near my chin. Instead of paying attention at meetings or in conversations during the day, I’d think about how clear a coworker’s skin was compared with mine. I’d avoid looking people in the eye because I didn’t want to see if they were noticing my breakouts.

Some weeks, I’d have to take money out of my hanging-out budget to put toward a pricey face mask that I prayed would fix all of my skin ailments. If a YouTuber subtly mentioned a clay mask that they used for occasional acne, I’d try to find it online right away and buy it, even if it took a sizable chunk out of my monthly budget. I remember buying a $60 clay mask that didn’t do much for my skin but make my face feel dry and irritated. I’ve also dropped money on foundation after foundation at the pharmacy, before learning that I should just buy a decent CC cream or concealer made for acne-prone skin.

Going to a dermatologist helped a lot, and so did taking medication to curb my breakouts; I’ve gone to three with hopes of finding out how to soothe my skin. I’ve also been on several antibiotics for acne and spironolactone for breakouts. The antibiotics weren’t super easy to deal with because I couldn’t be in the sun while I was on them, so I had to skip a lot of beach trips and even carry an umbrella on sunny days. One antibiotic I tried early on caused a weird skin rash on my chest so I had to cover up despite it being summer at the time; another made my skin super dry for a month, but did eventually clear up my breakouts. For the first time in a while, I felt like I could actually look at my skin in the mirror.

Then it hit me. A few years ago, after I finished grad school, I had to admit to myself that this was just the skin I had. I couldn’t spend the rest of my 20s hiding under layers of foundation and drying masks. Over the years of trial and error, I’ve learned how to deal with my very moody skin. I’ve learned to embrace that it’s just annoying to have acne, but not the end of the world if I wake up and have some breakouts. I’ve learned to find a more streamlined and gentler skin-care routine that works with my skin and doesn’t completely dry it out. But I still have a routine that is more extensive than a lot of my friends’ routines.

Now I use a very gentle gel cleanser or a foaming cleanser in the morning. I use a moisturizer, and for coverup, I use a concealer with SPF and a setting spray, or I mix a CC cream with my moisturizer and apply that to my face. I don’t use a harsh scrub at night anymore or a super drying mask. I use serums and an adapalene gel as a spot treatment for breakouts. I use a gentle chemical peel once a week, and a light therapy mask whenever I have several spots sprouting up at once.

The emotional labor of adult acne doesn’t really ever go away, and I always have at least one or two spots on my face at a time. But lately, there’s more and more space between some breakouts, which never happened before. It’s made it worth it to make my routine more about learning what’s best for my skin and what’s best for my physical and emotional health, even if it means leaving my apartment with no makeup on, or pushing myself to hang out with friends on days when I don’t feel good about my skin.

I have to live in the skin I’m in, scarred and all.

Angely Mercado is an editor and freelance writer from Queens. Her work appears in The Lily, City Limits on NPR, and more.

Originally Appeared on Teen Vogue