Bright red zits between my eyebrows have immediately thrown me into a downward spiral of hopelessness and panic. Dark spots across my chin were the very reasons I wouldn’t let a soul—not even my boyfriend at the time—see me without color-correcting concealer in high school.
As someone who dealt with persistent acne in my teens (and still does, at 25), let me tell you that it controlled my entire life—whether I was ditching school because I was too sad to get out of bed or making a habit of avoiding eye contact with anyone and everyone. If you can relate to any of these experiences, I don’t have to convince you that constantly battling breakouts can do a number on your mental health.
“I also had terrible acne as a teenager, and the impact it made on my life was so significant,” Ife Rodney, MD, board-certified dermatologist and founding director of Eternal Dermatology Aesthetics in Fulton, Maryland, tells SELF. “I was so stressed. It really messed up my self-esteem.”
Breakouts aren’t just a teen issue, of course, but regardless of when—or how—they show up, take it from me and the experts: Their impact isn’t only skin deep.
Here are some of the ways acne can hurt your mental health
It can shatter your confidence.
As a dermatologist, Dr. Rodney says many of her patients with active acne or scarring feel insecure and embarrassed about the way they look.
This self-consciousness can be so intense that you might avoid having your picture taken on your family’s annual beach vacation, for instance. Or, perhaps you have a mini breakdown after examining your hormonal cysts under the unforgiving glow of fluorescent fitting-room lighting. One 2011 study even found that folks with moderate to severe acne were less likely to pursue romantic relationships.
“Worrying about your skin might seem like a superficial concern, which is one reason why many people feel embarrassed opening up about it,” Dr. Rodney says. “But the fact of the matter is, it does affect your quality of life, and for that reason, it should be taken seriously.”
It can cause you to isolate yourself from even your favorite people.
If you’re anything like me, you might be convinced that everyone is zeroing in on those flesh-colored bumps or dimpled, ice-pick scars. So naturally, the solution to escaping any unwanted stares, double takes, or perceived glares of disgust is isolating yourself—which might include canceling plans at the last second or holing up until your skin is magically “better.”
Staying home once or twice isn’t necessarily a warning sign that acne is ruining your life. But if withdrawing during “bad skin days” becomes a habit, that means those stubborn zits are controlling your daily choices and relationships, Shasa Hu, MD, board-certified dermatologist and assistant professor at the University of Miami Miller School of Medicine, tells SELF. Hiding from the world might seem like a harmless way to protect your well-being, but research shows that social support can improve mental health and self-esteem. I also know from experience that connecting with loved ones can make a big difference in how you’re feeling about your skin.
It can make you depressed.
We’re not just talking about one gnarly zit cropping up before a big work presentation and putting you in a crappy mood (though to be clear, that’s miserable too). Sometimes acne can make you feel so overwhelmingly sad that you become clinically depressed.
