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
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.”
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.
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.
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There’s plenty of evidence that folks with acne are more likely to develop depression compared to those without the condition (two to three times more likely, according to one study). This connection makes sense, since not wanting to be seen or hating the way you look is a heavy emotional burden to bear, and it can make even the simplest tasks (like getting out of bed, taking a shower, or dragging yourself to work) feel impossible, Dr. Hu says.
In extreme cases, some people may also have thoughts of suicide, research shows. “I have a lot of patients come in and say they’ve tried everything—every product, every dermatologist, every prescription medication,” Dr. Rodney adds. “So there can be this feeling of hopelessness when you feel like you’ve tried everything and nothing is working.”
What to do when acne is destroying your mental health
It’s no surprise that treating your acne can help your skin and your mood, and seeing a dermatologist (if you can) is a great place to start. These pros can assess your breakouts, recommend the best over-the-counter and/or prescription treatments, and offer some much-needed peace of mind, Dr. Hu and Dr. Rodney say.
But even if you have research-backed ingredients and highly educated experts on your side, it can still take months—years, even—to figure out what works best for your particular skin and get the results you’re after, both dermatologists note.
There are ways to feel better in the meantime, though—and stepping away from the mirror (especially if it’s a magnifying one) is an excellent first step, according to Dr. Hu. “It’s more harmful to focus on every single pore and black dot,” she says. In other words, zeroing in on your zits can make the issue seem bigger in more ways than one. And whatever you do, try your best to avoid picking at your bumps in an attempt to flatten them or make them go away ASAP. This, Dr. Rodney says, can lead to more inflammation and cause stubborn scars, which will probably make you feel even worse.
And if your acne is getting in the way of your daily functioning—as in, you’re skipping work or regularly experiencing symptoms of depression like hopelessness or irritability—it might be time to find a therapist you click with. These mental health professionals can teach you tools to manage your mood as you work on clearing your complexion.
I know how much it sucks—I really do. But if you’re going to take anything from this article, I hope it’s this: Don’t make the same mistake I did for years and let your acne completely rule your life, if you can help it. Celebrate the small victories (like an annoying nose pimple finally giving in) and, most importantly, try to focus on the things and people that make you so damn happy, you forget about your appearance, even if just for a moment. These little perspective shifts helped me finally feel okay about my skin during the angriest of flare-ups—better than any cleanser or spot treatment could.
If you are struggling with feelings of depression or suicidal thoughts and need someone to talk to, you can get support by calling the National Suicide Prevention Lifeline at 988 or by texting HOME to 741-741, the Crisis Text Line. If you’re outside the United States, here is a list of international suicide helplines.
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