Navigating Adult Acne: The Good, The Bad, And The Oh-So Spotty

It’s day 108 on Accutane and I’m patiently waiting for this miracle medicine to cure my adult acne. Throughout my teens, I would’ve considered it a bad skin day with so much as a few blackheads. Hitting nineteen, however, mother nature cruelly decided to flip a switch. University was supposed to be my adult debut, yet it was shadowed by the spottiness of adolescence. Suddenly, I was tormented by some delightful cystic acne. This is a tale as old as time for many women, prone to hormonal acne after puberty. One study even found that 50.9% of 20-29 year old women report having some type of acne. So, if this is so commonly experienced, why on earth do I feel so much shame? 

I don’t think twice when I see someone else with acne, yet my self-inflicted stigmatisation follows me everywhere. My daily mood is often determined by which new friend has sprouted up overnight. Unlike the “Clean Girls” who start their day with Gua Sha, anti-bloating greens, or journaling, mine starts by begrudgingly making my way towards a mirror and inspecting my face. I search and assess each pore, accounting for every blemish, new or old, inflamed or scarred. I poke and prod and purge until my complexion is an unrecognisable blotchy red. I tell myself that’s better than leaving them be, right? 

When I look good, I feel good. Unfortunately, my self-worth is inextricably tied to my appearance. I could segue into unrealistic beauty standards and blah blah blah, but this would be to no avail. Despite my awareness of the superficiality of it all, I still care. I’m ashamed to say that it’s now been years since I left the house without some form of makeup. Even a two minute trip to the corner shop isn’t complete without concealer. I try and try to disguise my face and, though the redness can hide, the erupting texture and shame cannot. Acne, for me, dictates where and when I go out based off the state of my skin. This social isolation is stupid, duh, but still it continues. Hence, the only way to try and resolve this is to attempt to cure my adult acne, once and for all. 

So, I first consulted the internet for any top tips and tricks for my newfound enemy. From internal to external remedies, I fear I’ve tried them all. Supplements, herbal teas, probiotics, acids, topical retinoids, silk pillowcases, and, the most financially upsetting, a red light mask, have all had their moments. At this point, I may even be susceptible to the keto, paleo, raw milk, carnivore, seed oil conspiracist, fruitarian nutjobs. Apologies, enthusiasts. After two years of no luck, Accutane is now my final Hail Mary, and, fingers crossed, the nuclear obliteration my skin needs.  

The September before final year, I consulted a dermatologist with the sole intention of getting prescribed isotretinoin, the drug commercially known as Accutane. Though she did suggest other medications first, I pushed to try Accutane as it’s recognised as acne’s most clinically effective arch-nemesis. After already wasting two years experimenting with other remedies, it was officially time to pull out the big guns. My dermatologist agreed and, after a blood test confirming my suitability, I finally got my hands on it. This prescription comes with the joy of frequent blood and pregnancy tests, thanks to its infamous list of side effects. The most serious include liver abnormalities, birth defects, and depression, while common ones include dry skin and headaches. But hey, at least my skin might be clear. But are all of these potential side effects worth it? After finishing the course, the majority of patients on Accutane continue to be acne-free, but relapse rates vary from 10% to as much as 60%… fingers crossed I won’t be one of the unlucky few.  

Almost four months into my prescription and I’m yet to see any drastic improvements. However, I’m assured this is completely normal and it’s all about playing the long game to reach the promised land. So far, in terms of side effects, I’ve only experienced dry skin. Although, my housemate did comment that my nose was looking extra tiny- an unofficial side effect caused by Accutane shrinking oil glands on the nose. Result! 

If Accutane doesn’t work, or my acne does indeed return afterwards, some definite soul searching will be due. At that point, I’ll at least know that I’ve tried the most scientifically backed treatment. So, it may begrudgingly be time to embrace self-love and, dare I say it, bare skin. I won’t get too ahead of myself just yet, though. Albeit, if you notice an article in a few months about finding myself through acceptance and love, just know that Accutane didn’t work, and I’ve been forced into optimistic mumbo jumbo. Stay tuned. 

Words by Alex Halkyard