The medicine of self care: a journey with acne

I had an email exchange recently with one of my all time favorite podcast hosts (and people I admire and respect deeply) about a subject I am intimately familiar with: acne.

I haven’t had clear skin since I was ten years old, and I will be 35 next month. From the moment my skin started breaking out, I was sent the very clear message that even though nearly everyone deals with acne to some degree in their teenage years, that having it was not OK. Between comments and unsolicited advice from well-meaning family members and the cruel behavior of my peers, I understood that my acne was a problem for everyone around me. I felt that I owed it to everyone I would impose my appearance on to do everything in my power to make it more palatable. So when I say that I tried everything available in the way of treatment over the course of the next 15 years or so, I mean it literally.

I systematically made my way through the drug store shelves, I saw countless dermatologists for topical treatments, extractions, antibiotic therapy, etc., I had a subscription to every mail-order system, not to mention the mask of makeup I would never dare set foot in public without.

Nothing I tried worked, and with every failed attempt at finding a cure I drove myself deeper into a spiral of shame and self loathing. Not only did I believe whole heartedly that I was monstrously ugly because of my acne, it hurt all the time. I had more than your garden variety pimples, whiteheads, and blackheads, I also had cystic acne that made it painful to talk and smile, even to lie down in bed because of breakouts on my chest, back, and shoulders.

In my early twenties, I was diagnosed with PCOS, the underlying cause of a hormonal imbalance that likely contributed to the severity of my acne. I thought I had finally found the answer: correct the imbalance and my acne would get better. I attempted hormone therapy to treat my PCOS symptoms, finding eventually that the most effective treatment for me was to lose weight. After my PCOS was well controlled and eventually asymptomatic, my acne persisted, much to my dismay. I knew I had to make a choice between either continuing to wage war against my own face, or to accept my circumstances as they were and find a way to make some peace with them. Truthfully, it was a pretty easy decision to make. I was exhausted and there were so many other things I wanted to give my time, energy, and money to that did not involve torturing my skin into submission.

Above all, I realized that it wasn’t my responsibility to make other people comfortable with how I look. I had already begun to shift my behavior under the influence of this belief: it had been years since I wore any makeup to cover up my breakouts, but I was still holding out for my miracle cure. I knew the time had come for the next evolution. I had deep-seated fears and doubts that my skin would always hold me back from fulfilling my potential. I thought I would always be judged harshly as unkempt, unclean, or otherwise less-than. I took time to compare these fears against what was actually present in my life. I reminded myself that I had never had a problem attracting romantic partners, I had a job where I interacted with the public, and so far as I could tell I never made anyone physically ill after they looked at me. My fears, though perhaps not unfounded when I was young and surrounded by childhood bullies, no longer had any basis in reality now that I was an adult.

I decided to shift my approach to skin care as just that: care. I had spent so many years fixated on obliterating all the ways my skin behaved that I considered unacceptable that I had no idea how to maintain the largest organ in my body holistically. I scaled back my protocol to the bare minimum of keeping my face clean, exfoliated, and fed. Mentally, I invited anyone who was offended by the condition of my skin to go fuck themselves, and I interrupted my own tendency to obsess by taking a break from mirrors unless I was getting ready for the day or to go to sleep.

After doing a bit of research on natural skin care, I began washing my face with a plain castile soap, exfoliating once or twice a week with a paste of baking soda + water + castile soap, and moisturizing with jojoba oil. After some time I found that my acne wasn’t much better, but my actual skin was healthy. I experienced what it was like to have a face that wasn’t constantly irritated by chemicals, raw from scrubbing, and dry/flaking despite being slathered with oil free “moisturizer.” Honestly, this was good enough for me. If I was going to have acne no matter what I did anyway, then I might as well do what makes my skin feel more comfortable.

As years went on, I experimented with different herbal products, looking to feed my skin more fully. I also dabbled in alternative methods of cleansing such as the oil cleansing method and using honey as soap. Ultimately, I found my groove with what I like the call The LITHA Method, as in Leave It The Hell Alone. This alone was the key for me to create the conditions under which my acne could abate.

At the time of this publication, I currently wash my face with my shampoo every other day when I’m washing my hair, but otherwise just use warm water and a wash cloth. Occasionally I use a witch hazel based toner, I exfoliate 2-4 times a month with salt + olive oil, and I moisturize/feed twice daily with the miracle cure I had been searching for in all the wrong places: elk/buck tallow blemish butter from Wild Wood Apothecary. Since adding the tallow butter into my routine a few short months ago, I haven’t had a single bout of cystic acne, in fact I hardly ever have a blemish of any sort any more. I also am in remission from rosacea flare ups. I can not stress the literal magic of this medicine enough, to me it has performed the impossible.

Of course I’m left with scars and hyper-pigmentation that will never fully fade, but I am thrilled beyond words to say that I no longer consider myself someone who suffers from acne. More importantly, moving through and processing my experience of shame in this part of my life is of the highest value to me, much more than any perceived “improvement” to my appearance. I feel that I have completely released the shame I carried so deeply for so long, so that I no longer feel driven to hide. I feel the echo of this release swelling to bolster me in deeper ways, in relationships, work, art, and more. I look forward to more fully embodying this echo’s radiance in my time to come.

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