Sanjana's Story Living with Acne

Sanjana L, McGovern Medical School, MD Candidate Class of 2027
Like many teenagers, I started developing acne on my face as I transitioned through puberty in middle school. My acne persisted through high school and eventually appeared on my chest and back. It seemed to compound my already shy nature in high school, as I became increasingly insecure about my skin. I stuck with my small group of friends who I knew since childhood, because they felt safe and nonjudgmental. Little did I know that it was about to get a lot worse.
During my freshman year of college, I noticed enlarged lymph nodes around my neck for which I was referred to a dermatologist. She prescribed me the antibiotic Doxycycline and claimed it could also help reduce my acne (I was so excited about that possibility). About a month later, my lymph nodes returned to normal and my skin was completely clear. I was beaming with confidence. Fast forward a few weeks and I began seeing cysts, whiteheads, pustules, and blackheads emerging on my cheeks, jaw, and forehead. I could not understand why my acne had randomly come back stronger. At times, my face felt raw and sore to touch. I would occasionally wake up with a small blood stain on my pillow or have a whitehead bleed during the day if I accidentally itched my face. I will never forget the day I woke up and immediately began to cry as I counted 36 spots on my face. At that point I felt hopeless, but my hopelessness also began to feel routine.
As a freshman in college hoping to make new friends, I had never felt more ashamed and embarrassed by my appearance. There was not a new person I introduced myself to or was around in which my first thought was not “what do they think of my acne?” or “do they see my acne as a reflection of me?”.
Me as a freshman in college
I made an appointment with my dermatologist and was determined to get rid of my acne once and for all. Unfortunately, my dermatologist spent a mere ten minutes with me that day. It felt as if she took a quick glance at my skin and immediately began listing oral and topical medications. I was perplexed why she did not try to understand my journey with acne or tell me that my acne does not define who I am. I felt like another appointment in her busy schedule, rather than an individual who was hurting on a profound level and ached for someone to talk to.
The prescriptions provided by my dermatologist seemed to have a minimal effect and I was still insistent on finding a solution. However, this quickly turned into an obsession. I watched numerous YouTube videos and read tons of blogs in hopes of finding a miracle cure. I applied numerous homemade masks and remedies, praying something would work. I cut out dairy, gluten, and many processed foods from my diet (even though I have never had an issue with any of these food groups) and was eventually eating a diet consisting mainly of vegetables and smoothies. I would never go to a restaurant with my family or friends without checking the menu or eating beforehand. I ordered boxes of spearmint tea because I read somewhere that it would balance my hormones. I used my hair to cover my cheeks in photos or would ask my friends to re-take photos if my acne was too visible. Using the smoothing filter on snapchat became second nature every time I took a photo of myself. Makeup became a necessity rather than a choice, as I began to wake up extra early to conceal each spot on my face. My acne became the first and last thought of my day.
My skin at its worst
Eventually, I came to realize that the Doxycycline I was prescribed for my lymph nodes had killed the good bacteria in my gut in addition to the bad bacteria. Thus, when I stopped using Doxycycline and was eating a very poor freshman college diet, the bad bacteria likely proliferated and had a direct effect on my skin. I began focusing on consuming prebiotics and probiotics in addition to applying the tretinoin cream prescribed by my dermatologist. Within 3 months, my acne had completely disappeared, albeit the many scars left behind.
My acne reappeared in waves a few times after. However, I came to terms with the fact that part of my acne was out of my control. What I could control was my outlook. I surrounded my social media with skin positivity and took the time to realize that airbrushing and photoshop is not the reality of celebrities’ skin textures. I opened up to my best friend about my feelings, who reassured me that she would never judge me for having a bad skin day or wearing no makeup. She even mentioned she couldn’t remember the last time she thought about my skin. I also forced myself to say yes to events and opportunities. I was no longer going to let my acne dictate how I live my life. At the end of the day, I was in perfect health, and realized I should be grateful for the things I am capable of, which others may not possess.
The scars left behind after I used Tretinoin
Although my acne has been under control for the past year, it occasionally continues to consume my thoughts. I started medical school two months ago, which meant a lot of introductions and first impressions. Once in a while, I will wonder if the people I meet notice my icepick, rolling, and discoloration acne scars. However, I actively remind myself that negative thoughts will only set me back. There are individuals in this world who will love and appreciate me regardless of what’s on the surface of my skin.
My skin now!
In spite of the time and energy acne stripped from me, I would never wish for a life in which I had perfectly clear skin. Each scar on my face is a reminder of how I desire to treat myself and those around me. Throughout my experience, I wanted others to be conscious of the weight that acne can have on someone’s life. Thus, I now have an appreciation for getting to know people on a more intimate and profound level. If you are currently struggling with acne, know that it is going to make you a strong, resilient, patient, and empathetic individual, characteristics that not everyone has.