My Weird, Life-Changing Experience With Adult Acne

“You used to have such beautiful skin.”

My mother, bless her, meant well. She had cut her vacation short to help me move my life from New York back to Canada, an act so generous I couldn’t justify my sudden desire to chuck her out of our U-Haul. She was lamenting the state of my 31-year-old face, the face she herself had created and nourished and raised, the face that had betrayed her good works by erupting in acne at the altogether inappropriate age of 30.

And the thing is, I did once have beautiful skin, fresh as a dew-dropped daisy, despite my storm of teenage insecurities: too pale, too mottled, my entire body mapped by freckles. With all the energy I spent wishing I were someone else, I couldn’t find time to feel grateful for clear skin. I didn’t wash my face until I was in my 20s, never ran through the litany of nuclear prescriptions or the creams and lotions that bleach out the bedsheets. The odd zit was quickly popped and dismissed, thanks very much for coming, see you next month.

My adult acne emerged from the hormonal swamp that was the result of switching from oral contraceptives to an IUD and starting medication for anxiety. The first zits were a curiosity; after a few months of pawing helplessly at my face, I asked my dermatologist during my twice-yearly skin screening what she recommended. She wrote me a prescription for topical Tretinoin, which made my skin blotchy and dry and my acne worse. “Yeah, that’ll happen,” she shrugged when I reported it on my next visit, her attention focused on a particularly funky mole on the bottom of my right foot, as if to say: Lady, I’m ensuring you don’t have cancer. Your lowly concerns are beneath me.

Adult-onset acne is not uncommon, especially among women. Fluctuating hormones, like those produced by pregnancy, menopause or a change in contraception, are a common cause — although stress, diet and heavier skin treatments (shout out to your anti-agers) also play a role. A 2015 study found a 200 percent increase in the number of adults seeking treatment for acne, which has some dermatologists convinced that adult-onset acne is becoming more endemic. It’s one of the sadistic circus games played by the human body: You’re lulled into a stupor by the clear skin of your 20s, only to wake up in what’s meant to be your prime with a face that looks like it’s been lovingly caressed with a meat tenderizer.

Along with the Tretinoin, which I stopped using after a few months, I tried the usual suspects: cult fave spot treatments like Murad salicylic acid and Mario Badescu’s drying lotion, oil cleansers, clay masks. My acne caroused over my jawline and temples; it experimented with vicious cystic bumps and the friendlier whiteheads. I vacillated between detached and deranged. I learned how to use concealer. I found new angles for photographs. I skipped work one day when I just couldn’t with a honker on my chin. My doctor suggested cutting out cheese, chocolate and wine, which was very cute and funny.

Above all, I found my prevailing reaction to my new face to be a benign shrug, a curious indifference, a general bemusement. A few years before I developed acne, at the still-blooming age of 27, my partner of eight years ghosted on me. Since then, I had moved alone to New York City, ripped live cockroaches out of the jaws of my cat, learned how to juggle Tinder dates. I once had my shoe eaten by an escalator RIGHT OFF MY FOOT. I had an army of salt-of-the-earth friends, a prescription for Lexapro, and a go-to recipe for spaghetti puttanesca. Ten years ago, acne would have crippled me. Now, I looked at my face and saw, very simply, my face: spotted, tired, and fiercely proud.

I used to wish for beauty with unrelenting desperation. What must it be like to be coveted, I wondered. What does the air taste like up there? I recognize that even beautiful people don’t necessarily believe their own beauty (I once tried to interview a friend about this and he replied that he “never saw himself as good looking,” making me snarf up my green juice). Still, I’ve always imagined that to be tagged by beauty is to move through the world with an ease that I had never myself experienced. But the great privilege of growing older is the possibility of self-ownership. So maybe I didn’t have “the look,” according to some absurdly narrow standard, but I had some of the smarts, an eye for wonder, the unerring ability to vocally identify each member of One Direction after only a few notes. There’s a certain self-assurance to be gleaned, over time, from looking in the mirror and seeing exactly what you’ve come to expect. When that is shattered, even by something as paltry as a smattering of whiteheads, it’s a rumble.

It isn’t, however, the seismic dismantling it would have been in youth.

Growing older is the process of endless regulating, of learning what to care about and what to discard. What adult acne taught me was that I’m no longer a person who deals in the currency of beauty. This isn’t about becoming inured to vanity; I still conceal the worst when I’m going out, still play whack-a-zit with toners and masks and salves. But I am gently impressed by my durability, my ability to (sometimes literally) turn the other cheek. If vanity doesn’t disappear with age, it at least changes shape and claims less real estate in your brain, which simply has more important things to care about. Each new zit has given me the opportunity to say, again, that I am more than this face.

Photos by Louisiana Mei Gelpi.

Meghan Nesmith

Meghan Nesmith

Author Meghan Nesmith is a writer and editor living in Boston.

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