The History of Acne


When I walk around museums, I’m almost never admiring the art as much as I am asking docents questions like, “Has Dante Gabriel Rossetti’s Lady Lilith been using Aztec Secret?” Why don’t you see any paintings or statues with armpit hair or pubes, I ask you? All I ever really think about, besides dying of a sudden brain aneurysm and this clip of Lindsay Lohan’s new accent, is other people’s grooming habits. When I see old paintings or photographs of young women with clear complexions, I want to trade in Twitter and penicillin for an acne-free era. But does such a time even exist? I dug into the history books to find out.

Acne Isn’t New

“Progressive,” “clean-eating” Americans like me (and probably you) have deluded ourselves into thinking that acne cropped up after the industrial revolution by willfully misinterpreting research studies. I want to blame yogurt and cheeseburgers, or the harsh chemicals and comedone-blocking properties of modern cosmetics. The truth is that acne isn’t new, nor was it created by the modern American lifestyle. According to cosmetic chemist Mark Broussard, “Acne is fundamentally genetic in nature. Those with acne overproduce androgen hormones which causes an overproduction of sebum. Excess sebum causes the skin cells lining the hair follicles that normally shed to become sticky, forming a plug of dead skin cells that blocks the hair follicle, trapping P. Acnes bacteria within the hair follicle where an exponential growth in the bacterial population results in a pimple.”

But you knew that already.

There are a couple of foundational studies about acne that are constantly misunderstood, wherein a controlled group of people indigenous to small, isolated populations act as stand-ins for our pre-industrial ancestors. One oft-noted 2002 study focused on the Kitavan Islanders of Papua New Guinea and the Aché foragers of Paraguay. Researchers found that both communities had a 0% prevalence of acne. This study has been interpreted to mean that people who don’t participate in the so-called “industrial world” have no acne. But really, all it indicates is that these two populations are extreme anomalies, and that is why they’re notable.

Click the link, it’s interesting.


A more recent study, published in an article titled “The Blemishes of Modern Society” (ughhh), came to a much different conclusion. Researchers studied the prevalence of acne in an isolated community in Mali called the Dogon. They hypothesized a low prevalence and severity of acne in the Dogon “on account of their traditional lifestyle, including a diet based on millet farming with limited consumption of novel, pro-inflammatory fast foods.”

You’ve probably seen banner ads for the anti-inflammation diet on the internet. Inflammation does play a fairly important part in the formation of acne, though its role is not completely understood. Using a design in which researchers compared members of the same cohort who migrated to the city against those who stayed in their rural villages, boys in the city actually had lower odds of having acne, even though researchers hypothesized that acne would be aggravated by urban migration, which they call “a globally important source of environmental novelty in the 21st century.” The boys in the study who moved to an urban environment had an 85% decrease in the odds of having acne.

Acne Might Date Back to Biblical Times

Look closely, and you’ll see that acne was written about far before Lady Lilith was even a twinkle in Rosetti’s beady little British eye. Some scholars have interpreted the mark of Cain, the disfiguring facial blight on the original black sheep boy of Genesis who committed the first-ever murder, to be little more than acne rosacea. If Cain’s a murderer for that, then I’m literally Aileen Wuornos.

“Leprosy” is a catch-all term bandied about all willy-nilly in the Bible, but the Hebrew word for it is tzaraath, which literally refers to “skin eruptions.” In the Ebers Papyrus, an Egyptian medical text probably from 1550, the author proposes sulphur as a skin-clearing solution for “aku-t,” translated as “boils, blains, sores or pustules.” Sulphur is a treatment still in use in high-end acne products today. In ancient Greek and Egyptian cultures, honey worked as another cure. Probably the same $27 Manuka honey sold at Whole Foods that’s purported to cure all redness. Kidding, another story for another column.


Billy the Bard once referred to acne –– and contributed to the still-crushing stigmatization of skin disease and disorder — in Henry V. Fluellen, speaking of Bardolph, says, “His face is all bubukles, and whelks, and knobs, and flames ‘o fire…”

In eighteenth-century France, acne was common enough that concealment of blemishes started a trend in “mouches,” or flies, little ornamental patches used to cover up spots. These were no clear, discreet “why won’t anyone look at me??” Korean spot patches. Mouches were dark silk or velvet and ornamental, shaped like moons and stars. Writes Katherine Lester in The Accessories of Dress, “As late as 1700 a lady of fashion was never without her patches, but in Queen Anne’s day (1702-14), the fashion of patches took a queer turn. The spirit of party rivalry ran so high that…the manner of patching proclaimed the party.” A Tory patch! A Whig patch! A Grab Her by the Pussy patch! Wow, now that the election is over I don’t know how I’ll be able to make jokes anymore. For polite conversation, we’re going to have to go back to talking about the weather and mutual enemies.

A Modern Understanding of Acne

By the nineteenth century, two doctors by the names of Willan and Bateman, considered to be the forefathers of dermatology, reach the popular consensus that acne is not a divine condemnation, but a product of sebaceous glands (just like that cosmetic chemist told us earlier!). By the twentieth century, when I was born, acne was estimated to affect 85% of people between 12 and 24. Clinical studies indicate that between 40 and 55 percent of adults have some sort of low-grade oily skin or acne irritation.

100 years from now, when our great great grandchildren in post-post-industrial America look at renderings of us all in the Met, which will be all-digital and funded by a generous donation from the Instagram-Haliburton Company, I hope they see our acne-riddled portraits and think to themselves first, Damn, our foremothers took a lot of pictures of themselves, and only second, Thank god I’m not the only one in history suffering from breakouts.

Collages by Emily Zirimis; paintings via Getty Images. 

Claire Carusillo

Claire Carusillo

Claire Carusillo is a beauty columnist at Man Repeller. She writes a weekly beauty newsletter offering off-label product usage advice and prefers to be referred to as "IDK, Some Girl."

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