Yes, It’s Acne, but Some Are Cool With It

“You’re ugly.” “Do you even wash your face?” Those are just a couple of the insults Hailey Wait, an 18-year-old student and influencer, has had to endure since she began to develop acne seven years ago.

“I was ashamed of my acne because of the shame people would place on it,” Wait said. Her acne affected her self-esteem, prompting her to raid the Walgreens makeup aisle for cover-ups, even if they did little but aggravate her skin condition.

Seven months ago, she had had enough, and instead of hiding behind cheap foundation or highly edited selfies, she did the opposite: She revealed her blemishes to her 15,000 followers on Instagram for the first time.

“I realized that my appearance wasn’t the thing that made me who I am, which minimized the importance I put on the spots on my face,” Wait said. “I didn’t expect it to blow up the way I did. I was just posting selfies like every other teen.”

But it was more than “just posting selfies.” She amassed thousands of new followers (her count is now 151,000), who began to send daily messages, sharing their own struggles and thanking her for helping them accept their acne.

Megan Collins, a trend forecaster at Trendera in Los Angeles, said that skin positivity has been brewing for a while — as far back as 2015, in fact, when the beauty influencer Em Ford of the popular My Pale Skin blog recorded a video, “You Look Disgusting,” that went viral for shedding light on how much hate she received from showing her real skin.

Cut to present day and acne acceptance has only gained traction, propelled by the momentum of the body positivity movement and backlash against two things: unrealistic beauty advertising and the many readily available photo-editing apps.

“Consumers — Gen Zs, especially — are sick of being told by these huge companies that they need to look a certain way, that they need to buy so-and-so products to fix their flaws,” Collins said. “They’re rejecting traditional forms of advertising that don’t do anything but tear down your confidence.”

Yet a movement that points to social media as a culprit is also using the same platforms to get its message across.

“There’s a cultural shift happening where people are becoming more honest,” said Matt Traube, a psychotherapist in San Luis Obispo, California, who specializes in skin conditions. “Tampering with photos on social media has become such a phenomenon that people are beginning to see how destructive it is. At the same time, social media gives us the opportunity to create these powerful social movements.”

And now, in the latest wrinkle, celebrities have joined the skin-positivity cause, with Justin Bieber (who recently posted on his Instagram Story that “pimples are in”), Kendall Jenner, Lili Reinhart, Lucy Hale and SZA openly embracing their acne.

About 40 million to 50 million Americans have acne at any one time, making it the most common skin condition in the United States, according to the American Academy of Dermatology. Doris Day, a clinical associate professor of dermatology at NYU Langone Medical Center, sees about four patients a day with acne concerns. A quarter of Traube’s patients come in with acne-related problems.

So for an issue so common, why does it carry such a harmful stigma? Day believes the reason exists on a primal level: We judge each other by appearance, and the healthier you look, the more fertile you seem.

“Discussions about acne aren’t out in the open, either,” Traube said. “People are embarrassed to talk about it because, unlike other medical issues, there tends to be a lot of judgment around skin since the experience can be subjective. Most skin conditions are often dismissed, trivialized and underreported.”

Earlier this year, a study published by the British Journal of Dermatology found that there is a 63 percent increased risk of depression in someone with acne compared with those with clear skin.

Traube is quick to point out that having acne isn’t going to “instantly create depression.” But if you’re genetically predisposed, feelings of disappointment at not meeting the “perfect” expectations of beauty can trigger depressive episodes. “Acne is incredibly debilitating,” Traube said. “The mind and body are intimately connected. And when you’re already depressed, acne presents an extra challenge to the situation.”

For many, blemishes are only part of the problem. Day said that in some instances she has found that patients blame the condition for everything that’s wrong in their lives, or they use it as an excuse to sit out social activities.

Conversely, depression can trigger breakouts. “The stress of having acne can exacerbate the condition,” said Rachel Milstein Goldenhar, a clinical psychologist in La Jolla, California. “Or when someone’s depressed, they’re not in a place where they’re able to take care of themselves, which could make acne worse, too.”

The proliferation of makeup-free selfies, along with a new “boy beat” beauty trend that highlights “flaws” like acne, freckles, dark circles and rosacea, points to how much has shifted. And with celebrities joining the skin-positivity movement, the acceptance of acne has accelerated.

“Celebrities have the same insecurities, so for them to give people the opportunity to see their human qualities, it changes everything,” Traube said. “We’re social creatures, we want to belong — and when we have that social support, that feeling of community, that will help reduce the risk of depression.”

But at the end of the day, as Day reminds us, acne is still a medical condition that scars. “I don’t think acne will ever be cool, any more than Selena Gomez having lupus would be cool,” she said. “But if this movement helps people accept it, boosts their confidence so they don’t feel ostracized, then I’m all for it.”

And for Wait, that’s the ultimate goal.

“I don’t wake up and think, ‘Oh, I want acne today,’ but if you have it, there’s no reason to hate it,” she said.