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Acne (young people)

Friendships and romantic relationship with acne

Many people spoke about how friends and partners gave them support, but a few felt isolated or found it difficult to talk to others about their acne.

Most people recognised that their acne probably seemed worse to them than it did to other people. Nevertheless, for some, having acne could make them less confident about seeing friends, meeting new people or being in relationships. Ollie felt it was “harder to make new friends with low self-esteem, low confidence that acne often gives people”.
 

When his acne was severe, Will had a close group of friends who he was comfortable with but having a girlfriend “went on the back burner”.

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When his acne was severe, Will had a close group of friends who he was comfortable with but having a girlfriend “went on the back burner”.

Age at interview: 21
Sex: Male
Age at diagnosis: 14
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I think like, things like girls went out the window completely. I think that was just like not an option for me. I was just feeling, as I say, I was going through my Morrissey years so I was listening to that, you know. ‘I know it’s over’, you know, all this kind of rubbish so that was never really kind of a, a thing for me so that kind of went on like the back burner for a while. A bit like that in friendships as well. I think in many ways like my friendships became a lot more solidified with like, with my good friends that I knew really well, like I would hang out, like I’d kind of recognise that they were people that I was really comfortable like with at the time and wouldn’t really have to put on a front almost. So I think kind of my kind of core friendship group grew quite significantly, significantly during that time because I felt that I was like comfortable with them I wouldn’t have to like pretend that I wasn’t like particularly happy and stuff. So, yeah, I think that was like quite a normal sort of friendship relationship kind of vibe. 
 

Eli sometimes talks to her friends about acne, but only those who have spots themselves.

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Eli sometimes talks to her friends about acne, but only those who have spots themselves.

Age at interview: 13
Sex: Female
Age at diagnosis: 11
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My friends wear make-up as well but they don’t have as many spots as me. Like one of them does but most like-, all of the others don’t, so they don’t really need it.

Do you talk to any of your friends about spots?

Yeah, but only the ones that have spots because the others don’t really understand.

I just like talk to them like because they have it as well, so we just talk about like how-, what we have to do to like not have it anymore
Friendships and acne

Having friends to talk to was usually seen as a good thing – Rachael’s friends were “really supportive and made me feel more positive about it”. Friends who also had acne often wanted to share their experiences and get or give advice and support. Will took isotretinoin when he was younger and, since then, has talked to some friends about it. Friends sometimes asked Tom about skincare products he recommended when they saw the products in his room at home. Friends without acne could also appreciate their expertise – Harriet’s friends saw her as a “fount of knowledge” about skin care in general. 

Friends could also offer practical support like going along to medical appointments with the person. Emotional support was important too and friends could help make the person with acne feel they weren’t being judged. Many young people liked having someone understanding to talk to about how acne affected their confidence and mood.
 

Fatima talks about going to a private skin clinic with friends.

Fatima talks about going to a private skin clinic with friends.

Age at interview: 21
Sex: Female
Age at diagnosis: 12
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Did you go to a doctor at any stage about your skin?

Yeah I think, yeah I did. When I was 16. Yeah ‘cos it, it got really bad and then, yeah then we went to the skin clinic. Then they gave like, I don’t know some sort of procedures, I don’t know what. Yeah basically you had to put lots of different layers of stuff every night. Yeah so that like you can remove the scar and stuff. Yeah, yeah.

So could you tell me a bit about how you ended up going to the skin clinic?

It was just like it got worse and then like my friends around me were saying like, “Oh yeah, that that skin clinic is like good”. So and my friends like go there so yeah. So we just go together to the skin clinic, yeah.

So did you have to get a referral from your GP or could you directly go to the skin clinic?

Anybody could. Yeah anybody can go there, yeah. I mean it’s quite, it’s quite popular actually, the skin clinic. Like we wake up at 6:00 am and to queue and it opens at 9:00 yeah. And it’s really, it’s crazy ‘cos like me and my friends had to go like, about like, at what time of year, day, we went. We went at 7 something. Yeah so we were a bit late and then we couldn’t get the queue number. Yeah so, yeah that’s. Yeah so many people back there have, actually have skin problems [laugh] so yeah. Yeah and it’s yeah the doctor is really good.
 

Having basic human contact with friends made Harriet feel like “a regular person”.

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Having basic human contact with friends made Harriet feel like “a regular person”.

Age at interview: 21
Sex: Female
Age at diagnosis: 12
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One of my friends actually, we di-, like we didn’t really, the nice thing was that they didn’t bring it up, but I felt that I could bring it up if I wanted to. But it wasn’t sort of, no one really cared. Which was nice. But I remember, I was always really conscious of people touching my face, because they’d feel it was like dry or scarred or anything like that. But I remember one of my friends, she’d be, she was really sort of open about it. And we’d do makeovers and she’d, she’d like touch my face like it was any other face. And I remember that was the, like the absolute nicest feeling. Because you sort of, in a way it feels a bit cursed when you’re like, you’ve got this face but you, you don’t want it, you don’t want anyone to touch it, you don’t want to touch it or look at it. So when someone just sort of approaches you and, you know, it’s like, “Oh, Harriet, it’s nice to see you” and it’s, you’re just like, “Oh, I’m a regular person.” [laughs].

[Laughs]

So that, yeah, that’s one of the things that stays with me actually and yeah. It’s just wanting to be, it’s not really that you don’t get treated normally, but you’re always really aware that people might, might sort of intentionally be treating you extra normal. Yeah, but it’s, it’s nice when you have those sort of moments of human contact, yeah.

I was actually always really conscious of people not wanting to sort of be near my face because they might, they might get it as well. That was probably one of the nice things about someone actually touching my face. It’s like, “I’m not scared. It’s okay” yeah. And it, I feel like people make assumptions about, they sort of see you and think, “She must be doing something wrong” you know. Even though you’re sort of, you’re trying harder than everyone else to do something right, yeah [laughs].
 

Abbie found a good group of people who she could be frank with about her acne.

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Abbie found a good group of people who she could be frank with about her acne.

Age at interview: 17
Sex: Female
Age at diagnosis: 13
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But, yeah, it was just nice to have kind of like a network of people who you could just complain to and just be like, “Oh, I’m having a bad skin day today.” And they’ll be like, “Yeah, that’s okay.” And like sometimes if I didn’t wanna go out cos I’d been having like a bad day, then my friends would be like, “That’s okay. We can just, we can just come over to my house and we can just stay there.” So that’s really nice, rather than you feel like forced to go somewhere that you really don’t wanna go to.
Feeling isolated with acne

However, some suffered from low self-esteem as a result of their acne or simply didn’t want to see friends when they felt they weren’t looking their best. Some people had experienced hurtful comments and a few were bullied because of their acne. Even when people had friends who were understanding, being self-conscious about their acne made some “withdraw” or “hide away”.
 

Although she used to be outgoing, Becky is very self-conscious about her acne and says it stops her from seeing friends and making new friends.

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Although she used to be outgoing, Becky is very self-conscious about her acne and says it stops her from seeing friends and making new friends.

Age at interview: 19
Sex: Female
Age at diagnosis: 16
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Because that previously, like before I have a very good condition and like I don’t grow acnes and my skin looks smooth and it’s just very good. And then I had a very serious like acne condition about one and a half years ago. That’s before I come to UK to read my degree. And it’s just I, when I grow acnes I don’t really want to meet my friends. And another thing is that I don’t really want to make new friends because I don’t want them to see me, the most ugly m-, like to see the most ugly me, yeah. So it kind of hold me back to, yeah, communicate with others. And sometimes I feel quite lonely.

Yes, I used to be very outgoing and I liked to make new friends. I really enjoy chatting to friends and listening to their stories. But after I’ve grown acnes I feel like a barrier between me and others. And I just feel not very confident to talk to them. And I think maybe they will despise me because I’ve grown acnes and because I think acne is related to a hygienic condition. But actually I’ve, I really care about hygiene. And I think it’s, yeah, so I’m, I think that others might think, “Oh, that person is not very, like, like they, they don’t care about cleanliness. So they’ve grown acnes.” But actually it’s not. But I think, yes, sometimes others will be, like s-, very despise about, yeah.
It could make it worse when friends who didn’t have acne, and so didn’t understand what it was like to have acne, tried to give advice. Rachael feels there’s a big difference between having just “the occasional spot” and having acne. If these were friends who they were not close to, they could feel awkward and a couple of people said they preferred it if friends didn’t mention their acne.
 

Deborah felt isolated because friends didn’t understand what it was like to have acne. She thinks getting emotional support from friends, rather than practical advice, is really important.

Deborah felt isolated because friends didn’t understand what it was like to have acne. She thinks getting emotional support from friends, rather than practical advice, is really important.

Age at interview: 25
Sex: Female
Age at diagnosis: 12
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And there isn't a one size fits all for supporting someone with acne, but. I think it's more recognising the emotional support is needed, rather than the physical support. I guess that's something that some of my friends have fallen into, they've tried to help by suggesting things I can do to make it better. And I get really quite frustrated at that, because I know all the things I can do to make it better. And people will say, "Oh have you tried this, this cream? I found it was really helpful when I had chickenpox." And I'm like, 'that's, that's a nice sentiment but it's not chickenpox, it's - I've tried all the creams that are out there, you can't - there won't be just some offhand general knowledge comment that can help.' But what I need is the emotional support, and I need for people to say, "Oh you're so much more than that, I know this is difficult now but it'll get better." All those sort of more personal support than the practical support is needed. Which sometimes - especially practical people tend to fall into. Perfectly well-meaning, I know they mean to help. But sometimes it's, it's not helpful at all. Cos it just makes you feel more isolated, that they don't understand what you're going through. And fair enough, why should they understand? But until you've been through it, I don't think you can. But you can be supportive through anything. You can make sure that you’re there, make sure you're reminding them that they're there more than that, that they're, that they’re your friends, they're there for you in whatever way. And they want to help, if you show them how to. You can't just expect them to know, know how to off the bat, so. I think that would be my main thing to friends and family, is it's emotional support not the physical support that they need.

 

Hester only really spoke about her acne to other friends who had acne.

Hester only really spoke about her acne to other friends who had acne.

Age at interview: 21
Sex: Female
Age at diagnosis: 15
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I've had really good conversations with a lot of friends who also suffered from acne. But I think anyone who didn't suffer from it, I didn't really speak to about it because it's not really worth it. Like the worst people are people who have like a spot and they, they’ll want to talk to you about how awful it is to be spotty. And yeah, I don't think you understand what it's like when it's genuinely really painful and like scarring. I think if you just never have clear skin at all, it's a bit different to them having like one spot. But I think people who also suffer from it were the only people I really would have spoken to about it and still do speak to. And I always find that really, really helpful.
 

None of Rachael’s friends had acne. It was helpful talking to them about it, but it could be frustrating too.

None of Rachael’s friends had acne. It was helpful talking to them about it, but it could be frustrating too.

Age at interview: 18
Sex: Female
Age at diagnosis: 16
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Yeah, I definitely spoke to my friends a lot about like having bad skin. Cos they always encouraged me and said that that wasn’t the case and, I was always like, "But, kind of like, it's so noticeable." They were, like "Can you not just see it?” Like it's like always like there; it's uncomfortable, it's red, it's like protruding. But, I think it was really good to talk to people about it and my family were really supportive as well. It did annoy me though when people would like point it out or be like, "You need to do it like, like what are you going to do about this?" cos you don’t really want to face up to it sometimes. But, yeah it definitely helped talking to friends and, yeah they would be like, "Oh, so it's actually acne?" and I was like, "Yeah," whereas they were just like I think, thought that it was just a bit of bad skin but, I just knew it wouldn’t, was not going away at all like, yeah.

So that’s an interesting word thing as well isn't it, sort of labelling ‘acne’ or ‘just bad skin’?

Yeah and I think some of my friends like were…they didn’t…were a bit like, they didn’t know really about it and they hadn’t been through it and so I felt sometimes it was a bit frustrating cos it was always there for me, whereas some of them just like… I felt like they took it for granted that they just had the occasional spot or sometimes just a bit, a few spots. And I felt like there's a big difference between the two, yeah. 
For some, talking about acne was just not something they wanted to do, whether they had close friends or not. Emma and Ish didn’t feel comfortable speaking to friends about their acne until they were in their mid to late teens.

Romantic relationships with acne

The people we interviewed ranged in age between 13 and 23 years old. Some who were older reflected back that when they first had acne in their early teens they were not looking for romantic relationships and were more interested in friendships and study.
 

When she was at school, Sarah was more worried about what people might think of her hair and worried she might seem less attractive because she was studious.

When she was at school, Sarah was more worried about what people might think of her hair and worried she might seem less attractive because she was studious.

Age at interview: 22
Sex: Female
Age at diagnosis: 16
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I think when I was at school, I was, I was quite romantically unsuccessful at school. And I know this sounds bizarre but I was very embarrassed about being un-, not very romantically successful but I never remember blaming the acne on it. I remember thinking that, I remember blaming my hair which was quite bushy at the time and I remember worrying that everyone thought that I was a nerd or a geek and just not very interesting and I remember worrying about not being cool enough and not wanting to go drinking and not being funny and not being a good dancer but I don’t actually remember [laughs] worrying about acne too much. I mean maybe I’m just forgetting it. And I did, I did worry about the rash. And yeah when I got to university it just didn’t really… 
 

Naomi wasn’t looking for a relationship when she was in school. Now she is in university she does have a boyfriend who is very supportive.

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Naomi wasn’t looking for a relationship when she was in school. Now she is in university she does have a boyfriend who is very supportive.

Age at interview: 22
Sex: Female
Age at diagnosis: 9
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Has acne ever had an impact on potential relationships?

I don’t know, I mean I, I wasn't in a relationship or even looking for one at school and then by the time I got to university I had I’d been through the first lot of Roaccutane (isotretinoin) and my skin was sort of like pretty good to start with and then I met my boyfriend and then it wasn’t until a little later that I had the second and third course of Roaccutane and he was very supportive throughout the whole way. So yeah I do, I don’t think it would really, I mean I don’t know maybe at school if I’d been more confident about myself I would have, I don’t know [laughs]. But I don’t think I was really in the right like frame of mind and I wasn’t really interested so I don’t, I don’t think so, but I don’t know it’s hard to tell.

Yeah. Was that, when you say not in the frame of mind for potential relationships - was that generally or do you think that was related to acne?

I mean I think generally because my, I, yeah I wasn’t really looking. But like also I think if I'd thought about it I didn’t really think that anyone would be interested… I don’t know [laughs]. It was probably part of that but , you know I was also busy with like all my academic stuff and like my friends. So I don’t think it would have been like the only factor but it probably did have some-, well it certainly had an effect on what I thought other people would think when they saw me so I just thought that no-one would find me attractive anyway so it didn't really matter but yeah.
People often wanted to look their best when meeting potential partners and felt that others would make judgements about them because of their acne. Eli felt that “boys don’t really find it [acne] attractive”.
 

Chris thinks it’s normal to feel self-conscious about your acne when meeting romantic interests.

Chris thinks it’s normal to feel self-conscious about your acne when meeting romantic interests.

Age at interview: 20
Sex: Male
Age at diagnosis: 17
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Oh yeah, definitely. If you’re looking for a girlfriend or like even just meeting girls you wanna be good mates with, like obviously they’re, like if they’re a nice girl they’re not going to judge you at all, but in your, in your own mind you’re always going to be like, “Oh, I don’t look good today”, and it’s just going to play on your mind and you will feel self-conscious. Well, I mean, it’s, some people might not, but in most cases you’re probably likely to. 

I mean, it always, it’s always worse in your own head than it is in theirs - like they’ll probably not notice it, but you’ll notice it a lot more. 
Feeling self-conscious about their acne could affect how they interacted with others. When Nina met someone she found attractive, she felt ‘held back’ by the thought of “Oh but you’ve got bad skin”. Hester couldn’t keep eye contact with men when she had acne and wasn’t wearing make-up because she “felt guilty that they had to look at me and I’m just like a bit of an eyesore”. However, Rachael always felt like “quite a confident person” and that “if I was wearing make-up I was OK looking”.
 

Alexandra is very aware about partners seeing her body acne. She prefers to date boys who don’t have completely clear skin themselves.

Alexandra is very aware about partners seeing her body acne. She prefers to date boys who don’t have completely clear skin themselves.

Age at interview: 22
Sex: Female
Age at diagnosis: 13
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Yeah, well you do feel uncomfortable showing boys, you know, your back or you feel kind of, I feel always really exposed when there’s a lot of light and then he can see spots for instance or still do sometimes. You know, it’s not I don’t have the big acne spots now but sometimes you do have little, little pimples or something, you don’t and you’re really like, “OK, fine, a little one is fine”. But you would still feel very aware that he might see it or I guess, I don’t know, I always felt more comfortable dating a guy who also sometimes has a little spot somewhere or something than someone who has a completely clear skin.

So I would always feel a bit uncomfortable with someone who didn’t have anything, you know.
 

Ish felt that in a relationship you “always want to show your best side” and it would be “embarrassing” having to do his morning skin routine if he had just started dating someone.

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Ish felt that in a relationship you “always want to show your best side” and it would be “embarrassing” having to do his morning skin routine if he had just started dating someone.

Age at interview: 22
Sex: Male
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I mean there is a feeling of waking up in the morning and having your own routine that you’re used to, is a lot better, especially if you don’t know someone that long. I mean, if it’s a friend for five or six years that I’ve known them, it’s fine, you know, if they see it. But if it’s someone that I just recently met or you’re dating someone on top of everything, it’s kind of embarrassing to introduce that into a relationship, as in like “Yeah, I’m just going to have to get up thirty minutes before because I have to do all of these things, you know like, washing your face, hydrating it, tonic, everything that needs to go on it. And I don’t know it just feels like they’re judging you on some level. As in like, “Oh, what would happen if they wouldn’t do that?” You know what I mean, they have a weird idea, like, ‘Are you going to turn into Shrek or something?’

It’s uncomfortable, to be honest. I mean, if you’re going to go on a first date or anything like that, you’re going to have acne. You’re going to try and do everything to hide it. No matter how we look at it. No matter what’s going on, who’s, how comfortable you are in your skin, for all I care, you can be Beyoncé and like, you know, be amazingly gorgeous, but if you have acne, you’re going to try and hide it, no matter what. So just having that in your life still to this day is frustrating, I guess. So in relationships, you’re going to try to show the best side of you, especially in the first few months or the first year. Then you don’t want them to see you having an acne, I mean you’re coming in contact with a person very, very close. So that’s going to be like, ‘Oh, God, what if they see it. They’re going to be grossed out or something like that.’ 

And what about for you, if you met somebody who had acne themselves?

It’s really hard not to, see that’s the bad, really bad part about it, you see I used to have acne and I know what worked for me and when you had acne and you kind of see someone and you’re interested in them, yeah and you do tend to accept them. But you really want to be like, “Oh, I tried this and you could try it too. Maybe it works for you.” ’Cos you’re not really able to say that to a person ’cos then they’re going to be offended. That’s like, ‘Oh, so you don’t like me this way or you think I’m ugly?’ You know what I mean, so it’s just like that kind of affects the whole thing. So you can’t even give advice to them. So that’s a little bit annoying. But you wouldn’t want it happening to you. So I wouldn’t want my partner to be like, “Yeah, you have a huge pimple on your forehead and I used to do this and it went away.” You know, so it’s a little bit weird that it’s a taboo on top of everything. So it’s such a daily thing but it’s still a taboo, no matter how we look at it. Like, no-one is willing to talk about it that much. You can Google it. You’ll see the weird commercials with Demi Lovato having whatever it’s called, her skin care these days. You know, she’s going to be talking about it but come on you’re a celebrity. I mean, if I had that much money, I would look like, my skin would be perfect too every day. But you know what I mean, it’s just like as an average every day person, an average person, we’re not going to be talking about it. It’s a taboo for everyone, in a relationship, in friends, everything. Most of the time we don’t talk about it. It’s still embarrassing.
 

Kosta finds it okay spending time with male friends, but feels more worried around girls.

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Kosta finds it okay spending time with male friends, but feels more worried around girls.

Age at interview: 14
Sex: Male
Age at diagnosis: 13
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Hang out with the boys I’d say I suppose not yet because some of them have not gone through the acne phase yet or people that do can relate to what issues occur during this age. Hanging out with girls makes it quite awkward sometimes, having spots it changes your image, how people see you in that sort of sense but you can’t change it.

I suppose it kind of does make you a bit more anxious or makes you think how they might be judging you and you kind of lose a lot of confidence talking to people while you have acne because it ruins your image to other people.
But not everyone was as concerned about their acne. A few people spoke about being in a relationship as a source of support. Also people could become more confident over time, or as their skin cleared up.
 

When she was 14 Harriet felt no one would want her because of her acne. But now she is at university she is building up her confidence and realises physical appearance isn’t the only thing people notice about you.

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When she was 14 Harriet felt no one would want her because of her acne. But now she is at university she is building up her confidence and realises physical appearance isn’t the only thing people notice about you.

Age at interview: 21
Sex: Female
Age at diagnosis: 12
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It’s in that time when, you know, everyone’s getting boyfriends or girlfriends and you just think like, ‘No one’s going to want me. I look awful. This is like, how, how is anyone, how, yeah, how can anyone love me when I have a face that looks like this?’ Which is, it’s kind of, it sort of becomes the be-all and end-all. Because that’s, obviously you want nice skin for yourself, but at that age you’re like, it, you don’t really want it for yourself, you want it so you can be beautiful for other people, yeah. Now I don’t, I don’t really, I don’t feel like that thankfully. But when, when you’re younger you do, you just want to sort of look pretty and fit in, yeah.

In your experience, has acne had any impact on sort of relationships or potential partners?

Well, not really. Like I, sort of my group, whole group of friends, we were, we, there was maybe like seven girls and we all just kept ourselves to ourselves all through school and through sixth form. So like I never really had any kind of romantic interest or involvement during that time. Which was fine by me. But like obviously you think, “Oh, yes, I fancy them, they’re cute.” But sort of nothing would ever come of it because, you know, you’ve got acne and no one will want you. Or like that’s how I felt. But it’s strange when I look at other people and they maybe tell me that they’re self-conscious about their skin, and you don’t even register when you’re looking at someone else and you really don’t notice. And it’s such a frustrating thing because I wish I could transplant that knowledge into like the head of 14-year-old me. But people, they, they just like, there’s more important things when you’re meeting a person or talking to a person than what their face looks like, yeah. So, yeah.

So in practice, do you feel like having acne did hold you back from sort of talking to people that maybe you did sort of have a bit of a crush on or like a little bit?

I think I was probably just quite shy anyway, and acne probably, it probably contributed to that. But I’d have probably been like that anyway because I’d, sort of all through school I was quite shy and quite reserved. And it’s only, yeah, only in sort of the last year of sixth form and coming into university that I’ve actually started to build up my confidence. And I think maybe it would have happened, sort of that confidence building, might have happened sooner if I didn’t have acne. But, so it sort of prolonged a shyness maybe, but the shyness was definitely there anyway.
 

Emma is a lot more confident about meeting people since her skin cleared up after a second round of isotretinoin (Roaccutane). She is in a relationship now and says she still feel self-conscious about her skin.

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Emma is a lot more confident about meeting people since her skin cleared up after a second round of isotretinoin (Roaccutane). She is in a relationship now and says she still feel self-conscious about her skin.

Age at interview: 20
Sex: Female
Age at diagnosis: 10
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Could I ask about relationships and potential relationships and any impact it’s had on those?

Yeah. I guess because of the self-confidence issue, until I was sort of 16, I just assumed that sort of people like weren’t interested and in sort of liking me. And quite, I always think quite interestingly it was after my second course of Roaccutane (isotretinoin) when my skin sort of cleared up a lot, I don’t know if it had more to do with me being more self-confident and noticing but, like, guys seemed to be more interested then [laughs]. Shallow [laughs]. 

[Laughs]

But, yeah, I guess sometimes now I am still a bit self-conscious around sort of people, even like people I’m in a relationship with – I feel like, ‘Oh no, my skin looks really bad today. Like, what are they going to think?’ So it does still affect me a little bit. But, yeah, I guess I wouldn't want to be with someone who is that shallow.

If my boyfriend is staying over and I’ve got to like take my make-up off, I’m like, ‘ahhh, it’s going to look, I’ve got bad skin today and I’m a bit concerned about it’. Actually when I first met my boyfriend, I’d just keep make-up on like all the time when I was around him which is a bit stupid really, in retrospect and he said it was really daft of me. ‘Cos, see I was like, ‘I really want to take this off, because I am going to make my skin worse but I don’t want to take it off because my skin will look bad’. So, yeah, it is, I suppose still an issue [laughs].
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