What It’s Like Having Adult Acne: ‘I Don’t Feel Like I Fit in With American Ideas About Skin Care’

Ishita Chatterjee, 30, started getting acne when she was 25, first on her cheeks and then on her forehead. She experienced regular breakouts, to the point that she always had at least one pimple. Over time, her acne and mental health became more intertwined. Although Chatterjee didn’t pick her spots, they often scarred. She’s also prone to post-inflammatory hyperpigmentation (PIH), which happens when inflamed skin becomes darker than the surrounding area.

Chatterjee started trying different treatment options for her breakouts, scars, and hyperpigmentation. She went to a dermatologist and an esthetician and tried various skin-care products and medications, but nothing has fully cleared up her acne.

Now, Chatterjee is working to rebuild her confidence based on the person she is and not the way her acne looks. This is her story about acne and mental health.

I had clear skin as a teenager, which is a time when many people start getting acne. But when I turned 25, I began constantly breaking out. Red spots covered my cheeks and eventually my forehead.

At first, I thought the acne was hormonal and would clear up on its own. A couple of years later, however, I was still getting acne. By then, I’d also developed scars, made even more noticeable by post-inflammatory hyperpigmentation, which is more common in brown skin like mine.

I decided I had to actively address my acne. This kicked off a long process of trying numerous lifestyle changes and treatments. I tried cutting out every type of food you can name in case I was sensitive to a certain food. I used every skin-care product and medication I found that promised to get rid of acne. Some things helped more than others, but nothing has gotten me to a point that I would call “cured.”

On top of the frustration of working through what felt like an entire pharmacy of treatments, I have to deal with other people’s assumptions. A lot of people still mistakenly believe that acne is caused by eating too much greasy food or sugar1, drinking too much alcohol, or some other external cause that I just need to avoid. I know this because they tell me.

The comments I get from people about my acne usually come in two forms. The first form is people offering what they think of as helpful advice, which ends up being quite hurtful. For example, I’m a first-generation Indian immigrant, and in my experience, Indians sometimes tend to be more direct with their comments than Americans. Sometimes, Indian people will straight up tell me that my face looks terrible, and I should try a particular face cream or stop drinking so much.

In India, people often practice Ayurvedic medicine2, which involves eating foods based on the specific guidelines for you based on one of three body types. People who follow this tell me my acne is caused by my American diet when I know that it’s not. This is just the way my skin is.

Or well-meaning friends will say something along the lines of, “Your skin looks so clear today!” I know they mean it as a compliment, but it’s another reminder that I have not-so-clear days.

I don’t feel like I fit in with American ideas about skin care and acne either. Growing up, everyone in commercials for acne products was young and white, whereas I’m an adult and brown. Even trying to find makeup that adequately covers my spots and scars has been challenging. There aren’t many options for Asian Americans with dark skin. I haven’t found a foundation that matches the olive undertones of my skin, which makes a massive difference when you’re trying to cover acne.

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