I have the worst case of acne I have ever seen. It is acne conglobata literally everywhere and it is extremely severe and inflamed. I am currently on minocycline and prednisone (steroid). These are the last options I can exhaust until should take accutane (which i problably wont be allowed to take). So, since im probably going to have to deal with severe acne for a long time, I'm wondering if people actually constantly judge me, or if thats just in my head?
My dermatologist told me it was one of the most severe cases he has seen, and that i am a definite candidate for accutane.... so thats how bad it is.
For severe acne, yes people do notice and it does affect how you are treated. I assure you that you are your own worst enemy, and you see your acne worse than other people.
But people certainly get grossed out when they see severe acne, or subconsciously label you as the "acne guy/girl".
Even as someone who has had severe acne, when I see someone with a whitehead practically dripping off their skin, I feel the urge to fix it for them...which is a form of judging I suppose.
It's just like anything else...if you saw someone with an open flesh wound on their face, I'm certain you would see them differently than someone without.
If someone judges you then they're insensitive and ignorant. I know something of how you're feeling though. If you're feeling self conscious you could use foundation-- girl or guy-- to get through the worst of it. Just remember "those who mind don't matter and those who matter don't mind".
Unfortunately, judging someone's skin is a natural reaction for all of us. It's terrible though when people treat others with acne like they're on a lower level. I've seen this happen many, many times in my life. Honestly if you feel like someone is acting dodgy because of your acne, they probably are bothered by it. Just something that we need to accept as acne sufferers. Not everyone is kind-hearted and able to look past acne to see the real you underneath. Don't let anyone's adverse reaction get to you though. Your acne can improve, but their lame attitude towards others probably can't.
Take your doctor's recommendations seriously, and good luck if you do choose to go on Accutane. You can at least be happy that you're actively seeking out treatment options instead of just letting the acne continue to ravage your skin.
How have you been doing on your treatment? I was very distressed when my acne got bad. I'm older (29) and have always had mild to moderate acne, but it was easily controllable. After a recent period of stress, my mild blackheads inflammed and got progressively worse in a weeks time to the point that they were large inflammed, interconnects cysts and pustules that were swollen, and scabby. I was disagnosed with mild acne fulminans (since its my face, mostly my chin, only) or pyoderma faciale. I tried everything to keep off of accutane because I was really scared of it from all the negative you hear about it. I waited a month longer than I should have... My acne just kept getting worse and I wasn't able to eat anything big or yawn or laugh without it cracking and hurting. It also itched intensly. I'm finally on accutane now and have been for a month and a half. I am finally getting some relief! I'm still breaking out but its more normal now and my old spots/clusters are still there but getting flatter and they don't hurt anymore which is in and of itself a huge improvement! I have suffered with anxiety for over 10 years and the accutane has not bothered me at all. My acne did get a lot worse at first though, but its finally calming now. Since I started, I've been happier than I have in years with the sense of hope its given me and the only side effects I've got are common and most (other than dry nose and lips) have been short lived and I'm on a high dose (60mg at 50kg). Honestly, the prednisone was way worse on me than the accutane. It made me sooo anxious and I couldn't sleep. The accutane has been a lot easier to tolerate for me. If you are still thinking about going on it, PM me if you have any questions. Severe acne sucks! 
Luckily friends and family have been supportive of my acne problems. They always try to recommend products that they think will help. For a time I was on spironolactone and antibiotics, and they helped for a while, but my cystic acne came back.
I recommend trying Dan's regimen before going on accutane. I was going to do the same, but then I thought what the heck, let me try the regimen before downing even more medicine that has strong side effects.
I have been on the regimen a little over a month using store bought products and my skin has drastically improved.
Good luck. 
People are mean! I think a lot of people who do have naturally clear skin do tend to judge, but those of us who do struggle with acne can look past it. I hate that virtually all of my friends have perfect skin without doing anything and I have to really work at having good skin. It sucks , but the right people won't care if you have acne. It's a silly thing to judge someone for. Keep your head up.
