As I was reading this I noticed there are a lot of similar behavioural traits that you have that I do too. I do feel that your self esteem problems are acne related while mine are related to aspects of my general appearance. For example; I can't stand people looking at me from the side and If I am out with someone I need them to be on my right side otherwise I start panicking. I need to stick to my skin, hair and make-up routine very strictly and if any of this is disturbed (for example staying in a hotel where the lighting and mirror distance might not be what I'm used to) I will get upset and end up feeling ugly. I am also extremely self conscious beyond the realms of regular shyness or social anxiety.

Last year I was diagnosed with Body Dysmorphic Disorder. I am in no way a psychiatric professional or are suggesting you have the same problem. But I went for 19 years with friends, families and teachers dismissing my behaviour as simply 'shyness' or the regular self esteem issues that all young women have. No one had any idea of the scale of the hatred I had for the way I looked and the way I had altered my ways of thinking in terms of my appearance. I only realised how odd some of my thinking patterns and thought processes were until I voiced them for the first time with a therapist. I wouldn't want that to happen to someone else, I am 20 now and feel like it wouldn't be as bad if I had help earlier on when I developed these feelings (15).

I noticed an article on this website about Acne Dysmorphia: http://www.acne.org/acne-dysmorphia.html . Which is interesting. Someone who might have one of these disorders might alternatively check a mirror compulsively, or avoid it altogether. There are also a lot of obsessive compulsive behaviours involved like skin picking and having a need to stick to a certain routine.