Tomorrow is my birthday. I will be twenty-three years old, and I suffer from body and face acne that make my life miserable. It will sound horrible, but at this point doing remote work is a blessing in disguise because I can hide and no one has to see what horrendous skin I have...

I have tried everything, including antibiotics, hormonal treatments, topicals, Accutane, diet changes (dairy-free, vegan, keto, sugar-free, low-FODMAP...), juicing, fasting, meditation, etc. Some have not been without side-effects (muscle pain from Accutane and depression, almost complete hair loss on Spironolactone), but I have always been ready to try everything with the hope that I could finally be freed from this suffering. My whole skin is full of blackheads, whiteheads, and cysts that have started when I was only ten years old. During the short period of remission I had thanks to Accutane which lasted a year, I felt so much relief, no longer having to hide and cry at night because of how ignoble I looked. I no longer had to hear the comments from strangers/well-meaning friends, cover up the bumps with thick layers of foundations, having to deal with the many scars and holes left in my skin because of this.

My acne gradually returned after Accutane, and I feel out of options. I feel so much sadness, I avoid mirrors. I broke up with my boyfriend and on the last night we spent together I remember his hands on my back where the skin was rough/full of bumps and I can't stop crying remembering the embarrassment I felt.

Moreover, I can't talk to anyone about it because of how "vain" it seems, or how it may seem like I have "poor hygiene" which "must explain my acne, obviously" (thanks, friends). I feel so desperate and my mental health is falling apart at this point.