how to overcome social anxiety about your acne

Feeling self-conscious about acne is not a matter of vanity – it's a matter of feeling comfortable in your own skin. This can be especially difficult when media and society constantly tell us that perfect skin is not just attainable, but expected. Acne, and anxiety about acne, can take a serious toll on a person's self esteem and emotional wellbeing. We know that firsthand.

We spoke to Azra Alic, LCSW, a psychotherapist who specializes in Social Anxiety Disorder and Body Focused Repetitive Behaviors (such as skin picking). She walked us through some of the steps that she takes with clients who are battling acne-induced social anxiety.

Have you ever been at a social gathering and felt like you couldn’t actually BE yourself because your acne was affecting your confidence? In this post, Azra gives us some tools to help us overcome those moments.

Q: how have you seen acne affect one’s emotional wellbeing?

A: Acne can really impact people’s self-esteem, and can even lead to depression. I’ve worked with people who feel so self-conscious that they don’t want to be around other people. They might avoid spending time with friends or dating.

They might also avoid certain outdoor activities so they don’t have to wear clothing that reveals body acne, or avoid exercise or other activities where they might sweat their makeup off. Basically, acne can keep people from fully enjoying their lives.

Q: why do we feel like people are staring at our acne? do other people notice our acne as much as we do?

A: No, they don't! People think way more about themselves than they do about other people. Sometimes, I'll have a client do a behavioral experiment to help them test out their theories. I’ll have them walk around a public area without wearing makeup and try to see how many people “stare” at them.

Sometimes I’ll even record them and we’ll watch the video together to see if anyone gave them a weird look. People are usually surprised to find that their worst fears didn’t come true. I’d recommend this experiment for anyone out there who deals with social anxiety and acne.

Q: what are some common tactics people use to try and hide their acne from their peers and social circles?

A: I’ve worked with people who spend an excessive amount of time getting ready and camouflaging their acne before going out in public. They won’t go out in public without extreme preparation. They can never be spontaneous. They spend an exorbitant amount of money on makeup and skincare products. Depending on the location of their acne, they might take great care to style their hair to conceal acne or acne scars. They might even avoid certain clothing or activities because they don’t want to expose their acne or acne scars.

Q: how do you help your clients overcome anxiety around acne in social settings?

A: I help people focus on the social experience, rather than focusing on their appearance. For example, I’ll encourage them to try really hard to focus on the conversation they’re having. Be present!

By practicing mindfulness in this way, people start to learn to be fully in the moment instead of focusing on negative thoughts about their skin. 

Q: it's rare to see any mention of acne-caused anxiety in today's popular media. why do you think that is? 

A: Hmm that is a good question. I would guess that it’s because most of the advertising and product development in our culture is still focused on prevention and elimination of skin imperfections, rather than acceptance.

Also, I think that there is still an overarching belief in popular media that if you look good, you’ll feel good, and that gets reinforced over and over again in so many ways, whether it’s related to weight, skin, hair type, etc. But trying to find confidence solely through “looking good” is a never-ending battle.

It's much more common now to see “plus-size" models, but I think we have yet to see an editorial spread in which a model has a pimple (not to mention a pore!).

Q: how do we get ourselves to see more than our skin flaws when we look in the mirror?

A: It can be helpful to step away from the mirror a bit and take in the whole body, rather than getting up close and focusing only on what we are most self-conscious about.

Also, it can be helpful to focus on what is going to happen that day and why it’s important, rather than focusing on how you're feeling about yourself or how you look. For example, the thought “I’m going out with my friends tonight because these friendships are important to me” can start to negate the negative thought of “I have a big pimple and everyone is going to see”.

Q: do you have a good mantra to pass along to help those struggling with anxiety about acne? 

A: I don’t have a go-to mantra because I usually have clients come up with their own, but often it’s along the lines of, “my skin problem is probably not as noticeable as I think it is, and even if people notice, what is so bad about that? Can I handle whatever happens?”

Deep down, most people are afraid of being rejected for their perceived flaws but usually, that fear is unfounded.

Q: do you think that by sharing personal struggles about these topics with our peers online or via social media, we can begin to foster a more skin-accepting community and even society? 

A: Yes! Talking about insecurities and being vulnerable with others plays a big role in reducing feelings of shame and isolation. So often, people think that they are the only ones who are struggling with negative self-image when statistics tell us otherwise.

I do think it’s important to caution people about the “misery loves company” mentality and make sure that people are not just complaining to one another, but rather that the messages being exchanged are empowering.

Thank you, Azra!

 

so what are our steps to feeling better about our “imperfections”?

1) Look people in the eye when you’re having a conversation with them.

2) Be present.

3) Remember that you are always your own worst critic.

4) And, finally, remind yourself that your breakouts do not impact your self worth.

 

we hope you found this helpful - if you have any questions, email info@cocokind.com!


20 Comments

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juliana on

to whoever reading this , yes you cant make your acne go away but please dont feel anxiety or depress . girl , you are beautiful . its just you are giving negative thinking to yourself . i understand you feel insecure when you see a girl with clear skin , clear arm so she can wear whatever she want while you need to choose clothes that can cover your acne . But please rethink . imagine you dont have leg , hand or you dont have eye . im not downgrading the people who dont have these i mentioned buttt please appreciate yourself . still can walk , can learn can see , imagine if you cannot hear and all people make fun of you . wdy feel ? acne can be removed . i also have so many acne but i tried so hard to remove and now its getting better from before . try using turmeric powder + honey + lemon put on your face . im using that remedies . Before that , i spent so much money for my face but end up getting worst . So last , please appreciate yourself . Maybe you are not perfect in face , but trust me you have your own beautiful at another way . maybe you can sing well or can do beautiful drawing or maybe faster learner ? we dont know . everyone is pretty !!!! stop your anxiety . spent your time with family . ask your mother abt your face . yah mother is always an expert in everything . believe in yourself . dont worry about who doesnt like you . do you like you ? its okay to have acne . i pray that you all and also me can overcome this anxiety . xoxo

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amanda on

i’m 17 years old . i suffered from acne scars as i loved to picking it cause i think its better than having a big acne on my face . I have many acne since im 13 years old . At the beginning , i think the acne will come and go but now im suffered double for the acne scars too . its full on my cheek , i feel hmm i dont know mybe almost to depressed :( i once had a boyfriend but i will decline whenever he asked me for a date then we break for no reason . i feel insecure when seeing most of girls on soc media is very very pretty but they are saying “ im not pretty ” “ can someone teach me how to be pretty ” i dont understand their ways . if the pretty ones said that they are ugly then how abt me :(((( im full of acne ! i tried many skincare that people said will reduce acne and remove scars but nothing happen , i dont know whats wrong with my skin . i even avoid family gathering and rarely looked my siblings and family face , i mean talking while looking into their eyes as i feel im so ugly :( i never forgot my own mom said my face is getting worst and not pretty like before … idk if she is kidding but yah her word is on my mind every night .. i really relly hope i can face my anxiety !!!!! i always cry because of this , i think if i have clear skin all my problems will go away :<

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Matt J on

I had awful acne from ages 15-17. I suddenly became way less confident, lost friends as I didnt go to gathering etc. When i got onto medication for it at 17, i had just moved school and my acne cleared up. I made so many mates, had a blast of a time (which i never used to at school.) However at the age of 19 my acne has become resistant and i’m back to square one. I now avoid social gatherings at all costs and am very anxious about my acne. Everything I do in life i question “is this making my acne worse”. SUCKS really but this is life. Sorry if this came across as a rant, never have had anyone to talk about it.

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Pamela on

I had persistent acne from about age 12 on into my 30s. During my teens, it was bad enough that even my dermatologist would wince. My mother blamed me and compared me to my sibling who had other issues but clear skin. I say this because now, several lifetimes on, i bear the physical scars and remember the hurt and shame I felt, but I took care of my skin through it all and my scars could be worse.

In addition to basic healthy skin products, a good diet, a balanced perception, and a rich inner life and spirit are the keys. Through my own experience, I can agree with the thoughts in this post.

Practise taking the focus off your feelings about yourself and, as was suggested, be present. I’ve lived through many unpleasant things, and mindfulness has kept me going when all else seemed unbearable.

For those living with acne, we face a difficult challenge. But you can do what you love and grow through it. I performed onstage as a musician with terrible acne, and you can follow your passion as well. Hold hope close! Best wishes.

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Kristina Petrova on

I have been suffering from acne for 3 years now…I can’t remember the way my skin looked like before all the scars, redness and huge pimples. My family is going on a trip tomorrow. I pretended I’m sick because 2 days ago I completely destroyed my face by picking it. I can’t leave my house without the tons of makeup. I can’t believe I spoiled my family’s trip because I’m insecure about myself. I wish my acne would just go away…

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ErickaJello on

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ErickaJello on

Hi, Im ericka and Im 17 years old. I have acne and large pores. I always over think when ever I see my reflection in the mirror and always wonder what if the guy I like will see me in person. Do he still like me if he sees the truly me? But i was end up crying because maybe when he see me he wouldnt like me anymore. I always have this anxiety everytime I look at his picture why would a handsome guy would end up dating an ugly girl like me? But now i read your article maybe my confidence boost a little bit. If he will see me in person I will be true to myself and if ever he wouldn’t like me because of my appearance maybe he is not really the one because if a guy really likes you he will accept you no matter what but i still hope he will accept me no matter what i am. Thanks for the great advice by the way.

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Juliana Banuelos on

Im 15 and Im dealing with bad acne, sometimes my acne would appear over night. I don’t use makeup Because I know it would make it worse. I cut off junk food and greasy food I also stuck to drinking water only. I’ve been cleaning my face day and night everyday but I really haven’t been seeing any clear results.

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Amar on

It’s very hard when you can’t face yourself in the mirror.
It’s hard when people tell you how bad your acne are.

But after all this there is one thing which cannot change is your mindset that you perceive over the time.
I had acne till i was 26 years old, and its been an year or so that i am completely off from this. I can tell you just one thing is that It cant get worse then this. the day you realize that this is it, now the only scope is improving that day you will feel free from all the stress that you you have developed.

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S Munster on

My life revolves around my skin. I’m constantly looking in the mirror, looking at the few actives I have but the massive amount of scarring. It gives me anxiety. I hate it and always wonder why this skin disease has to happen to me.

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Carrie on

Hi I’m 44 this year and just finished cancer treatments. Then about a month later I start breaking out. I had bad acne as a teen into my 20 and for the last 20 years it has been good. Def know that is is a hormonal thing because of the cancer and having to go off birth control and take a hormone blocker. Trying to stay positive but to be honest I stress more about the acne then the possibility of the cancer coming back. Should be worrying about wrinkles not stupid pimples at my age.

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Anna Lopez on

I’m 20 years old and I’ve had acne since I’ve been 11 years old. I have tried every topical treatment that doctors have given me and my face always grows a resistance to all of them. It has reached a point where I feel completely hopeless. I honestly feel ugly all the time, I do not like my face at all. I’ve never been asked out, no one has ever been attracted to me, guys never pay any attention to me and the only conclusion I can come up with is that it’s because of my acne. My acne has stopped any kind of love life from happening, it has given me severe depression and anxiety, and it’s made me completely give up. I wish I didn’t feel so alone with this issue.

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David on

I’m 40 and have been fighting acne since a teen. For all you fighting out there, it will get better, but do not stop fighting. In order of importance, I will say try this:
1. NO ANTIBIOTICS – dermatologists are too quick to prescribe it. I developed resistance and it was a NIGHTMARE. Don’t do it, long term use can develop gram negative folliculitus. It’s bad stuff – please hear me.
2. Stop all dairy and gluten – it’s hard but it is necessary. Depending on your severity, go to a low inflammation diet and look to cut out all sugar.
3. Only after no. 1 and 2, then start playing with your regimen – face wash 2x per day (no more), moisturizer, sunscreen, spot treatment, concealer, etc. – read reviews and TEST small patch before applying. Make small changes not wholesale moves of all products.
4. I highly recommend considering nutritional supplements – zinc, fish oil, probiotics, turmeric, gut balance items, etc. Find a nutritionist to support you in this.
5. No high intensity workouts (e.g. boot camps, power lifting, insanity, etc.). Cardio 3x per week for 25-30 mins with 2-3 days of yoga to keep yourself cool.

Even after this, it will come to managing this journey (it’s a disease unfortunately, so it’s all moderation and finding balance).

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Shivanih on

Ive had acne since I was 11 years old at that time my mom dismissed saying its just puberty which Probably what it was but I’m almost 20 now and I still suffer from acne i do have hormonal issues but nothing helps i watch my diet , exercise and drink water as well, but it just won’t go away. Ive been using recommended products etc they do a little help but the acne just always pops back..i don’t know if it will ever end..i feel so powerless

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Alison on

I struggle with skin issues, always have off and on. I get it.
I’ve come to realize in adulthood that it is so much less about skin care (aside from moisturizer- a must!), and more about diet and hormones. I think it’s different for everyone but ultimately, as a person of science, I cannot possibly imagine how diet (carbs, refined sugar, processed foods) does not play a direct role in how certain people’s skin is affected by hormonal acne.
Sugar=insulin= free testosterone (and other reactions in the body) = increase sebum… etc – we know the rest. Causes more stress, we lose sleep over it (or other more important things, even), more skin issues… we get sad and eat more shit… at least I do!! it’s a terrible cycle.

No amount of scrubbing or hiding from the outside will fix what is happening from the inside out.

I am following modern advice and my skin flare up is starting to simmer down. I got my worst breakout of my life at 33!

Medication was doing nothing to help deep cysts, painful and red as hell for weeks at a time. I wouldn’t go get the kids from daycare or the bus stop. I was missing my oldest play sports because I wanted to avoid talking to the parents or coaches, for my skin. It was so sad.
I strongly believe in looking at non-western societies and how they nourish themselves and what they expose themselves to.

From my experience, I would do your own research. Nobody knows your body better than you and Drs only go by the literature… I’d Look for food sensitivities FIRST THING! This is totally within your control- no prescription needed. Try an elimination diet for two weeks -get very, very basic on diet and see if there’s improvement. Look for hormone disrupters in your current routines, eat less but eat well (natural/nutritious) , sleep, hydrate always, be less “busy”, protect the energy around you as best you can, and work on your self-care/self-love. Exercise is supposed to help too. Haha. Haven’t gotten there quiet yet. I hate to sweat ;)
I’ve personally seen a huge difference these last two months and am only seeing improvement as time goes on. Still using prescription benzoyl peroxide and vitamin a for scaring but it’s actually working, after months of only getting painfully worse. I can actually cover my acne with makeup again. It’s subsiding and I couldn’t be happier so I thought I’d share.
Good luck to you all.

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anonymous on

People would always cover their faces on social media thinking they’re ugly while they have the perfect smile and clear skin. I do not understand their ways. They would say they do not care about looks and everybody is the same to get a good reputation for themselves while they insult people because of their acne. I have acne and try to hide it but always covering my face with my sweater. My parents would say it’s just puberty but I do not think so. I wish everyday to just rip off my face and get a new shiny one but of course that will never happen. If your reading this and is insecure about your face, just know there’s clones of you out in the world dealing with the same problem and your not alone. (:

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Cole on

I’ve had acne all over my body and face for two years now and I have gradually gotten more and more insecure about it, it’s to the point where I can’t even wear a regular t-shirt anymore. My face, neck, arms, back, shoulders, chest, and even torso have developed severe acne. I walk in the halls of my high school and feel extreme jealousy looking at people with clear arms like it’s expected. Despite my best efforts over the past two years to fight my acne it’s just gotten worse.

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Jonathan on

I hate my acne it is super bad like very bad to the point we’re ive had to use 3+ kinds of medications and I wish it would just go away I hate it

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Lacey on

I suffer with horrible acne which makes me cover my acne with makeup everyday it’s so bad that i feel like people won’t date me because of it or don’t like me it gets in the way of living my life and i literally don’t know what to do about it anymore i’ve tried so many skin products to make it get better and sometimes i feel like it gets better but after i think it’s getting better i break out again:/

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Karrington Nuon on

I am very insecure about my acne, it honestly isn’t bad compared to a lot of people, but I am a guy, and I wear some concealer to hide it, I spend an hour or two getting ready for any social event trying to cover my acne, I sometimes do not attend social events, I am afraid of being seen by people in the raw light of the outdoors. My life revolves around my acne, it is the worst, people with perfect skin do not understand how blessed they are to be able to wake up everyday and not have 10-20+ new pimples on their face in the morning. I hate it, and I don’t know what to do.

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