A number of things could impact on people’s experience of being at school or university with acne:
• how severe or manageable their acne was and whether they could cover it up
• how common it was to have acne amongst their friends and peers
• how understanding people were about their acne, and whether people were unkind
• how supported or isolated they felt in general
• how confident they felt about themselves
Having acne didn’t impact on school life for everyone. Molly has always felt confident about herself and no one mentioned it at school. Alexandra was always firm that she wanted to enjoy school and not let acne get in the way of this.
When Abbie started sixth form, her acne was clearing up and she had a nice group of friends who accepted her as she was.
When Abbie started sixth form, her acne was clearing up and she had a nice group of friends who accepted her as she was.
Age at interview: 17
Sex: Female
Age at diagnosis: 13
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Yeah, so we made, cos not many people actually came to our sixth form from other schools. And in my like friendship group there was only I think two people from other schools that we made friends with. And at that time my acne was kind of in the process of getting better, so I didn’t really mind. And then there was my friend with the, the acne that I said about earlier. So we were both, I guess people are just really accept-, more accepting now than they, than they would have used to. Like they, you, people wouldn’t even mention it like if you spoke to them and you had a face like full of acne. They just, they just like accept you for who you are. Which I think is nice.
But for many people going through school, college or university life with acne was a difficult time in their lives.
When Naomi was in primary school, no one else had acne. A cream she was prescribed didn’t work and she couldn’t cover her acne up.
When Naomi was in primary school, no one else had acne. A cream she was prescribed didn’t work and she couldn’t cover her acne up.
Age at interview: 22
Sex: Female
Age at diagnosis: 9
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Yeah well I mean that was just, the first person was just one of my, my parents’ friends who was a GP and you know, he, he just saw me and prescribed this like cream. And I just remember like the first, the first time I was like really happy because I was like, “Oh, this is brilliant, like I’ve got this cream and it’s going to get rid of it and then I can just like move on”. And especially when you're at primary school and like no-one else has skin problems and like you can’t, you can’t wear make-up or anything to cover it up because like that's just not acceptable. and so I just remember being really happy because I thought like that would be it and then obviously like there was the disappointment because that didn’t work. And then it just kept going.
And because you said you were in primary school when you first started to get acne.
Yeah.
Could you tell me a bit about what it was like for you at that age, being amongst peers you said also didn’t have acne?
Yeah I think I think that was, that was one of the like, yeah I mean it was, not, I wouldn’t say the worst time but it was quite a hard time to have it because, yeah, no-one else, well I mean maybe people, people did have it a bit but like I wasn’t aware of it ‘cos I was just so consumed by how bad mine was. and you know, one time my mum gave me like some like, you know, cover-up stuff to put on it and I just remember like someone in school being like, “What’s that orange stuff on your face?” Because like children don’t understand that you can’t ask questions about things like that and so then I just like never used it again.
Bullying and education about acne in schools and colleges
Most people started getting acne as they moved into secondary school and many felt that there was then increased peer pressure on them to cover up or find a remedy for their acne. Image consciousness seemed more important, and quite a few people felt singled out or bullied because of their acne.
People often had to cope on their own when others made hurtful comments or asked questions. Emma felt “isolated” when she had acne at the age of 11 and had started at a secondary school where no one else had it. She found that “children can be a bit sort of mean about it” and she became quite shy.
Devan remembers verbal bullying at school and a teacher pointing out his acne to other pupils. He has since set up a website to inform teachers and parents about bullying.
Devan remembers verbal bullying at school and a teacher pointing out his acne to other pupils. He has since set up a website to inform teachers and parents about bullying.
Age at interview: 18
Sex: Male
Age at diagnosis: 13
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Yeah basically the teacher just says that I was spotty. And so obviously that was in Year 9 and it wasn’t, it was just like ‘uhhh’. And the teacher started coming out with words like that, that’s one of the main reasons why I’ve worked with Fixers to sort of educate teachers about bullying because what the teacher didn’t see was that I actually got the bullying because of him saying that comment. And it was actually the same teacher that told the group about another operation that I’d had that had caused further bullying for me as well. So it wasn’t just the acne…
Right.
..that was a problem.
Yeah. Could I ask you about the bullying, if you don’t mind?
Yeah well it were just sort of people would say, “Oh, you freak, you’re spotty”, and different, different sort of evil words that you could come out with. There were also talk, calling me fat, ugly, different things like that as well. But a lot of the bullying was around the acne and the other operation that I’d had that which I’m not gonna sort of go into.
I basically created a website for teachers just to provide them with advice about bullying and it also sort of gives them a few case studies of young people And I’ve also created a few other websites as well. One for young people themselves so they can go on there, if they’re being bullied, and find out who they can talk to, where they can talk to somebody, and different things like that. And I’m currently working on creating a website for parents as well.
Oh, wow.
So that parents can sort of have a bit of advice about it, bullying. How to sort of spot it, because young people are pretty good at hiding it away.
Rebecca started to feel more self-conscious about her skin during secondary school.
Rebecca started to feel more self-conscious about her skin during secondary school.
Age at interview: 18
Sex: Female
Age at diagnosis: 12
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I know like when I’m going to school and stuff a lot of people really care about what they look like. And for me to start with, when I first started school, I didn’t really care. I was just there for education. But then I got made fun of and people made fun of like my acne and my bad skin. So I got really nervous and I wanted to be able to be normal and kind of look good like everyone else did. So that’s when I did start wearing make-up. Because I thought-, I felt more empowered when I was kind of covered from basically my insecurities.
Some gave ideas about how schools could do more to educate young people as well as teachers (such as about causes and triggers) to support pupils with acne.
Because young children often think acne is related to poor hygiene, Emma suggests that information about the causes of acne should be part of the PSHE classes.
Because young children often think acne is related to poor hygiene, Emma suggests that information about the causes of acne should be part of the PSHE classes.
Age at interview: 20
Sex: Female
Age at diagnosis: 10
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Yeah, I guess, I suppose even before I had acne, even I thought it was fully caused by what people ate or what people put on their skin or not washing enough. And I think that’s probably the preconception that a lot of younger children have about acne whereas actually it’s, you know, a condition that you can eat really well and you can wash your skin really well but you will still get it. So that’s quite difficult because I was always worried that people wouldn't understand the causes. I think it would be good, I always thought it would be good if like during sort of PSHE classes and something, it was an issue talked about more, because they talk about a lot of other things that teenagers go through. But I think that’s quite an important one that they don’t really say much about, so.
What do you think would be helpful for a PSHE teacher to cover in relation to acne?
I suppose like the causes of it, sort of the, maybe the sort of impact that it has sort of socially on people and ‘cos people before they have acne or if they don’t have acne they can say quite mean things and not mean to. Yeah, I remember actually, I was on holiday somewhere and someone mistook it for chicken pox and it was only a very tiny child. But that made me quite self-conscious.
Ollie suggests doing an assembly or workshop to support children in school with acne.
Ollie suggests doing an assembly or workshop to support children in school with acne.
Age at interview: 16
Sex: Male
Age at diagnosis: 13
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Could you say a bit more about what you think maybe schools could do around acne for their pupils?
Yeah. I think it's always quite hard when talking about stuff in schools because in terms of assemblies and things like that, is a lot of people don’t listen, and sort of zoning… including me I admit sometimes sort of zone out, I don’t really pay attention. But I think…and also with doing like workshops and stuff like that, taking out, time out of lessons especially in this sort of period is really, really difficult. But I think that for something like acne and something that can be so… affect somebody's life so much is it's very important that you do maybe take some time out. Well that’s probably, probably at the beginning of the year have a workshop with people coming in and talking about acne and stuff like that, cos even now I know of a lot of people who have pretty bad acne that could sort it out themselves, and are too embarrassed or afraid to actually do it, and I think…and it does affect their life quite massively. And even then I think a workshop, like an hour-long workshop, or maybe even in assembly cos it would reach some people; or like a newsletter or something like that, or promoting online sort of support would definitely, definitely, really, really help people.
In Nina’s school, they learnt about the causes of acne and she thinks this helped a lot. She was never bullied at school.
In Nina’s school, they learnt about the causes of acne and she thinks this helped a lot. She was never bullied at school.
Age at interview: 20
Sex: Female
Age at diagnosis: 12
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Yeah, I mean I think we had to learn about it in PSHE or like or watch a video in science [lessons] or something, and, like, you know, I guess I think we were basically told ‘Oh it’s a little bit diet, a little bit like, you know, factors that you can’t really control such as how oily your skin naturally is’ and yeah I think that was really frustrating as well for me because if it’s something you could control, you know, it’s like an environmental factor yeah of the, that would have been great, you know, if it was just like ‘Oh, wash your skin more often’ or something. but at least I think it was very much reinforced that it wasn’t because you were an unhygienic person so at least I was never like bullied about that or anything, so that was good yeah. And I guess that was PHSE or science [lessons] to thank for that, I don’t know I can’t remember which we learnt about it in.
Participating in school and doing exams
Acne could disrupt school life and meant that people either missed lessons or were not able to perform in the same way as other pupils. People could be more self-conscious during certain lessons, like P.E., if they were worried about other people seeing their acne or scarring. Devan wore his P.E. kit under his school clothes so that he could change without others seeing the acne on his back. A few people had to miss lessons to see their dermatologist or because they didn’t want to go to school or college.
Chris describes a day when he didn’t feel like going into college because of his acne.
Chris describes a day when he didn’t feel like going into college because of his acne.
Age at interview: 20
Sex: Male
Age at diagnosis: 17
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Yeah like the worst experience I’d say, in sixth form it was getting quite bad. Obviously, like in sixth form and school in general really like you’re such a sort of, you was conscious about how you looking, like your image, like people sort of, sort of just like just talking about - you, you, you might think people are talking about your skin or something like that. Like, oh, yeah it’s, and like I say, like people looking at you like looking at your cheeks or whatever like, you know, they’re, you know, they’re looking at how bad your skin is.
And making it like an opinion from that. But yeah, One, there was one day I got out of bed, looked in the mirror and it was like, I mean, I went, I went to like college at the worst of days, but this day was particularly bad and I just thought, “No, I’m going back to bed”, and I put some cream on, went back to bed. I just couldn’t like deal with, with just going in that day.
I suppose that was like the worst case, but at, in terms of at uni it never got back to that sort of level of severity. I mean, there were bad days and, and you’d try to just cope with it as best you can.
Feeling self-conscious could affect how people participated in classes and exams. The stress of doing exams along with poor diet (“comfort eating”) and missed skincare regimes meant acne was more severe for some near to exam time. Ollie felt his acne affected his confidence and that impacted on his performance in exams.
Harriet recalls teachers commenting that she didn’t contribute much in lessons and thinks that acne partly contributed towards her shyness at school.
Harriet recalls teachers commenting that she didn’t contribute much in lessons and thinks that acne partly contributed towards her shyness at school.
Age at interview: 21
Sex: Female
Age at diagnosis: 12
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I remember all through school every single parents’ evening without fail it would be, “Harriet should contribute more in lessons. She should put her hand up more often.” And I think there probably was a link, but at the same time I think, I don’t think it was the most important thing in terms of that. It was, cos sort of my friends were all in the same boat, we were all quite quiet, always get told ‘you need to speak up more’. So I think acne was just sort of an extra part of that. And I think it’s, a lot of, a lot of it was just like being a bit uncomfortable in yourself. And sort of like you’re getting all like gangly and lumpy in weird places. And you just, the last thing you want to do is be in a classroom full of people and just have them all suddenly turn to look at you while you answer a question. I mean, yeah, acne was a contributing part I think but it wasn’t, it wasn’t the be-all and end-all of it.
Having certain treatments for acne, could in turn add to that stress. Rachael was sitting A-level exams when she was on isotretinoin and says she wasn’t her usual self. She thinks the drug contributed to her “not coping” and crying a lot. Naomi explains how the check-ups associated with taking isotretinoin were time consuming and she found it a “traumatic time” whilst taking the medicine.
The pressure of exams, plus having acne and going through different treatments, was all quite stressful for Abbie.
The pressure of exams, plus having acne and going through different treatments, was all quite stressful for Abbie.
Age at interview: 17
Sex: Female
Age at diagnosis: 13
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I think when I had it when I was younger, it didn’t really affect me that much cos like I didn’t have any exams or anything to study for. But when I started going on the Accutane (isotretinoin), so that was September, like cos I’d just started sixth form. And during like the lead-up to my GCSEs as well, that was when it was quite bad. And it used to stress me out a lot, like all the exams like plus me having acne as well and I was doing all the treatments and things. And it was quite a, like a build-up of things kind of made it, made it worse. And especially when I went on the Accutane, cos then I got the side effects. And obviously sixth form, cos I started A-levels. So it was all a big like change. And that was all quite stressful as well. So I think the acne didn’t help with that either.
University life with acne
Starting university was a big change for some people. For most it meant moving away from their family home and this had practical challenges as well as worries about meeting new people. Living in student accommodation could mean sharing a bathroom with many other students, so that daily skincare routines had to be timed around other people and commitments like lectures.
Some found that university life included more opportunities for socialising with a wide range of people. Some found this difficult. Chris thinks the new opportunities to socialise and make new friends are the hardest things about starting university because this can make you feel more self-conscious. This wasn’t the case for everyone though.
Rachael feels less self-conscious at university because people are less ‘cliquey’.
Rachael feels less self-conscious at university because people are less ‘cliquey’.
Age at interview: 18
Sex: Female
Age at diagnosis: 16
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Are there any sort of particular places that you'd feel more conscious of your skin than others?
I guess in school environment, a college environment – I feel like you'd be more conscious because I think… I dunno, I always felt like that’s the sort of place which could be more sort of quite, people try to look good or quite… yeah I think that’s the main place and then also sort of social gatherings.
Yeh. And does that sort of extend to at university as well – do you feel that’s a similar setting or?
I feel it's different. I think university is very different than the sixth form college I went to cos that was more sort of cliquey and very friendship group based, whereas here I feel like everyone just gets on with everyone and I think it's a very different set-up. So, I feel like I wouldn’t be as self-conscious here.
Hester describes how she became more relaxed about not covering up her acne at university.
Hester describes how she became more relaxed about not covering up her acne at university.
Age at interview: 21
Sex: Female
Age at diagnosis: 15
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So I think I just learned to just go without it, and it was almost like a kind of, a stubborn thing in me, that I was like ‘I'm just refusing to wear make-up', because I was. Yeah. I just, I kind of was almost like daring people to have a look at my face, and... And I've still tried to keep that where I've tried not to wear too much make-up and to be kind of comfortable with the way that I do look. And I think at uni it was hard because I think the first term I would wear, mostly wear make-up if I was like leaving my room because, just a little bit of like foundation just to kinda cover the, so you couldn't really tell there was scar tissue there. And I think it was quite a scary moment the first time I was like 'I'm going to go to the canteen and have breakfast like without make-up on'. Because people can sort of tell that it's a bit discoloured and... But now I'm much more relaxed. I think it took a while, because like- because it's new people at uni, you don't know anyone before, and you want people to think that your skin's better than it is. And then eventually you get, when you get comfortable with people, you’re like ‘oh, I don't really mind if they, they know’. So I'm not really a big, a big one for wearing lots of make-up.
Going out in the evenings with friends often meant drinking alcohol and some people talked about the challenges of having to reduce their alcohol intake because of their acne or certain medications (like istotretinoin) they took for it.
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