Kind of a gross topic

Sometimes I get cystic acne. I know that's a disgusting thing to talk about. It happens mostly when I'm stressed or particularly hormonal. It's been this way for most of my life, and while two rounds of Accutane as a teenager made it so I can get by without a dermatologist's care, I still have flare-ups occasionally and probably will for the rest of forever.

I hate when this happens. Mostly because 1) it looks AWFUL; 2) it hurts; and 3) I am 29 years old, for pete's sake, and at some point it would be great if I outgrew this. Ugh. While this isn't some horrible affliction, it's still a problem; it affects self-esteem dramatically, and for someone like me, whose job it is to talk to and interact with people for a living, it can be really complicated. Fortunately, I've gotten pretty masterful with concealer and powder over the years, so I can at least lessen the startling effect of particularly bad episodes. I can't make it invisible, but I can at least make it so that, from a bit of a distance, it's not so noticeable.

This latest round, which started last Saturday, got me thinking...about why I feel so horrible when I'm in the middle of a breakout, and about what makes me feel better so I can get through it without just crawling into a hole and hiding. So, here are my tips for those going through the same sort of thing (holla, teenagers...or other 29-year-olds who wish they would outgrow this, too), and for those who love them.

Things That Make Me Feel Better When My Skin Isn't Cooperating and I Feel Ugly

• Wearing clothes I really like. When you break out, it is not the time to wear things that don't fit right, or that you don't particularly care for. Wear a really great sweater or something and hope it draws attention away from your face.
• Not having to talk to people in person. This isn't always feasible, but hiding really is a nice option sometimes.
• Makeup. I feel sorry for guys who are barred by social norms from wearing it. If I were a guy, I think I'd try to figure out a way to wear makeup anyway when I broke out.
• My husband. Because he never thinks I look ugly.
  
• My daughter. Because I really don't think she notices as long as she has someone to play with.
  
• Tylenol. Because it really does hurt.
  

Interacting with a Person Who Has Cystic Acne: DOs and DON'Ts

• DO try to keep your face-to-face conversations short.
• DON'T force eye contact; the person in question probably doesn't want to know you're looking at her, and so it's easier for her if she doesn't have to look at you.
• DON'T make any sort of comment about the cyst. This has always driven me crazy. I can understand why horrible kids in middle school would say stuff like, "Hey, did you get in a fight?" It's because we were all 13, and you just say mean stuff when you're 13. But worse is when someone tries to be sympathetic. "Wow, does that hurt?" is never appropriate to say. This is because the person with the cyst needs to pretend that you can't tell there's something amiss, and if you say anything about it at all, it breaks the illusion.
• DO compliment some other aspect of the person. See "great sweater" above.
• DO act surprised if the person says something about the cyst first. Appreciated comments would include, "Wow, I couldn't even tell" or "Really? I didn't notice until you said something." Even if this is sort of a lie, it will make her feel better.
  
• If the person in question is your kid, and he or she is not an adult yet, DO force him or her to go to the dermatologist. DON'T take no for an answer on this. This is the only time I think it's okay to break the "don't say anything" rule above. Your kid will be really annoyed at you, mostly due to embarrassment, but it's worth it.
  

So...I know it's icky, but I felt like I had a public service to offer here. Twenty years (no kidding) of dealing with this stuff makes me sort of an expert.