Episode 8: Dermatologist’s Take on Acne Positivity
Dermatology Weekly Flash Briefing – The acne positivity skincare movement has taken social media by storm, but should we be glorifying a medical skin condition? Here’s what accredited dermatologist, Dr. Teo Wan Lin has to say about #acnepositivity.
Chelsea: Hi everyone! In this episode of Dermatologist Talks: Science of Beauty we’re going to be talking about a recent movement that’s been trending on social media: Acne positivity.
The acne positivity movement has been making it rounds on social media since early 2018. When activists such as #freethepimple founder Lou Northcote started building a movement online to destigmatize acne, and empower others to embrace their skin. Acne positivity is in some ways, an extension of the body positivity movement. In which it promotes acceptance of all skin regardless of its state. The hallmarks of the movement are unfiltered, make-up free photos. Particularly, those that showcase their natural skin, encouraging others to do the same.
As a dermatologist, what do you think of acne positivity? Is it something that we should glorify?
Dr. TWL: Acne positivity, while probably coming from good intentions, unfortunately, is not a sound movement. From a dermatologist’s perspective, acne is not a cosmetic issue. The cause of acne is truly medical, and it has to do with genetically induced inflammation in the skin. Acne can be very distressing and painful, especially with severe forms of cystic acne. It can also lead to psychosocial problems such as affecting one’s self esteem, or even conditions like depression and anxiety.
This has nothing to do with being positive about acne or not. Though it may be easy to ride the trend that it is ok to have acne, it is not something that is going in the right direction. This is because we can grade the severity of acne. If you have moderate to severe acne, it is very likely you started with mild acne, as would not have developed severe acne overnight. Moderate to severe acne tends to be cystic in nature. It can lead to bleeding, pus, abscess formation (which is a collection of pus under the skin), and in very severe cases, Acne Fulminans.
Acne is not a cosmetic issue
A lot of the dramatic cases that I have seen on social media under the #acnepositivity movement, are really semi-dermatologic emergencies; especially those who look like they have abscess under their skin. It can potentially be life threatening because it starts with infection. The abscesses start with infection, and if uncontrolled, can lead to systemic inflammation and sepsis, causing fever. Additionally, the pus and the blood can also be very distressing.
The key thing here is that it is timely for us to remind the public that acne is not cosmetic. Hence it should not be treated by beauticians and non-medical evidence-based therapies. It is important for us to emphasize the relevance of evidence-based medical treatment for acne. Acne is 100% treatable, so there is no need to be positive about something that you can treat. In severe cases of cystic acne, isotretinoin – which should be used under medical supervision – is a very effective treatment, and it is certainly necessary to advocate this.
Positivity in general
In my opinion, what’s more important, beyond acne positivity, is positivity in general. This should apply to individuals who are suffering from all types of skin conditions. As dermatologists, we are acutely aware of the psychosocial effects of visible skin and hair disorders on the psyche of an individual who has a dermatological condition. The key here is that we do not advocate ignoring the condition, or pretending that everything is okay. Doing so can have disastrous and dangerous results. This is because the skin is a barrier against the external environment, and you have to ensure it is healthy.
But, shaming individuals with skin conditions is certainly inappropriate. This goes for body shaming and all other types of humiliation and bullying. Nevertheless, I feel that it is important to draw the line at recommending appropriate medical treatment – as acne is imminently treatable with medications.
Acne is treatable
I have personally never encountered acne that was not treatable, and was not treated successfully. I can speak for the rest of my dermatologist colleagues as well. The key here is that we have to acknowledge the significant amount of psychosocial distress that acne patients undergo. We should focus more on educating people who don’t have acne who can sometimes pass very insensitive comments. I personally have heard these testimonies form my patients who feel terrible, simply because of these insensitive comments. And this applies for anybody with any sort of visible imperfection and disability.
Chelsea: Well there you have it! That about sums up this dermatologist flash briefing. Thank you guys for tuning in and see you in the next episode.
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