Everything is Fixable
Written by: Kate Pappas
Everything is fixable.
This is an affirmation I used to repeat to myself from a young age, often without much conviction. But these words became much harder to believe the day I turned sixteen, when my skin erupted overnight with painful cystic acne. And not the small, directly-under-the-skin kind of cystic acne you can mask with a swipe of concealer, but the deep, painful kind. The kind that stings when you wash your face, burns under acne cream, and throbs when you lie down.
However, the physical pain wasn’t the only weight I carried; the weight of the eyes staring at my skin might just have been heavier. As someone with a naturally alabaster skin tone, the red bumps and pustules of my condition stuck out on my face as badly as you’d imagine: raw, inflamed, and impossible to ignore. Every blemish had its own story to tell, each one louder than the last—and most aggravatingly, louder than my own.
Other people looked at my skin everywhere I went, and I couldn’t blame them. It was the most striking thing about me at the time. I learned to feel strangers’ pity before they even opened their mouths to verbalize it. Internalizing these experiences led to paralyzing self doubt. And as much as I hated being stared at, I couldn’t stop staring at myself either. Every mirror became a microscope. I pressed my face close, scanning for new blemishes. This became an obsession until it wasn’t just about my skin. I started noticing how my eyes looked uneven. My lips looked crooked. My nose felt wrong. My face, all of it, felt wrong. It wasn’t just acne anymore—it was my identity unraveling.
The Obsession with Fixing
Most immediately, I tried finding solutions to my problems, things that could ‘fix’ my condition as quickly as it started. I was desperate, anxious, and fearless in my quest to kill my acne. But even with an insatiable desire to find my cure-all and an unnerving amount of internet literacy for a sixteen-year-old, I found myself lost in a sea of contradictory information. For instance, one blog said eating nuts healed acne; another said it caused it. Nothing made sense. Nothing was as clear-cut or as easy as I hoped it’d be. Until… (drumroll please) a routine visit to my dermatologist turned into something more. She suggested I take accutane, claiming this one single pill would clear up my skin for good, within a matter of months. It sounded like the miracle cure I was looking for, the quick fix I was so dead-set on finding. So, I considered it. I was desperate, but luckily not desperate enough to say yes without doing some research.
Mood changes, liver damage, and increased cholesterol levels are all potential side effects of taking isotretinoin, most commonly known as accutane. Appalled by the drug’s potential to cause life-altering side effects, I refused the prescription. Unbeknownst to me at the time, this would be a long journey.
Band-Aid Solutions
Fad diets, self-help books, and wellness cleanses became my religion in the following months—replacing old, ineffective protocols for the next-best promising solution almost every other week. I even tried the carnivore diet in hopes to clear my skin. This lasted a mere two weeks until my acne got worse and I nearly fainted from nutrient deficiency. I wouldn't recommend it. I also spent a regrettable amount of money on skincare products, only to find each new “miracle cream” as futile as the last.
Still, I kept trying. For a year, I tried everything I could. Eventually, I decided to get my hormones tested. The result: high DHEA levels caused by chronically high cortisol. This diagnosis broke me. There’s no quick fix for that kind of imbalance, no magic cure. I had to face the truth: I’d been living in a state of constant stress for too long. My nervous system was dysregulated, and had been for quite a while. Ironically, knowing this only made things worse. I blamed myself. I was convinced I’d built this hell, my severe anxiety the foundation for my torture. I was trapped in a cage of my own design.
Maybe my brain chemistry is wrong. Maybe it’s all my fault. Maybe I deserve this, I thought to myself.
This thought pattern persisted until I realized that I would never be able to heal if I couldn’t get over myself. I would have to face these internal challenges head-on and do intensive inner work if I ever wanted to make any external progress with my skin.
After more research, I found that limiting sugar in my diet would make my skin somewhat better. It did. Even so, my acne didn’t completely go away. I continued experiencing breakouts on a weekly basis, each one contributing to the emerging scarring on my cheeks.
I was despondent. I felt hopeless, like my skin was going to be stuck in this quasi-clear interim period forever. I thought I was doing everything I could: not eating dairy, gluten, sugar—or anything fun, for that matter. But I had hit a plateau.
Unhappy with my skin, I turned to social media for more answers, but ended up finding all the wrong ones. As someone prone to self-criticism, social media became a breeding ground for comparison. I logged onto Instagram intending to do research, only to find myself staring at influencers and their perfectly clear skin and toned bodies for hours. Why couldn’t I just look like them, I wondered. I was falling victim to my own bad habits, and facing their damaging repercussions.
Comparison is a dangerous game. Even if you’re the only one playing, you can’t win. And so, my anxiety and self-consciousness grew. Eventually, it showed up in my body—and on my skin. At nineteen, I was back to square one. Three years of progress erased, and what was left of my confidence was gone too.
But as ugly as I felt on the outside, I felt even more disgusting on the inside for caring about my appearance so much. In time, the way I felt about my skin also started to negatively impact my quality of life, contributing to an increasingly dysfunctional world view. I was scared to leave my house without makeup on, and even more afraid of what other people thought of me. No matter how much I washed my face and obsessively disinfected everything in my living space, I always felt dirty. With every layer of concealer and powder I tried to hide under, I couldn’t escape the painful reality of my skin. This cycle continued until I reached a breaking point.
In the spring of 2024, I started taking Yaz birth control pills and spironolactone—two medications that would change my life, for better and for worse. Within three months, all my acne was gone, and a new kind of mental clarity arose. The weight of my insecurities related to my skin had mostly dissolved. I finally felt comfortable going out without makeup on, a fantasy I’d had since I was sixteen. It felt too good to be true, and it most definitely was.
Stitching Up the Wound
Clear skin was just one of the many side effects of these pills, which were, in truth, just another band-aid solution to my problems. For context, Yaz birth control has faced class-action lawsuits in Canada alleging it caused injuries and deaths due to blood clots and other complications—so you can imagine the kind of fear someone with severe anxiety might feel while taking it.
Not only were the potential side effects formidable, but these medications also allowed me to lose sight of the real root cause of my acne: anxiety. While on the pills, I could ignore the fact that I was nervous about nearly everything in my life, constantly feeling either easily rattled or emotionally numb. Deep down, I knew I had to stop taking them and start healing myself from the inside out. It was the only way to clear my skin for good; not with another band-aid, but by stitching up the wound.
I was eager to stop taking the medications but scared that if I did, my skin would revert back to the way it was. I knew that if I didn’t want to face the latter outcome, I’d have to make some changes to my lifestyle by breaking old patterns, habits, and thought processes, finally treating the root cause of my hormonal imbalance instead of its topical symptom. So that’s what I did.
What Actually Worked
This is a very oversimplified list of what actually helped clear my skin and lower my cortisol levels, but covers some of the most important changes I made:
Firstly, I made some mindset shifts. I deactivated my instagram and deleted all other forms of social media off my phone; if I wanted my cortisol levels to decrease, I would have to eliminate unnecessary stressors—at least until I was in a better place and could cultivate a healthy relationship with social media. I also started journaling, meditating, and working through my emotions, using spiritual and energy healing to guide me.
Next, I adjusted my diet and exercise. I cut out all added sugars and limited workouts to pilates three times a week, along with 10,000 daily steps. I started doing somatic exercises and working through my disordered eating and exercise habits, something that I will likely have to continue to manage for the rest of my life.
Finally, I regulated my sleep schedule and circadian rhythm, perhaps the hardest change of all.
Preparing my body to come off these medications was one of the most challenging yet rewarding experiences of my life, for it helped me clear my acne in a sustainable way by transforming my body from the inside out. As I sit here writing this, although my skin isn’t perfect, I can happily report that I no longer deal with cystic acne regularly (and can even indulge in the occasional sweet treat without worry). I’m also so lucky to be in a much better place with my mental health, no longer avoiding it until physical symptoms arise. I’m no longer hiding, no longer hurting in silence.
Sixteen-year-old me wouldn’t believe how far we’ve come. I’m nowhere near perfect, but I’ve realized that I don’t have to be. And despite all the tears and heartache, I’m grateful to have gone through this journey with my skin. I’ve learned too many valuable lessons to not at least be somewhat thankful for the hardship that taught them.
One of these lessons: perfection is never promised, but everything is fixable.
Be Well,
Kate Pappas
