He recoiled with repulsion, “Ew what’s that all over you face?” He, a hotshot athlete at school, asked me this without expecting an answer. My winning combination of thick eyewear, braces and a face replete with pimples was helping me make some new friends. Embarrassed and avoiding eye contact, I stared at my open locker for what felt like hours.

My skin has always been rather volcanic, probably since I was 9 years old. Keeping the Himalayan mountains that sprout on my cheeks under control has been emotionally taxing throughout these past 10 years or so. Where other girls struggled with body image issues concerning their weight, I struggled with keeping my skin from exploding.

Up until recently, cystic nodular acne covered nearly every corner of my face. It was physically painful, to the point where animating and smiling were sometimes impossible. The spots would linger for weeks unlike normal zits. Not only that, they were also gargantuan. Acne spanning the width of a thumbnail is difficult to conceal and new ones were appearing nearly every day. Worsening over time, the acne began to scar, some of which remain. Despite all the treatments I took, there was no recourse.

I became fixated with other people’s complexions. I constantly wondered what exactly it was that I was doing wrong in attempting to treat the issue. My dermatologists exhausted every solution: drugstore products, home remedies, burning topicals, antibiotics, retinoids, oral contraception, chemical peels, light therapy, extractions and even laser treatments. None of it brought relief — it was driving me to sheer insanity.

I once coveted the unrealistic, poreless, airbrushed skin of people on social media and in advertisements. But after trying an array of prescriptions that did nothing to heal my skin, I just wanted to look normal. Even average skin with some wrinkles, visible pores and sunspots felt beautiful and unattainable.

Although they meant well, I was further discouraged by the constant suggestions from others because it confirmed that my skin was not getting better. They ranged from the crude “wash your face more often” to the milder “eat less dairy.” But, I didn’t consume dairy, sugars and meat, I washed my face morning and night, and I exercised every day. Why the state of my face was not improving was a mystery. There was no explanation as to why new spots were appearing each day.

The acne was so relenting and severe that I once considered Isotretinoin, more commonly known as Accutane. I was willing to risk an long list of potentially permanent adverse side effects instead of temporarily having what I considered to be bad skin. That speaks to the pressures that young women (and men too) face in reaching their understanding of what beauty is. It is sad to think that at one point I was this desperate and discontented with my skin. Seeing images of perfect skin everywhere did little to help.

Numerous studies suggest a link between mass media and body dissatisfaction; we have heard this before. Girls on social media do not have scars. Lead actresses are not overweight. None of them have a blemish in sight. Back then I did not realize that I shared a small commonality with the girls who were starving themselves. We were unhappy with our bodies, albeit for different reasons.

Years later, I finally found a medication that worked. Today, some scars and marks stand as vestiges of a tricky period in my life. I must take pills daily to keep the acne away. I wish this were not the case but I feel fortunate to have found something that finally worked.

Interestingly, the world does not fall back into place once the acne goes away. Sure, there are subtle changes. I would look in the mirror and see clear skin but I still felt insecure when taking photos with friends or looking someone in the eye. After the skin trouble, it was my self-confidence that needed work. Acceptance and loving yourself begins on the inside, not outside.

Being comfortable with oneself far outweighs achieving some arbitrary beauty standard. Telling young people, especially young women, that they are beautiful the way they are is incredibly important. Yesterday was International Women’s Day, and I made sure to show the women in my life that they were special, loved and gifts to the world. I hope to do that every day.

As for that guy who once made unwelcome remarks on my skin — he asked for my number last year when I was working out at the gym in our hometown. I respectfully declined.

Karina Pauletti writes the Thursday column on media discourse. Contact her at [email protected].