I really thought I never cared what I looked like. It's not that I don't have fun with style, with hair color, with fashion and frippery: I've embraced a spontaneous bleached bowl cut or an even more spontaneous array of meaningless tattoos. But the basics of bodily self-consciousness — being hyper-critical about my undulating belly, my wide ass, my off-white buck teeth, my whatever being too whatever — have mostly passed me by. Don't get me wrong, I have plenty of horrifying qualities (codependency, pendulum moods, a propensity to call everyone "sweetie baby"), but in this one area, I've been granted some golden pass.

I held onto this preposterously high self-esteem even though, when I was a teenager, a solid effort was made to take this confidence right from me and cut me down to (sample) size, From the anonymous phone call junior year ("You're fat and you deserve to die") to the litany of images of perky teen princesses with a minimum of belly fat and a maximum of boob, the exact inverse of my proportions, it often felt like the world's message was: "You are too messy, too much, spilling into space that isn't yours. How dare you leave the house without trying harder?" In response I just went further, wearing miniskirts as crop tops and pearls as tiaras and ceasing entirely to brush my hair.

When my career started, it was like high school on terrible speed, each tweet (and even some cogent reviews of Girls by respectable critics) taking pains to point out the ways in which my body wasn't TV-ready. But despite the vitriol and regularly fluctuating 30 pounds, I enjoyed a bright, beaming sense of self-love. Some of it came from the women who told me what I was doing mattered to them, women I'll always feel grateful and connected to. But more of it came from looking in the mirror and being like "Damn, son." As a member of a public couple, I laughed when I read comments like "He's a rock star. Doesn't he know he could date a model?" Because they didn't know my secret: I AM a model. As Jenni so elegantly puts it, I am Rihanna to myself.

But chronic illness — endometriosis, along with an accompanying autoimmune disease that gives me chronic joint pain and fatigue — has made my body far less predictable to me, and in far more frightening ways than whether I'll wake up able to fit into my high-waisted jeans. And a few weeks ago, a course of steroids to treat a massive flare of joint pain and instability led to rosacea's appearing overnight, making me look like a scary Victorian doll, two perfect pink circles painted on her porcelain face. "It's actually pretty cute," my mom said. "Very '90s editorial fashion!"

Then, after a long, sweaty night shoot in which I was covered in strange makeup, I washed my face to reveal that the rosacea had become hundreds of tiny pimple-blisters that covered me from forehead to neck. The sound that came from that hair and makeup trailer was similar to when the bitch in the Craft starts losing her hair in the locker room. Terror, rage, and piteous sadness. My face burned, but not as badly as my pride.

Now, let's back up a moment. I had pimples as a teenager. A bunch of 'em, enough that I used Proactiv (probably once a week) and slathered my face in Wet n Wild concealer. After my first camera test for Girls, a producer gently pointed out we'd need to do some visual effects work to cover an angry red zit. I hadn't even noticed. For my 24th birthday, Jenni introduced me to Terri Lawton, a woman we call "the face witch" because of her incredible ability to discern and cure all skin ailments, and most emotional ones too. She promptly handled my acne, and I got compliments left and right on my pure, blemish-free skin. I appreciated it, but at the time, I hadn't been particularly shaken by my other reality.