Night after night, I’m jolted awake in tears by a recurring anxiety dream. It’s the day of my wedding, and despite having spent a fortune on a make-up artist to mask the red, raised acne that coats my face, the reflection in the mirror is an unfortunate disaster.
The horror intensifies as I dash to the bathroom, frantically scrubbing off the botched make-up. I try repeatedly to fix it, only to find the clock racing ahead of me. Soon, it’s too late, and the once joyous occasion of my wedding spirals into cancellation.
Since the first spot emerged at the tender age of 13, acne has cast a shadow over my life, dominating my thoughts every waking minute.
School days were a punishing cycle of bullying and insecurities. Cruelly labeled ‘pizza face,’ I awakened each morning to a pillowcase stained with blood. My life became a series of intricate rituals designed to keep my bare face a secret—hiding behind layers of make-up, concealing myself with my hair, and avoiding eye contact at all costs.
By 16, I had exhausted every conceivable cream and gel. At 17, my doctor opted to prescribe the contraceptive pill, hoping it might temper the hormonal upheaval fueling my cystic acne.
Acne moulded my personality, making me the sort of person who would do anything to escape being the centre of attention. I don’t know if I’m really an introvert, but that’s who I became.
By 18, I was going through my first course of an oral drug called isotretinoin (80mg a day), which is also used for chemotherapy. It is so toxic that girls always have to use two forms of contraception (the Pill and condoms) because it can cause life-threatening birth defects if you accidentally get pregnant.
It dried out my skin and hair so much that the corners of my mouth would crack and bleed. It did give me a brief respite for the year I started at Loughborough University in Leicestershire to study graphic design. However, the spots soon returned – slowly at first, then the same as before.
Chloe first got acne when she was 13. By 16, she’d tried every cream and gel and, at 17, her GP put her on the contraceptive pill in the hope it would cure her acne
Aged 21, I went on a second six-month course of isotretinoin, which gave me a few months of clear skin. But by 23, I was back in the acne gloom of my teens.
Every doctor I saw blamed my hormones – too much testosterone, apparently. They told me things would improve when I was older, but that’s no consolation when you wake up every morning to a fresh painful crop of boil-like cysts on your cheeks.
I’d met my boyfriend Isaac in freshers’ week in 2018. He made it clear he couldn’t care less about my skin. Isaac had had his own battle with spots during his teens and his skin had responded to antibiotics and supplements. But he understood the pain I was going through and was incredibly supportive.
When we moved in together in our third year, he was the only person I allowed to see me without make-up. Isaac quickly learned to build our social life around my chronic self-consciousness and my need to hide away when my skin was particularly bad. I played lacrosse for the university which meant a constant round of training sessions and tournaments.
While the other girls could give the sport their 100 per cent focus, I could never escape my spots. I avoided team huddles and photographs.
In January last year, Isaac proposed on the top of the O2 Arena in London. This was a wonderful surprise and my first thought was, ‘Yes!’. My second thought was, ‘Can we elope and get married without any fuss, no one looking at me and no photographs?’
We fixed a wedding date for December this year, but I found myself taking a back seat over the planning – leaving my mum to make all the arrangements. Yes, I desperately wanted to be married to Isaac, but I simply couldn’t get excited about a day when all eyes would be on me and my spots. That’s when the wedding anxiety dreams started.
Then Isaac’s mum, Louise, who is a health writer at the Daily Mail, declared she was going to make it her mission to help me fix my skin once and for all.
In January last year, Isaac proposed on the top of the O2 Arena in London. This was a wonderful surprise for Chloe and her first thought was, ‘Yes!’
Her second thought was, ‘Can we elope and get married without any fuss, no one looking at me and no photographs?’
She and Isaac’s dad Jon had had their own battles with acne when they were younger, so they understood my pain and misery. Louise had been on antibiotics throughout her teens and her skin had only finally cleared when she was in her mid-20s.
Jon had it much worse – his acne covered his face, chest and his entire back. He had been picked as a guinea pig for one of the early trials for isotretinoin and was given a huge experimental dose, which did the trick eventually.
Louise threw herself into researching dermatologists, searching for any new ideas or approaches for stubborn hormonal acne like mine. Many told her my best bet was another course of isotretinoin. But I’d already had two rounds of this poison and was dead set against it.
Then, last October, Louise arranged a Zoom consultation with dermatologist Dr Adam Friedmann who provides tailored treatments for severe, complex and persistent acne at ProDerm clinics in Harley Street, London, and in Bristol, Cheltenham and Birmingham.
I didn’t hold out much hope of success, but I felt Dr Friedmann understood me and he was prepared to investigate different options rather than just handing me a prescription to usher me out of the room.
Dr Friedmann said he wanted to try microdosing isotretinoin, putting me on a sixteenth of the dose I’d been on before with a 10mg tablet every other day.
He assured me the side effects would be minimal at such a low dose. I also took a daily antibiotic (Erythromycin – to settle the inflammation) and he recommended a prescription rosacea gel (Rozex) to help with the redness and scarring.
For the first three months nothing happened. I felt defeated, especially as I was having to pay for the cocktail of drugs (£160 for three months) out of my meagre earnings as a marketing executive for a sports company.
Dr Friedmann said he wanted to try microdosing isotretinoin, putting Chloe on a sixteenth of the dose she’d been on before with a 10mg tablet every other day
Now Chloe’s skin is much clearer after months of treatment with isotretinoin and Trimethoprim
Now aged 26, she finds it incredibly liberating not to have to worry about her skin for the first time
At my next consultation after four months, I was ready to give up but Dr Friedmann seemed determined to prove me wrong. He upped my dose of isotretinoin to 20mg every day and switched the antibiotic to Trimethoprim.
Then gradually – very gradually – I noticed that new spots had stopped appearing and the old ones started healing. Was there finally light at the end of this tunnel?
In March, I was made redundant and braced myself for the stress and emotional overload to erupt on my face as it would have done in the past. But, incredibly, my skin didn’t react at all.
In May, I stood in a supermarket with Isaac suddenly realising that I’d left the house with no make-up on. Dr Friedmann then lowered my daily dose of isotretinoin back to 10mg and took me off the antibiotic and skin cream.
We know I’m not completely out of the woods yet and he has suggested I keep going with this tiny trickle of isotretinoin until after the wedding. If my skin stays clear, I’ll start taking the tablet every other day, then once or twice a week. And then maybe just every so often if I need it.
Today, aged 26, it’s incredibly liberating not to have to worry about my skin for the first time. Now all my wedding fears are different ones: my hair and my dress – the sort of things any bride-to-be should be worrying about.
I’m so grateful to Louise for helping me to turn something I was dreading into something I’m really looking forward to.
And that nightmarish wedding dream has disappeared. I’ll be doing my own make-up on the day and I’m now experimenting with sheer, minimally covering foundations to create a fresh, dewy, no-make-up look.
I’ll just look like me. Not me covered in spots.
As told to Louise Atkinson.