I was nine years old when I awoke to my first real breakout, a cloud of hormonal acne nestled in the shadow of my lower lip. What I remember most vividly is how it hurt to smile. 

I’m 21 now, and I’ve had innumerable breakouts of every kind of acne since then. It carried throughout my teens and into adulthood, working against everyone’s assurance that “it gets better with age” and instead getting worse. I’ve spent a humiliating amount of hours with my face an inch from the bathroom mirror and an equally humiliating amount of cash on heavy duty concealer, both in the effort to cultivate the courage to walk through the world with the skin I’m in. 

Since my first breakout, the ever-changing landscape of my skin has come hand-in-hand with a shifting sense of self, coming rapidly in and out like a textured and inflamed tide.

I’ve never been able to properly articulate how it feels when your own skin repulses you, but this is my best try. In the years that I experienced the worst skin problems, I never tended to my skin. I fought with it. I never understood my skin, I denied it. At 17, I held back tears in the dermatologist’s office, my mother watching me from the corner as I read through the list of serious side effects that came with taking Accutane, a controversial drug often prescribed to people with severe acne. At 19, cystic acne once again erupted on my face after my birth control no longer kept it at bay. I cancelled lunches with friends who wouldn’t even have noticed, let alone cared, because I was terrified of being seen. 

At some point, maybe years or maybe days after that first pimple, I no longer thought of the acne on my face as just the acne on my face. My face was an extension of my body and, therefore, how I felt about it — monstrous, vulnerable, and mainly, ugly — became how I felt about the rest of me. 

In high school, my skin led me to internalize this feeling of ugliness to the point of morphing the picture I imagined when I thought of my body. Engaging with the world, my body felt textured. Uneven. Bulbous. I lost sight of where I began and where I ended. 

Once, I disclosed this to a friend I trusted. She had pristine, pale skin and, often, when we spoke, I wanted to reach out and place my fingers on her cheek. I think 16-year-old me wondered whether, if your skin was so soft and so clear, you felt soft and clear too. We were lying on my basement carpet on a summer afternoon, shoulder to shoulder, when I told her that my skin made me feel ugly. 

She shook her head, laughing. “It’s just skin! It’s not a big deal.” I knew she meant it to be encouraging, but the shame sent a trail of heat down my back.

My skin, now, is probably the best it’s ever been. Makeup has become more a welcome hobby and less an art of disappearing. But the victory seems partial. I won’t pretend that the link that was forged between my sense of self and the state of my skin no longer exists. If I woke up tomorrow morning with a cystic acne breakout, I would navigate my day with the an underlying urge to disappear. 

A little over a year ago, I made tending to my skin a part of my everyday routine. Not battling it or identifying every pimple or scar, but actively and ritualistically caring for it. I’m not staging this choice as the solution that cleared my skin (because it’s not) but rather, the choice that allowed me to remap myself. After years spent internalizing the belief that if my skin was going through a problematic period, it meant that my body was problematic or, implicitly, that I was problematic, adopting a skincare routine forces me to actualize the idea that I am worth tending to, spotty or not.

It’s worth being wary of the way ‘skincare routines’ are marketed to young women as essential ingredients in attaining physical perfection or halting the natural and completely acceptable effects of aging. That aside, my skincare routine has been a catharsis in every sense of the word.

In the morning and at night, I take my time during my routine. For those few minutes, I am focused on myself only, on loving myself as a continuous and conscious act, not as a finite location. Every step is careful and tender in a way I’m not used to being with myself. 

The self-care isn’t the serum or the moisturizer or the face mask. It’s the unlearning occurring beneath the steps, glacial but definite — unlearning of the idea that the way my skin looks makes me more or less worth caring for.