170. The psychology of acne

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Speaker 1: Hello everybody, and welcome back to the Psychology of Your Twenties, the podcast where we talk through some of the big life changes and transitions of our twenties and what they mean for our psychology. Hello everybody, Welcome back to the show. Welcome back to the podcast. New listeners, our listeners, Wherever you are in the world, it is so great to have you here. Back for another episode as we break down the psychology of our twenties. Thank you for joining us. Today. We're going to jump straight in, no ramble, no dilly daling. We're talking about acne, specifically the psychology of acne in our twenties today. This has to be one of my most highly requested episodes. A few weeks ago I posted that I was doing some research on this topic. The amount of who emailed me dm me messaged me was insane because I think that this experience of struggling with our skin, struggling with our appearance, is a universal part of this decade. Everybody has some aspect of themselves that they feel self conscious about, from not feeling thin enough, or tall enough, or big enough, like each of us harbors an insecurity that we imagine everyone else notices and is judging us on the basis of acne is no different, and I think is one of the most common insecurities that we face during this period of our lives. For many of us in our twenties, acne is a daily reality. About eighty four percent of people between the ages of thirteen and twenty five are affected by acne according to your Medicine. That is a sizable majority. And yet despite that, there is so much shame and stigma, there are entire industries making billions on the backs of our embarrassment. No one, I think, is born hating how their skin looks, how their skin turns out. We are taught throughout our teenage years and well into adulthood that acne is ugly and that we should cover it up. We need to go on medications that could have long term health risks just so that we can have that milky, glass like skin that so few people actually have. I am one of those people who has really struggled with acne for a while. It used to be so terrible. It caused me so much sadness, so much frustration, so much anger in my life, particularly when I was in high school. I distinctly remember showing up at school wearing a full face of makeup, layers of remal foundation, maybe lane, whatever it was elf foundation that I would get from Kmart, and even more layers of powder. It probably just made it worse in hindsight. But this like practice of sitting down every morning and putting on my makeup, over all of my scarring, all of my like pimples, all of my breakouts, it was like protection almost. It was like this way to almost put on a mask and feel less embarrassed about my skin. And the occasional times I would go in bare face. Anytime someone would look at me or talk to me, I would think that they were just staring at my acne, thinking about how gross it was, assuming it didn't wash my face. That I ate terribly, rather than the truth, which is that it's just a skin condition, it's genetic, it's biological, nothing more. But that built up anxiety and insecurity leaves lasting scars that aren't just skin deep, and the kind of insecurities more importantly, that really travel with us even when the acne may fade, even as we age and mature. Even now my breakups have really been contained. They've reduced a lot in recent years, as I think my hormones have stabilized, I still find it really hard to go out without makeup on especially with the podcast. You know, people always ask me when we're going to do full video episodes, and I just can't. I just really can't because I hate to admit it. I'm so self conscious about my skin and I think one negative comment would absolutely ruin my day. I've seen this happen with so many other creators and podcasters. I always think about Emma Chamberlain and her struggles with her skin and how cruel everyone was around that, and that terrifies me. Those comments always stick with us. They play back in our memory again and again and again that one time someone said something that made you realize that they could see what you saw in the mirror, that you had an outbreak, that you had acne, and that it was disgusting and that it was gross in their eyes. I had someone once say to me that I looked like a plague victim when I was like sixteen or seventeen. That was like eight years ago, and you best believe that its stayed with me. Perhaps because of that negativity bias we see in psychology, our brains hold on to those mean, mean comments, and besides the impact on our self esteem and confidence, the bullying we might face, the genuine emotional pain that psychologists are beginning to identify. Acne can also be physically painful at time, especially if you have very inflamed cystic acne. The severity of that can impact our lives on so many fronts. It's really difficult to feel like you have control over this part of your body, the most visible part of your body, and during such a formative period when we already are filled with so much self doubt, so much expectation to fit in, and very much prone to social comparison. Acne does not help the situation on so many levels. It is part of so many of our journeys to self acceptance, to feeling ugly, to feeling unlovable at times. So, if you are someone who struggles with acne like myself, who has gone to every doctor looking for a solution, take an accutane, tried clean eating every skin care product there is, who maybe has passed their acne days, but worries about flare ups, the breakout that always happens before like a big event, This episode is for you because we're going to discuss just how acne is as much of a psychological condition as it is a dematological condition as well. There are so many interactions between acne and our mental health and vice versa. So let's get into it. Acne is the most common skin condition in the world, but it's mainly experienced by people between puberty and their early thirties, sometimes a little bit after that. The reason we see so many people struggling with acne during this period is because of the underlying hormonal changes we're going through. The hormones most responsible for acne are androgens, which are essentially sex hormones that bring on puberty and fertility. Our prime time to be reproducing is right now, and so that spike and androgen levels is going to be a massive contributor to our predisposition for acne, and honestly, sadly, there's very little we can do to control that. Hormones are a big factor. But acne, whether that is mild, severe, non inflammatory, whatever it may be, basically it comes from oil and dead skin cells that get into our hair follicles that we have all over our face and all over our back, anywhere on the body that has large oil depositories, large natural oil depositories. I'm sure that if you've struggled with acne, you already know a lot of this. A quick Google search can tell you all you need to know about follicles and oil glands, and skin cells and hormones, the whole cocktail of contributing factors. But also, if you are genetically predisposed to acne, if your hormones are raging and unbalanced, you are going to get acne regardless of how many clean products you put on your face. The thing that I think we don't speak about enough is how much acne is truly biological and not behavioral. That means that when we think about things like clean skincare or like a healthy diet, they are not necessarily going to really help you. For some people, they definitely do. But if you're going to get acne, you're going to get acne, and normally you're going to require some very intense medication to overcome those biological factors. I think despite that knowledge, there are so many other misconceptions people have about acne that really contribute to the negative connotations, the negative image of this condition, and also with that it also contributes to us feeling so bad about what is so normal. These false beliefs around acne confuse us into believing that our acne holds some bigger truth about who we are. If that sounds confusing, let me break this down for you. For a long time, we were told, and I remember being told this as a child and as a teenager, that acne came from diet and not washing our skin enough, which we now know are really very minor maybe contributing factors, definitely not causing. And so because of this, acne for a long time was associated with being unclean. If you had that must mean that you're unhygienic, that you don't wash your face, that you're eating poorly. I always think back to all those rom coms and teen movies we used to watch where a character would like eat a bowl of ice cream or like too much chocolate after a breakup and get a breakout, or the gamer guy who ate pizza, and he was always depicted as greasy and sweaty and dirty, and of course he had acne. And these repeated storylines and tropes meant that we have begun to associate acne with slothfulness for lack of a better word, slothfulness is such an unsavory character trait it even sounds terrible. We all know the negative connotations and we don't want to be lumped into this like characteristic this category of people. The thing is, though, that these myths that acne is like a dirty condition are complete fallacies, and a lot of the time they have been sold to us by several industries that benefit from us hating our skin so they can sell us something to make us feel better. I know this sounds a little bit like a conspiracy, but I think the recognition and the moment I recognized this was when I really asked myself, like, if my acne is not painful, if it's not physically disrupting my life, what reason do I have to hate it other than that we have been taught to especially when you reflect on the fact that more than eighty percent of the population is going to experience this at some point in their life. You know, acne has never been normalized at any point in the media or beauty industry until very recently. Every face in every odd campaign is airbrushed, no one has skin texture, movie sets, whose thousands of expensive products to sell us on this perfect image we have celebrities having access to face tune as much as the regular person does, and this creates this whole systematic, I think, belief system that acne is not normal, it's bad, and it's ugly, which I honestly disagree with all of those points. What really fascinates me is about this culture is when you see those celebrity like before and afters on TikTok or Instagram, when they show the raw files and then the picture that they actually posted with the flawless skin. I think it just goes to show that even with millions of dollars, sometimes your skin isn't going to do what you want it to. Normal skin is pigmented, it's pimply, it's rough, it's textured, people have little breakouts, people have acne, Yet we have been made to feel really ashamed of our skin. It's interesting because as we've seen a rise in social media, I think we've seen a rise in insecurity to do with acne, and we've seen some studies on this. According to the UK Psychology Association, when we have that constant exposure to highly edited and perfected images in media, that naturally creates unrealistic beauty standards. Those standards lead to feelings of inadequacy and self comparison. There was even a point when the American Medical Association, the literal American Medical Association, went to advertisers and said, please stop using photoshop, Please stop using these ways of editing photos, because it is making people like mentally unwell. It is painting this very unrealistic representation of beauty that very few people can meet. And if that is all we see, how do we have a fair and realistic point of what is normal. We're essentially set up to hate ourselves because our comparison point is so unattainable. And that might sound very incident, but over time, this repeated exposure, especially when we're teenagers, especially in early adulthood, it has a cumulative effect and it makes us feel increasingly embarrassed by the ways in which our skin is not perfect. I think, especially in our teen years and in our twenties, we don't want any reason to stand out. So when our acne is particularly bad, it becomes a massive source of self consciousness, and it creates a plummet in our self esteem because it is already so fragile at this stage in our lives, when we're just trying to figure out who we are. We're trying to figure out so many other parts of our identity, and we have this part of ourselves that people can perceive that isn't what we want it to be, and we can't control it. We know people may notice it, and we worry what they might think when they do well, they think that you're not attractive. In our twenties, that is a factor that we place a lot of importance on. A lot of us are dating, a lot of us want to find love, and I don't think it's vain to want to look good and feel good about yourself. In fact, having poor body image has a lot of consequences for our psychological wellbeing. In research studies that have been done quite recently, actually, people with acne have repeatedly said that their skin was the major reason they felt unattractive, They felt embarrassed or self conscious. When we have that constant negative thought pattern in our mind, in our brain, it's going to stop you from doing a lot of the things that you want to do, making new friends, applying for new jobs, dating, participating in I don't know, hobbies, sporting activities, so many activities that are really, really valuable in this decade. That really make this decade, there was one major study in particular on the psychological effects of acne that broke down the exact impact of this across a number of different areas. Use of research is honestly magnificent. It's incredible. I'm going to leave a link. And it's one of the first time that researchers have really looked at acne more as a mental condition with emotional symptoms as much as a physical one, acknowledging that when we see so many poor mental health outcomes associated with a condition or a disorder, it probably deserves some attention. You know. For example, we see increased levels of anxiety, of depression, even psychiatric symptoms. We also seek greater levels of social isolation. And that makes so much sense to me. If you don't feel good in your skin, if you don't feel like your external appearance is what you would like it to be, that it reflects who you are and who you are not, and that perhaps people are passing judgment. Why would you want to leave the house. It takes so much courage to be comfortable knowing that people can perceive you and observe you and think whatever they would like about you, and especially it takes even more courage when you're not even able to do that for yourself. You're not even able to look in a mirror without feeling a sense of real deep hatred and hurt. So with that in mind, in twenty sixteen, two researchers recruited one hundred people who had been diagnosed with acne in the last couple of years and they wanted to understand exactly how this condition was impacting them across ten different domains of daily life. They followed them for three months. This is what they found, so in eighty eight percent of cases, people reported feeling embarrassed or self conscious due to acne, and those two emotions were directly linked to low self esteem and self image. Each of these participants, part of the eighty eight percent said the major factor behind why I feel embarrassed in my daily life, why I'm lacking confidence, is my acne, and it was also one of the main reasons why most of these participants actually sought treatment in the first place, was because because they needed to deal with this insecurity, it was holding them back. Thirty seven percent of these participants reported that acne influenced how they dressed, and how they chose clothes and outfits that either covered their acne if it wasn't on their face, or which they believe almost like quote, compensated for the acne. This is really interesting to me. I'd never heard of this before, and I don't think we often correlate acne with a change in the way we dress. But I think if we don't feel confident in one area, we want to make up for it or increase our level of confidence in another through our fashion choices. It just shows how deeply ingrained this really is. Like it's not just something that's on your skin that you can ignore. It makes its way into your decision making as well. Sixty eight percent of patients reported acne affected their social activities. They said they avoided social gatherings, parties, doing sports, especially during an episode of a que acne flare ups. They felt that they were making other people uncomfortable, or that people were going to stare at them, and that they wouldn't be able to be themselves. This was more so the case in women. There was a high degree of social anxiety withdrawal, and I think this pattern and cycle of avoidance contributes further to low self esteem and of course social isolation. It just becomes, i think, increasingly harder to want to leave the house and want to put yourself out there. So we also, well, this study wasn't me. These researchers, these amazing researchers. They also looked at the effect on work and study, and they found that fifty seven half of these participants were seeing acne have an impact on their work, whether that was academic work or Korea focused work, a professional job. People were saying, like, I'm so bothered by my appearance that i cannot concentrate because I'm picking at my skin because I'm I'm feeling to see if it's gone down or if it's if it's getting worse. I can't stop going and looking in the mirror. I can't stop thinking about what other people are thinking of me. I just want it gone. It's hard to be completely focused or even slightly focused on doing something when you have this big, giant other ogre thing in your brain thumping around taking up so much space. Finally, let's talk about the impact on interpersonal relationships. Seventy five percent of individuals reported that their ACNE made it harder for them to date and created difficulties in their interpersonal relationships. And there were a lot of people who said that part of this experience, and part of their struggles in these relationships in building new connections, is because of previous instances of being bullied or even teased by peers and in some case relatives and family members. Women yet again felt this more deeply. They felt that having acne made them less attractive, made it harder for them to put themselves out there in a romantic way. I think women are very acutely aware of how much looks matter for them and less so for men, and so of course appearance in this aspect is going to be a bigger factor. Not to say men don't also experience it, but I think women really do understand that there are a lot more beauty standards for how we look than how others look. I've seen this with my friends quite a bit, where their worth becomes very much tied to how their skin's doing that day, and so they cancel dates. They kind of refuse to believe that anyone could possibly be attracted to them when it's so obvious to be their friend, to see how wonderful they are, to see how amazing they are to never really think about what their skin looks like. It's just, you know, it's just there. It's not a contribute, it's not a changing factor. It doesn't impact how we think of them. But when that is a belief that you're holding so deeply, it's very hard to feel desirable when you don't really fully love yourself in those moments. The final finding that was so interesting to me because it really affirms a lot of what I believe contributes to the stigma and insecurity about acne is that many of the participants reported that their difficulties in their interpersonal relationships emerged because they were acutely aware that they failed to live up to the idea of perfect, flawless skin portrayed in advertising television media. This led to a self perceived reduction in general attractiveness, which we talked about, and an increased fear or perception of being judged, specifically being judged to be unhealthy or unhygienic. Once again, we're returning to those misbeliefs at the very beginning of this episode that we spoke about the misbelief that acne is behavioral rather than biological, and when we have this huge cumulation combination of factors that's going to create a lot of further symptoms of serious mental health conditions. One in particular that I want to talk about is body dysmorphic disorder. They found again and again and again a correlation between people with ACNE and BDD. And we've spoken about BDD on the show before, but for a refresher, BDD is essentially a mental health condition characterized by constant worrying over a defect in appearance. We become fixated on our flaws and obsessed with correcting them, and alongside that we are unable to appraise our appearance objectively. So basically we don't know what we look like because our perception is so continuously influenced by our negative self beliefs and intense focus and shame and anxiety, that we can't see as clearly as others, as friends, as family can that it's not that big of a deal, that really it's not that noticeable that no one is judging you based on what your skin looks like. When you're in the throes of a condition like BDD, it's very hard to see that. And an interesting facet of this that I think really applies to the acne and skin space as well. Is that some people with BDD subsequently develop what we would call an obsession, even an addiction to cosmetic prosceidures, looking up surgeries, looking up clinics and treatments, investing thousands of dollars in these procedures, even when the primary issue in this case, the acne, is solved. Once again, there is this whole other industry that leverages and profits from our insecurity. I think how we feel about ourselves some people might call caring about your image vein. I actually think it has a really profound impact on our mental health. Of course, we are going to be concerned with how our physical form presents, because that is who everyone else in our lives sees. And all of these observations demonstrate just how wide this effect truly spans, even to things that we wouldn't think about. Very few parts of our identity and our daily lives remain untouched. So what I want to talk about next is what to do about it? What do we do when the treatments aren't working, when we don't want to go outside, And maybe also just offer some encouragements for those of you who are struggling with your emotional and mental health in the face of past or current ACNE. I don't really want to go through treatment options or anything like that because I'm not a licensed dermatologist. Obviously what worked for me might not work for you. But I do want to explore, of course, the mental and emotional and psychological side of things. So all of that and more after this short break, managing the emotional impact of acne, teenage, acne, adulthood acne. I think it extends a lot further than just finding the right treatment. But honestly, that is a good first step, getting onto a medication or seeing a dermatologist, reducing your symptoms, reducing your flare ups. Honestly, it removes our main source of anxiety and insecurity. It is the best place to start. I think the biggest factor for me was not that it necessarily removed my acne immediately. In fact, it kind of actually got worse in the interim, but it reduced my feelings of hopelessness and not feeling in control. I felt like I was doing something about it. There was a solution. I wasn't going to feel this terrible for so long. I wouldn't have to worry about it as much as it were as much as I was kind. I don't want to sound cheesy, but it just just give me hope. And although like this podcast, we talk about acceptance a lot, we talk about self confidence. I don't think that you need to be a martyr. I don't think that you need to like embrace your acne so that other people feel confident to do so. Sometimes, if your mental health is really suffering, if you're really struggling, if your self confidence has never been worse, the best thing for you to do is to find a treatment that works. That can take time, though, and in my experience, it also takes a lot of trial and error. Some medications just don't work for some people, or they do work and they have secondary consequences. You know, our acne may settle down, but then we have really bad headaches, I irritations, stomach problems, rashes, maybe even an increase in mental health symptoms like depressive symptoms that might cause us to cease a particular therapy or medication. So in the meantime, what options do we have for living a really good, fulfilling life not held back by our parents or by our acne. I think The biggest issue in this is managing self image and self esteem, and part of that is starting to normalize acne for yourself. We've spoken a lot about how there is a culture around seeing acne is ugly, seeing it is gross. There are a lot of people out there who don't feel that way and who have made it their mission to ensure that this next generation of people grows up without those negative connotations start following acne positive influences. We spend a lot of time on social media. It gives us a lot of subliminal messages on how to think, how to feel, many other factors. And when you are constantly in an online space of perfection, flawless, skin, face tune, whatever it is, that is not going to do well for you when it comes to your social comparison. And it's not to say that you're going to compare yourself to these other people and be like, oh, yeah, their acne is so much worse in mine, I feel better. No, it's about seeing people who you actually can relate to reflected back at you on a platform where you spend so much time, but also try and buy from brands that have a no photoshop policy. I love these kinds of brands. You can find a whole list online. It means that you can shop on their sites without feeling like everything is so heavily photoshopped. Just expose yourself to media where you see characters who look like you. I feel like people have been saying this for so long when it comes to representation in so many other forms, it is so important to see people who you can relate to, even if they're fictional, because it means that your story, your narrative, your experiences are validated, and you don't feel as alone in what you're in what you're experiencing. The one movie that I think does this really well specifically around Acne is Ladybird, the Sersha Ronan Greta Gowig movie. Absolutely amazing euphoria as well. I know these are very like teen focused girls. That show is so I can't watch it without seriously wanting to slap every single one of those characters in that TV show. But it's all about being like, this is a realistic depiction of what the average twenty year old looks like. We're so inundated with perfectly altered, filtered, edited skin that many of us also adopt those same strategies of swiping through filters or covering our blemishes, covering our scars. We are also subjecting ourselves to the illusion of perfection whilst showing ourselves that it doesn't exist, if that makes sense. Like, it's sometimes hard to realize that if you're editing your photos from a place of insecurity, there are so many other people who are doing that as well. If you are never going to put your face on social media without makeup on, think about all the other people who are doing the same thing. I'm so guilty of this. I said this the other day in a video, but I only do videos with the full face of makeup on. I often think, oh, yeah, this won't get as much engagement. People aren't gonna like this content. People. I'm definitely gonna get cruel comments if I do this without makeup on, if they can see what I really look like right now. So, like I said before, it's not that you have to be a martyr. It's not that you have to go out there and reveal all of your insecurity for the world in order to be part of the normalization process. It really is about what makes you feel best and creating an online environment in which you see yourself reflected back at you. You're not faced with like the literal propaganda wall of perfect skin trying to sell you a new product that is going to be so freeing. I think a small step to accepting acne as well is thinking about what small activities you can do in your day to day life without makeup, with a bare face. Challenge yourself, get used to being a little bit uncomfortable, get used to people. Maybe they're looking at you. But why does it matter? Why does it matter? It really doesn't matter, Like, what is that going to mean for your life? Does it mean that is them in your acne? Is that going to mean that a family member drops dead tomorrow? Does it mean that your boyfriend's gonna break up with you? If someone sees your acne, does it mean does it mean you're going to fall ill? Fall seriously ill? No. If someone makes a judgment based on literally what is skin deep? Quite literally, so skin deep, so shallow, that says so much more about them than about you. I just want to remind you of that fact. It's scary sometimes I used to use makeup as a crutch for my insecurity all the time. But over if you keep repeating this practice, you get used to feeling a lot more unburdened by the opinions of others, and you'll start to notice that you're too busy to even care. I also think it's part of this is addressing confidence more generally. And the way that I always like to talk about this is what are you doing when you feel your best? What activities make you feel amazing regardless of a bad skin day. What activities make you feel more in control of your health even when your skin is being frustrating. What activities take you away from how your skin is looking? More so, what put you What activities put you in a state of just like completely forgetting to think about it? Do more of those things you need, more of that energy in your life. You will be amazed at how little you start thinking about it when you start filling your hours with things that feel good for you, and you start addressing your confidence and your health more holistically. The other tool that I have in my self confidence toolkit is the what if game. Now we've spoken about this before. If you've heard this, I'm gonna just say it again for the people who haven't. Oh my god, I say, like such a teacher just then that is so embarrassing. But anyhow, the what if game? This is a tactic that is taken from cognitive behavioral therapy and CBT cognitive behavioral therapy. Essentially, its whole premise is, if we change our cognitions, we can change our behaviors, and we can change how we see the world and our attitudes and how we act. We can apply this to our acne. Acne and our anxiety around our acne and our appearances always starts with the thought, and the thought always starts with a what if. That's how you can identify an anxious thought. Let's start. Let's play the game. Let's play the what if game. What if they see my acne? Okay, answer the question. If they see my acne, ah, they might think I'm ugly? Okay, what if they think I'm ugly? If they think I'm ugly, they might not like me. What if they don't like me? Well, if they don't like me, then maybe someone else would. Maybe other people won't like me. Maybe they don't want to be my friend, Maybe they won't want to date me. Okay, what if they don't want to date you? Well, well then what Well if they don't want to date me? What they don't want to date you? And that's fine because it doesn't say anything else about the other people who do or don't want to date you. And if your response to that, what if they don't want to date me, what if they don't like me? Is well, no one will ever like me. That is a thought where you can, I think, objectively, look at it and realize that it's irrational, and realize that it comes from a place of fear. The what if game basically looks at our thoughts and proves to ourselves without undermining those thoughts that they are not correct, that they are coming from a place of self doubt, that they are out in a critic speaking very loudly. And it's also speaking over the parts of us that are rational, that are gentle, that are kind to ourselves, that understand that once again, if a person sees you as no more than and what your skin looks like, that is the epitome of a superficial attitude, a superficial attitude towards connection towards other people. You don't want them in your life. You'll be okay without them. I also think it's important to address the mental health perspective of this as well, and the mental health consequences. You deserve to have a very fulfilling and happy decade your twenties, but also a happy life in which you get the opportunities that everyone else is having, the experiences that everyone else is having. If you're finding that your skin is really holding you back, it's really keeping you in an isolated, unhappy place, therapy is amazing for that. I am going to say it again and again and again. Having someone who is a neutral party to just talk through, who kind of is like you're paying to tell you the truth is so powerful. I also think they'll help you see a lot of I was talking to a friend of mine who's a therapist and who does a lot of things about body dysmorphia but also just like appearance based counseling and appearance based work. She was like, the amount of times that I have people, full adults, who are coming into my office and crying because of their skin is ridiculous, ridiculous, noting that they shouldn't be, but like she just never expected that that would be such a point of insecurity for so many people, because once again, we don't talk about it, but this is your reminder. You're a very loud reminder. There are so many other people dealing with this. That's not to devalidate what you're going through. It's more to show you that in this place of fear, this place of anxiety, this place of frustration, you are not alone in that. A lot of people spend a lot of time worried about whether their skin looks good today, what's gonna happen when it looks bad, how they can fix it, how they can have it under control, the doctor's appointments, They need to go to the photos of themselves that they see that they hate. That was a huge thing for me. I hated seeing photos of myself when I had bad acne. There's literally no photos of myself from back then, and I'm really disappointed by that. It's such a shame because I don't get to see myself grow up and grow through that. I don't have that whole chapter in my life. And although it was a hard chapter because I was so insecure, I did make it through. Obviously, here I am, and I think that it taught me a lot about recognizing that your worth is not always tied to what you look like, and that you can fake confidence, even when you have this thing that really is holding you down and making you feel bad about yourself. So I really hope that you have enjoyed this episode. I hope that you've learnt something about the psychology of acne. I'm going to link that study. I think that you should read it if this is something that you relate to, just to understand that there is a whole community of people out there who have similar fears. And it's so fascinating to realize that for how much we stigmatize and create like an aura of shame around acne, it is such a common skin condition, and it's time that we normalize it, but also that we recognize that it's not just physical, it's also mental, and it's also emotional. So thank you again for listening. If there is someone who needs to hear this, please feel free to share it with them, and also feel free to leave us a five star review on Apple Podcasts, Spotify, wherever you are listening. I read all of your reviews sometimes when I'm feel little bit sad, I go in and I have a look and they are so encouraging. So thank you so much for all of the love. I always say this but if you do have an episode suggestion, I get a lot of my ideas, a lot of my inspiration from what you guys the listeners are thinking about, are talking about, are experiencing in your own lives. So suit me a message on Instagram at that Psychology podcast and we will be back next week with another Bisarde