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The homepage of Acne.org looks like a zit cream advertisement thinly veiled as an online resource. Scrolling down, you see a list of recommended readings like “Alcohol and Acne,” ads for the Acne.org regimen, a slew of product reviews, and a gallery of photos of blemish-ridden faces.
Then you see forums — very, very active forums: “Scarless Healing,” formed just one minute ago; “I’m 50 and breaking out all over my forehead,” formed 20 minutes ago; and “Seeking acne scar advice and reccos,” formed 22 minutes ago. And in the footer of the site, you see the rather arresting numbers: Acne.org has 641,596 members, 2,089 of whom are online now, and more than 3.5 million posts. What initially appears to be a sterile, dictionary-like website actually hosts the largest online community dedicated exclusively to discussing acne.
Reading these forums made me feel like a preteen again, surfing anonymous message boards where people discuss seemingly fleeting problems that can be deeply traumatic. Although acne is common and temporary — like many things associated with teenage years — living with it can feel alienating, especially in adulthood. The creator of Acne.org, Daniel Kern, knew this feeling, which is why he started the site.
From their genesis, a couple years after Kern created Acne.org to share his own skin care journey, the forums were always active, something that didn’t surprise him. “Everyone has had acne for a period of time at some point in their lives,” he says. But what did surprise him was how active and populated the Emotional and Psychological Effects of Acne forum became. “I suppose I thought it would be a place where people would exchange scientific info with each other or exchange ideas of what worked and what didn’t work,” he says.
But as anyone who grew up in the early aughts could attest, anonymous forums frequently become emotional oases. Here, conversation extends beyond how acne makes you look and into how it makes you feel. “Acne is devastating psychologically for a lot of people, so I guess I should have expected it,” Kern says.
With more than 360,000 members and hundreds of thousands of threads, this forum is the largest and can get really dark really quickly. (Kern made some topics off limits and pinned a post that includes an aggregation of mental health resources for those who are considering self-harm. Volunteer moderators also monitor the site to make sure all discussions are safe.) Discussions about accepting loneliness and giving up on love are interspersed with diary-like posts from those looking to vent about how acne has negatively impacted their lives.
This forum is also where more of the bizarre “support” is born. In one particular thread, a member posts that he’s worried he’ll never be intimate with a woman because of his acne, to which another member responded telling him to go after “young dumb girls” or “fat ugly girls.” This advice was then challenged by a member who said, “DUDE stop suggesting people to PREY ON GIRLS WITH LOW SELF-ESTEEM. this is a forum for people with acne!!!!!!!!!!” As disturbing as this thread is, advice like this is rare on Acne.org, and unproductive or harmful threads are promptly shut down by moderators.
According to teen and young adult psychologist Dr. Jaclyn Ghamar, even more so than literal scarring, emotional scarring is one of the most lasting effects of acne. “Those who had acne are more likely to have low self-esteem, which could affect them in social situations and when interviewing for jobs,” she says. Even when your face clears, the shame of having acne lingers.
Kern’s battle with acne started at 11 years old and continued through college. He tried over-the-counter topicals and dermatologist-prescribed routines, none of which were very successful. At one point, his acne was so bad he couldn’t even look in the mirror. Eventually, he was prescribed Accutane — the holy grail of those with seemingly incorrigible skin — and his acne cleared up instantly. But after weaning off the medication, some of the same problems resurfaced. Though his body acne had subsided, he was still battling facial acne daily. This is when he returned to a topical that had somewhat worked for him: benzoyl. After doing independent research, he found that 2.5 percent benzoyl, as opposed to the 10 percent he used in his youth, cleared his skin without drying it out. Thus, the Acne.org regimen was born.
With the boom of the internet in the late 1990s, he saw an opportunity to share knowledge about something he considered his “unique talent”: how he cleared his skin. In 1996, he created Acne.org and shared his success story. A few years later, he added interactive features to the site, including a place to write reviews, a photo gallery, and forums. He wanted Acne.org to be a space where people could learn from one another, not just from him. “More minds are always better,” he says. Members of Acne.org are as young as 12 and as old as 50, but most fall into the young adult category.
Dr. Ghamar can attest to the trauma acne inflicts at a young age and the importance of having a safe space like Acne.org. “Acne can diminish a person’s self-esteem and cause heightened anxiety,” she says. “It can definitely increase the likelihood of being depressed and increase suicidal ideations.” But having a community where others are experiencing and discussing the same problem as you can be tremendously therapeutic.
Acne.org normalizes their experience, and the anonymity of the message boards helps them feel less defined by their acne. “Your face is the first thing people see when looking at you, and so if you’re self-conscious to begin with, throw in hormone dysregulation, those with acne feel like no one will ever know them by anything besides their acne,” Ghamar says. But on anonymous online message boards, your face doesn’t really come into play.
Forums are broken up into categories that include Acne and Its Treatments, Lifestyle, and Acne Specifics, all of which contain thousands of threads. The specificity of each discussion communicates the raw desperation of people who have combed through their every habit to pinpoint exactly why they have acne. New members hesitantly post their skin care journeys in hopes that someone will commiserate with them, and for the most part, that’s pretty much what happens.
In one thread, a member shares his story about how vaping caused him cystic acne and users responded with comments like, “This may be the first time I’ve ever been driven to respond to a post like this, but I’m struggling with the same EXACT issue.” Other questions posed include “Are pumpkin seeds good for acne?” “What is more likely causing my acne, high carb or Gluten?” and the more medical “Is it ok to take zinc and Vitamin D3 pills while on Minocycline and tretinoin gel?”
What are probably the most off-kilter discussions on Acne.org, however, are the ones not about acne at all. A forum called The Lounge hosts threads where people share what they’re reading, what movies they’re watching, or anything deemed “off topic.” It’s not as active as the other forums, but it does demonstrate how Acne.org makes people feel — safe. People stop and look around, see what others in the community are up to. A place that I originally thought was a one-time stop is where many have pitched a tent.
Ryan (whose name has been changed) discovered Acne.org when he was 16 and has been a moderator for three years. He was recruited by another moderator who noticed his frequent activity on the forums. Moderators take on the responsibility of viewing user-submitted reports and enforcing the community rules. They also send people who find themselves in mental crisis to the appropriate resources. For Ryan, the site offers instant support for something that is often dismissed, especially by those who don’t suffer from it. Those with acne are “told constantly, ‘You’ll grow out of it,’ and, ‘It could be worse,’ which aren’t all that comforting,” he says. “They need support and advice in the moment.”