Nothing scars the human psyche more deeply than severe acne during the teenage years. Too many of us believe that a boy wouldn't love you because of the shape of your nose, the kink of your hair or the curve of your hips - but those are things that, with careful discipline, can be shaded, masked, smoothed and straightened. It might take hours, but it can be done.
But skin? Skin is meant to be what protects the body, not makes it vulnerable. It is the jacket we wear for others. The thing we look at when we are trying to decide whether or not to love someone and it is the thing someone sees, first, when they are trying to decide whether or not to love us.
If your skin is good, you don't even think about it. If it isn't, there is a constant liturgy of questions: Can I take off my shirt in front of everyone when we go swimming? Eventually, we might get married and she'll see me naked. I'll have to let him touch my back when we're making love. In his memoirs, writer John Updike openly admits that he married the first woman who loved him in spite of his skin.
I don't think teenagers appreciate the dramatic improvements in over-the-counter cosmetic treatments for acne. Back in my day (which doesn't really seem like it was that long ago), there really wasn't much you could do. A trip to Walgreen's might yield a giant-size plastic bottle of Sea Breeze Antiseptic, Clearasil with .05 percent benzoyl peroxide and - maybe towards the end of high school - Neutrogena with salicyclic acid.
Our parents - who had to endure their zits with no help at all - patted us on the back, assuring that the acne would eventually disappear. They warned against the traps of vanity, and gentle suggestions that, in the meantime, perhaps we should consider avoiding greasy foods and chocolate. Friends with more-than-pimples and helpful parents went to dermatologists but, for the most part, came back disappointed. You had choices, but they weren't good ones. In the 80's and 90's, there were antibiotics and there was Accutane.
Missy was the first person in my high school to try Accutane. She went through a phase so awful it made you crave the burqa. At lunch we'd watch the skin peel off her face in chunks (literally) and, because we loved her, we sat through it and didn't say a word. However horrible it was to watch, we knew how much worse it was for her to go through it in front of everyone. Our inner trolls were all right there, sitting at the lunch table right next to us, talking loud enough so that we could easily overhear what they were saying.
There has to be an answer, we told ourselves. I'll try harder. I'll buy this new thing. I'll drink more water. A just and loving universe would create a solution to this problem. Luckily, Missy pulled the arm of the cosmetic slot machine and won.
In adulthood, when the pimples are [mostly] gone and the science of dermatology can put our kids' zits on the moon, the experience of severe acne still bubbles under the surface. Give a 40 year-old a couple of glasses of wine and mention "high school" and you'll find that the scars are as tender as if they were made yesterday.