There’s a particularly addictive strain of skincare videos on social media that scratch a fold deep in the viewer’s brain. In 45 seconds or less, these videos centre a glistening cheekbone, the glide of a slippery liquid over a smooth jaw and the brushed glass of a bottle of serum. The subject turns her cheek in a practised way to show the glimmer of sun on her skin, which is as slick as that of a dolphin.

I’ve watched dozens of these videos in bed while falling asleep, squinting in the dark. I find them irresistible.

Over the last few years, an emphasis on flawless skin has superseded the trend of heavy, air-brushed foundation, in effect merging the skincare industry and the make-up industry into one. It’s no longer enough to cover up imperfections; now, we must eliminate them completely. Skincare brings in more than $90 billion (£74bn) in sales worldwide each year; the global skincare market is expected to grow at a rate of 6% year over year (YOY) from 2022 to 2027. Every few months, a new synonym for dewy reigns supreme: glass skin, jello skin, donut skin.

For those who suffer with acne, this shift is not only stressful, it is impossible. It feels like a moral condemnation, a collective demand: if you have acne, fix it. You are not supposed to look like that.

But some are choosing a different stance: you don’t need to fix your acne at all.

Maia Gray (@its_just_acne on Instagram) is one of the faces of the acne positivity movement. She posts unfiltered photos of her own skin coupled with encouraging captions. Under a photo of her temple and cheek dimpled with cystic acne scars, Gray writes: “Sometimes it just happens. Sometimes it’s what skin does. Does it make you any less beautiful? No.”

“For the longest time, I just felt so insecure,” Gray tells Stylist. “In putting myself out there, although I still get hateful comments, it doesn’t affect me as it did. And I think that’s progress.”

Gray has had acne for much of her life. From the age of 13 to 18, she endured bullying from her peers. In high school, Gray said, she went to the girls’ bathroom to find her own name scrawled on the door of the cubicle: “Maia is ugly.”

“From that moment, I felt so insecure and alone because I didn’t have very many friends during school,” Gray said. “I felt like I was the only one with acne.”

Gray’s page is dedicated to disproving that assumption. Lots of people have acne, and they lead fulfilling lives: she is one of them. Gray posts pictures of herself unedited, unfiltered and often without make-up. Though the concept of the page is simple, Gray seems to be doing what most are unable to do: display her skin without apology and decline to offer a solution. In doing so, she shoulders the burden of so many young women who will grow up relentlessly exposed to perfection – and will thus learn to expect it in themselves.

To be a woman on social media is to be inevitably caught up in that cycle of consumption and self-critique.  

At the end of April, dealing with a bout of post-inflammatory hyperpigmentation and eager for a dopamine rush, I bought a 30ml bottle of vitamin C serum from a Korean brand for £33 on Amazon. I’d seen the product in a TikTok video. The serum claimed to do the things all vitamin C serums do: decrease dark spots, soothe inflammation, make your bathroom smell like orange juice.

I pumped a dollop of the stuff into my hand, massaged it around my face with the technique that many videos had instructed me to use in order to increase lymphatic drainage and waited to see the results.

All throughout that month, I broke out. 

The globalisation of beauty trends and the migration of Korean skincare to the US, UK, and beyond, is changing the way we think about our faces in the West. Most significantly, it is shifting dermatological beauty standards away from the biological and into the cryptid.

In Korea, this obsession has reached a fever pitch, with the US and the UK not far behind.

The Westward creep of Korean culture is known as the Korean Wave (or Hallyu). NPR Ted Talks Daily host and former Seoul bureau chief Elise Hu writes about the effects of Hallyu on beauty culture in her book Flawless.

I spoke to Hu about her thoughts on the skincare industry over Zoom, while I was breaking out in small surface-level spots all over my right cheek. I hoped that Zoom’s retouching filter would smear the texture of my face into something resembling smoothness. I was also completing my sixth month on spironolactone, a medication typically used to regulate high blood pressure that is also surprisingly effective at treating hormonal acne in women. It was working with an agitating slowness. Actually, it wasn’t really working. My dermatologist had advised me to try Accutane. 

In Flawless, Hu discusses the ever-present spectre of ‘lookism’ in Korean culture. While living in Seoul from 2015 to 2019, she observed the way that the ever-heightened beauty standards placed undue pressure on Koreans.

“It was a real bombardment of a physical ideal,” Hu said.

Hu told me that she was first struck by the overwhelming presence of female faces on advertisements and billboards and products, all with similar features: “Long luscious hair and big round eyes and feminine jaw lines and perfect high noses and this porcelain white skin.”

In her book, Hu explicates further: “The beauty imperative felt omnipresent and overwhelming, with an eerily familiar ideal female face following me wherever I went… It’s the Asian variation of a global ideal: the It Girl. The girl’s face is always dewy, unblemished, and unwrinkled, her eyes perpetually bright, her forehead uncreased.”

Though Hu is Taiwanese American, she still felt pressure to conform to the Korean physical ideal. But her freckles, which many Koreans advised her to remove, would stay.

“That’s something where I was like, ‘You know what – no. No.’”

Freckles – which have emerged as a desirable beauty trend in the West – are a fitting example of the way that traits float in and out of the accepted physical ideal. A flaw in one part of the world may be considered a virtue in another. Part of the unremitting power of the beauty industry is its ability to pinpoint latent flaws in the consumer – to condemn her to eternally resolve a discrepancy that can shapeshift at any moment.

“The industry continues to thrive on this notion that there is something wrong with us and you can buy or consume in order to fix it,” Hu said. “The target is ever-moving in order to keep people consuming.”

“The notion of physical beauty and striving to improve ourselves can also be really deeply human. What I think gets dangerous and harmful is that if we conflate all of our worth, and our morality with our physical appearance… we are overly conflating what our bodies look like with ourselves and who we actually are, which is a [much] more nuanced and complex and spiritual concept.”

I asked myself: who was I with acne? Was acne a part of me, or was it a parasite, a usurper of my true self? If I had acne forever, could I still be attractive? Could I ever be beautiful?

I knew that few could answer this question for me – a partner or a friend would always be too lovingly biased, an aesthetician too exacting. So I chose a dermatologist.

I’d come to see Rikki Korkowicz, a dermatology physician assistant, a month earlier to increase my spironolactone dosage from 50mg to 100mg. It was a diuretic, and I took it at night, so I woke up every morning with a violent urge to urinate and a compulsive desire to examine my face.

At our most recent appointment, Korkowicz had advised me to try the higher dosage for one month and note any improvements; in the meantime, she’d ordered a full lipid panel, a pregnancy test and a follow-up check-in to start me on Accutane. 

When I called the office of Schweiger Dermatology Group, I explained to them that I already had a follow-up appointment, but that I wanted to speak to Korkowicz not as a patient, but as a reporter.

“Skincare products have exploded in the last few years,” Korkowicz told me. As a result, many patients have become “married to their 42-step skincare routine and will not have it wrestled away from them”.

A few years ago, Korkowicz said, patients would express loyalty to a small handful of brands. She noted that Ponds was frequently cited.

But skin culture has shifted. Now, Korkowicz said, patients are inundated with products – and they’re bringing them to their appointments: ‘I put this along my hairline; I put this in my eyebrows; I put this around my eyes; I put this on my lips, the rest of my face.’

“The products and the consumption of the products is definitely up 1,000%,” Korkowicz said. “I can always tell what is popular on TikTok.”

The issue, Korkowicz told me, is that patients are not always looking to solve basic skin gripes and concerns. Now, they want to eliminate all traces of imperfection. Just what defines imperfection is often dependent on what their feeds are showing – whether that be a new eye cream or preventative Botox.

“Obviously if there’s anything that we can do to make patients feel better about themselves, we want to do that – that’s part of medicine,” Korkowicz said. “But it’s tough to hear… that people are upset by what they’re seeing when they look in the mirror.”

Ultimately, dermatologists can only do so much: despite the many advances of modern medicine, complete stasis is off the table. Even if we could tune our internal processes to optimal efficiency, we cannot control the unpredictability of living itself.

“Everything is changing all the time,” Korkowicz said. “The composition of tap water changes, the quality of our air changes. Our living environment changes. Our stressors change. We are constantly ageing; our skin is constantly ageing.”

The race against time – against change – is genderless. But women are particularly inured to the struggle of stopping the clock. I have always begrudgingly seen my own body as an incomplete form – something that can and will be more attractive if I can only apply the correct amount of effort at the right time. Now, at the age of 24, I am starting to see how that form can be a handful of water, rapidly disappearing.

How do we reap the benefits of the beauty game, while also not letting ourselves be carried away by the obsessions that it engenders?

Hu suggests that instead of shirking beauty standards completely (as this is impossible), we should play in as much as we feel is necessary – and prize efficiency over labour. To minimise suffering, we should change the things about ourselves that we find impossible to ignore – once, and never again. Then we can, hopefully, spend the rest of our time on the kind of work that actually merits our attention.

“The more I think about aesthetic work as labour, whether it’s toning or plucking or waxing or dyeing,” Hu said, “the more I’ve changed my practices to try and find things that are more permanent, that I don’t have to return to again and again.”

But what if you can’t get rid of the things about your appearance that disagree with you –what if you have no choice but to accept them?

Isotretinoin, or as it is more commonly known, Accutane, is currently the closest thing that we have for a cure to acne. But while Accutane has been called a miracle drug for many acne sufferers, it’s not a solution that works for everyone. It wasn’t a solution for Maia Gray, who has an auto-immune condition known as Ehlers-Danlos syndrome (EDS), which primarily targets connective tissue and the collagen that supports it. The symptoms of EDS include abnormally flexible joints, and stretchy, fragile skin that bruises easily and is slow to heal.

Apart from its myriad other side effects, Accutane is known for one other key symptom: severely dry skin. Gray’s Ehlers-Danlos exempted her from taking Accutane – the dry skin period necessary to complete the drug’s full course would agitate her already sensitive skin.

Instead of perpetually fighting her acne, Gray chose to embrace it – to acknowledge the face she bore to the world as her true one, and not live beholden to the fact that it might look slightly different in a few months. 

By doing so, she was unknowingly giving her users permission to live without a sense of shame. Gray said that young people have told her that her account prevented them from taking their own lives.

“I can’t advise anyone, but all I can say to them is you’re not alone,” Gray said. “And if ever your skin gets you down, just look at my page. You can see that you’re not alone in this.

At the end of my most recent dermatology appointment, Korkowicz’s assistant handed me a small cup for a urine sample and a blue bag in which to put it. I would have to go through this process once a month for the following six months to confirm that I wasn’t pregnant and could continue taking Isotretinoin.

I sat on the toilet and positioned the cup in the bowl, shaking slightly and fighting tears. I had taken two buses to get here, and I was dehydrated, and I was worried that the medication would make me horribly unattractive to the opposite sex. I imagined explaining to potential partners that I would be gorgeous, I promised, if only they could survive the winter with a hag.

When I returned from the bathroom, the assistant handed me a clipboard with a series of acknowledgement forms and a pen to sign. I read them through: I would use two forms of birth control at all times or abstain from sex while taking this drug; if I became pregnant and saw that pregnancy to term, my child could have severe birth defects; I would not drink excess alcohol so as to avoid liver damage while taking this drug; I could become severely depressed and/or suicidal while taking this drug.

Check, I wrote. Check, check, check.

After I signed the forms, I scheduled a follow-up appointment and took the elevator down to the first floor. I walked into the bracing sunlight, letting it hit my cheeks, letting it age me. I thought about the skin I would have come spring. 

This article is part of Skin Freedom, a Stylist Love Women series that aims to champion the reality of women’s skin in all its glory.

Images: Getty