My acne was never severe. It never covered all or most of my face and it never left me scarred and pockmarked. For this I am tremendously grateful. Every day when I look at my face and see the pimples that I do have, I am silently relieved not to be one of the small minority of people whose faces are ruined by it.

Even though I was never an extreme case, for the last 16 years I have always had at least one pimple. Sometimes it’s many more, like eight. They’re always in different stages of recovery, sometimes normal, sometimes whiteheads, sometimes blackheads (depending on what part of my face), sometimes on different parts of my body, but they’re always present.

I’ve called it “moderate but persistent” or “mild but persistent” acne and I still think those terms describe it best. When I was a teenager, I used every type of topical treatment known to medical science. Creams, gels, you name it, I tried it. Over the counter, prescription, only available in third world countries – it’s all been on my face. Retin-a, Differin gel, the stuff made from Dead Sea sulphur – gross. Then I moved on to the antibiotic treatments. They destroyed my digestive system (not that it wasn’t already destroyed) and gave me terrible diarrhea.

Eventually, when I was 17 and 18 I did two cycles of Accutane, the absolute last-ditch weapon used by dermatologists on patients for whom they’ve lost hope, the medication with so many side effects that they basically come out and tell you never to use it. My face practically peeled itself completely off when I was on Accutane. The acne faded away. Then I stopped the Accutane and the pimples came right back. I’ve never heard of anyone whose acne returned, as strong as ever, after two cycles of Accutane. Neither had my family physician or my dermatologist.

For the past six years or so, I’ve been following versions of the acne.org regimen. I wouldn’t exactly say it works, but I would say that it certainly doesn’t irritate my face or make the situation any worse than it already was. Perhaps it even does help a little. I’ve also lately tried eliminating certain foods from my diet to see if one of them might be triggering outbreaks. In addition, I drink at least two liters of water a day to keep everything flushed.

I have a hunch that the acne is tied to my endocrine problems. It’s possible that my Hashimoto’s could have some effect on my testosterone levels. But the last time my testosterone was checked, in spring 2004, my doctor said it was normal (I don’t know if she meant normal for an average person or normal for a 23 year old boy). But I also know that acne is largely genetic. My mom once said that my dad had it when he was growing up.

It would be nice to have clear skin for once. I am average in appearance, and when my acne is bad it makes people not pay attention to me – but when it’s not so bad, I can always get girls to talk to me. I often forget how it is, or don’t realize that I have a new pimple, and embarrass myself, and I am too old for that to be happening. Acne is for teenagers – I put in my time and now I want it to go away!