Acne has left me with no self-esteem – a woman shares her story & a dermatologist shares skincare tips

Woman looking for pimples on her face.
Woman looking for pimples on her face.
Adene Sanchez/ Getty images

Living with acne while in your early twenties can be daunting, especially if you thought your skin would clear the minute you left your teens.

 Zolakazi Nqayi, a 22-year-old student who’s studying farming management in Cape Town, tells Move! about her long struggle with acne and the scarring it has left on skin. She says she’s tried every skin product you can find in the store.

Read more| Take care of sensitive skin

 “Puberty struck while I was in my first year of high school in the Eastern Cape and I started to develop pimples on my face. Yet it was only in Grade 11 that my acne became so bad that my mother started buying me skincare products to help combat it,” Zolakazi explains.

 “When I moved to Cape Town, my sister bought me facial products recommended for teenagers who have acne, but that didn’t work either. So we tried different ones that were advertised on TV, but nothing worked. Even when the pimples would get better, I’d be left with terrible dark spots and scarring from the acne and nothing worked for that.”

Zolakazi Nqayi
Zolakazi Nqayi's acne has been very difficult even after using multiple skincare products.
Zolakazi Nqayi / Supplied
Zolakazi Nqayi
Zolakazi Nqayi's acne has been very difficult even after using multiple skincare products.
Zolakazi Nqayi / Supplied

While detailing her problem, Zolakazi mentions nearly every cosmetic product recommended for pimples, and she says none of them actually worked – some would help for a couple of months but then the acne would come back worse than before.

‘My self-esteem is very low’ - Zolakazi

“I don’t have self-esteem – even when I dress up and I put on makeup, the pimples are always visible and clear to see. I no longer like hanging out with my friends, even before the lockdown happened my friends would make plans to go out and I would refuse. I also don’t like taking pictures with my friends, I have friends who are light skinned and here I am, I’m dark with pimples. It has got to the point where I look down on myself. I try to work on my confidence, but I don’t seem to be improving.

“Now, to take care of my skin, I steam three times a week. I currently don’t have a skincare routine using products.

“I would love to have clear skin with all my heart, I think that would change my life. I would have more confidence in myself. I don’t want to be light skinned, but I want to have a beautiful dark skin that doesn’t have acne and scarring. I just want to have clear skin,” Zolakazi says.

Dr Nomphelo Gantsho, a dermatologist in private practice, says if acne persists one should see a dermatologist.

“It is important to be patient when you’re dealing with the skin problem. One needs to use the products consistently,as told– skipping daily treatments will make it to take longer for the ingredients to work. Patients must stop trying every product recommended to them as each person’s skin is different. Everyone has different needs. What works for your friend may not work for you,” Dr Gantsho explains.

“Acne scars are formed when a breakout penetrates the skin deeply and damages the tissues beneath it. The scar often develops within the dermis, where the original acne-caused inflammation formed,” she explains.


There are different types of acne scars and each is treated differently.

Atrophic or depressed scars

Atrophic scars are most common on the face. A depressed scar sits below the surrounding skin. They’re formed when not enough collagen is made while the wound is healing. There are three types of atrophic scars:

Boxcar–These are wide, U-shaped scars that have sharp edges. They can be shallow or deep. The shallower they are, the better they respond to skin resurfacing treatments.

Ice pick–These are narrow, V-shaped scars that can go deep into the skin. They can look like small round or oval holes, like a chickenpox scar. These are the most difficult scars to treat because they can extend far under the surface of the skin.

Rolling- These are wide depressions that typically have rounded edges and an irregular, rolling appearance.

Hypertrophic or raised scars

These are common with chest and back acne. They stand above the surface of the surrounding skin and are caused by too much collagen production during healing.


Before treatment to remove scarring can start you first have to get rid of your acne since new breakouts can lead to new acne scars.“Acne scars are difficult to get rid of. Consult with adermatologist for a treatment plan. It’s best to treat your acne as soon as possible. To avoid scars,do not pop your pimples,” she explains.

These are some of the treatments that can improve acne scarring. All treatments must be repeated to see results:

Chemical peelshelp promote collagen production by destroying old collagen fibres to make way for new ones. Peels minimise scars.

Microneedlinginvolves rolling needles over the skin to stimulate collagen and elastin. This is aneffective technique for acne scarring.

Surgery– Punch excision and submission.

Soft tissue fillers–Injecting hyaluronic acid, collagen or fat under the skin into the scars can fill out and stretch the skin. This makes scars less noticeable.

Laser resurfacingimproves the appearance of the skin.


Acne can be caused by the following factors:

• Excess oil production

• Hair follicles obstructedby oil and dead skin cells

• Acne bacteria (especially propionibacterium acnes)

• Familial tendency

• Excess activity of hormones (androgens).

“Acne is most common amongst teenagers, though it affects people of all ages. Teens get acne because of the hormonal changes that come with puberty.

“Adult acne is defined as acne that develops (late-onset acne) or continues (persistent acne) after 25 years of age. The disease is more common in women. The clinical features are quite specific: inflammatory acne in the lower facial region or macrocomedones (microcysts) spread over the face,” Dr Gantsho says.


Dr Gantsho’s tips for those struggling with acne are:

  • Wash your face once or twice a day with a mild soap and warm water.
  • If you wear makeup or sunscreen, make sure it’s labelled “non-comedogenic”or “non-acnegenic”.
  • When you’re washing your face, be sure you take the time to remove all of your makeup so it doesn’t clog your pores.
  • If you use hair sprays or gels, try to keep them away from your face as they can clog pores.
  • If you have long hair that touches your face, be sure to wash it often enough to keep oil away.
  • Wash your face after exercise to wash away the sweat and dirt that may clog your pores.
  • If you look in the mirror and see a pimple, don’t touch it, squeeze it, or pick at it.This can cause more inflammation and can introduce more bacteria to your broken skin and prolong the length of the breakout.Picking at pimples can leave tiny, permanent scars on your face.

 “If over-the-counter medications have failed to clear up your acne,including your acne scars, it may be time to make an appointment to see a dermatologist. They can help by prescribing stronger medications to treat your acne. These may come in the form of topical treatments or oral tablets. Some prescription acne products make your skin more sensitive to the sun, so be sure to wear sunscreen daily,” Dr Gantsho says.

“Acne scars can be frustrating, but there are many treatments that can make them less noticeable. Most scars are permanent, but a dermatologist can help you find the right treatment to help reduce the appearance of your scars,”Dr Gantsho adds.

More on what you can do to reduce your acne scarring visit