How I lost my perfect marriage and became suicidal over severe facial acne

Acne is a condition where eruptions (often nasty looking) appear on the skin – usually on the face; and thus conspicuous under any amount of light. The whole biological process is much more complicated than that, Dr Hashim Kaderbhai, a dermatologist at MP Shah Hospital, says.

“The skin is populated with pores. These pores have sebaceous glands which secrete sebum – oily substance – to keep the skin moist and supple. Acne occurs when pores get clogged with sebum. Bacteria and dead cells then build up; causing an inflammation from under the skin,” Kaderbhai says.

Acne, he adds, often affects the patient’s self-esteem. It mostly affects of the body with lots of sebacious glands on the face, upper back, chest, shoulder and upper arms. However, Kaderbhai notes, when the average person seeks medical help, it is almost often for face acne - also known as Acne Vulgaris.

Lucy Kiriga*, 38, knows this only too well. Kiriga first suffered from acne when she was an adolescent. “I was not really alarmed at first,” she says, “I felt that it was just for a short while then they would go away.”
Three years down the line, the acne had gotten worse. “They were bigger and more prominent. They made my face rub like gravel,” she says.

By the time she was joining college, she had done a good job concealing her distress. As her body blossomed into womanhood attracting interest from men, so did the attention on her own face.

“In my first year in college, I couldn’t stay still while talking to people. I had to move my head a lot; hoping that by doing so, no one could see the pimples that had colonised my face,” she says.
At times, she wore a wig with a thick bob over her forehead. And when she could, a hat with a deeper brim.
Kiriga would meet a man who loved her in spite of the acne. They married and started a family. Eight years later, they divorced and went separate ways.

“I have had time to think about what exactly transpired but I think I never accepted that he could love me,” she says.
In the lead up to the divorce, Kiriga had long suspected that her husband was cheating on her. The fear of abandonment was thick and heavy in her imagination that she often went into fits of rage against him.
“In reality, he was not cheating. I just did not believe that he could remain committed with many girls out there having smooth faces.”

Just as the divorce was taking place, she recalls, her mental health took a turn for the worst and she contemplated suicide.
“I wouldn’t say that acne had everything to do with it but it was a fundamental part of it,” she says.
Charlene Kinyanjui, like Kiriga, first got affected by acne in her adolescent years. “I was about 14 years old,” she says.

She would pop them and they would come back with a vengeance. “It is highly advisable that you do not pop the acne as this usually causes more to form,” Kaderbhai says.
In 2015, Kinyanjui gave birth to her firstborn and the acne flared up. “For the first time, I experienced an extreme version of acne: the big painful cysts that pop – exuding pus and whitish debris,” she says.
Her face reddened. Her skin stung. And her anxiety skyrocketed. “My self-esteem took a beating,” she says. “I lost my confidence.”

An alumnus of Moi Girls Isinya, Kinyanjui had found herself working in the film industry. She felt awkward in meetings where everyone seemed to notice her face. She hated being asked what was wrong with her face. Yet, she could register the question even before it left the mouth of a discussant.

“I hated it. I did not want people noticing the acne before anything else. I was already uncomfortable with my face. Being asked just compounded my discomfort,” she says.

Over the years – since leaving high school – she had used hundreds of cosmetic tubes to address the acne. But none seemed to solve the problem.

When her face broke out following the pregnancy, Kinyanjui had grown cynical of cosmetic products in chemists, boutiques and even supermarkets.

“One time, my hairstylist asked if he could introduce me to a lady who sold skin care products that had worked for someone else. I was skeptical. I didn’t even believe him. But my acne got worse and at some point, I told myself why not try – what could I possibly lose?” she says.

Enter Dr Mercy Wambui Kamara, an environmental geneticist and CEO for Exuviance Professional in East Africa.
“She did not trust anything and anyone,” Kamara says of Kinyanjui. “I asked her to trust me with her face if she needed my help.”

Kamara herself suffered from acne for 16 years – something that eventually dictated her career path.
She says: “I was always the girl who cared about how she looked. And acne took a good amount of my confidence away. It was not how I wanted people to see me.”

I ask her why it mattered how people saw her.
She says: “It was not so much about what people see but rather how I feel about myself. How you feel translates into how well you do things, your relationships and drives you to want to succeed.”

Kamara, who has also studied skin care, prescribed an acne regime that included a clarifying cleanser (to unclog the pores), a toner (to take out dead skin and debris), a brightening serum (to stop overproduction of dead cells), and a day crème with sun protection factor (SPF).
She also asked Kinyanjui to do one more thing: ea

healthy. “Because diet is an important factor in controlling acne. Sugary foods and foods high in the glycemic index, as well as milk, have been shown to exacerbate acne.”

In the first two months, the acne on Kinyanjui’s face persisted and seemed to even worsen. 
But afterwards, she entered a period of skin restoration that eventually saw her face achieve the premium texture of a baby bum.

“I can’t explain to you the relief: the fact that I could meet people and no one would ask what was wrong with my face,” she says.

Catherine Mbau, a counseling psychologist, points out that both men and women, boys and girls, are affected by acne related self-esteem issues equally.

“We look at each other in the face. And so, acne is a direct assault on one’s self esteem,” she says.
Low self-esteem, Mbau notes, is a precursor to depression: which in severe cases can lead to suicidal thoughts, or worse, actual suicide.

Dr Kaderbhai says that acne can be treated using combination therapy aimed at stopping pore blockage, bacterial build up and deposition of dead cells and debris. Kamara cautions that acne is chronic and easily recurs when the patient relaxes from advice given by the professionals.

Acne, Kaderbhai says, could come about as a result of genetics or hormones. Kamara says bad food, stress and bad skin care routine exacerbate the disease. Acne, the dermatologist says, affects people within a spectrum – from mild to severe.

Not all patients, however, will suffer from diminished self-esteem. Some, like Purity Mukami, a financial analyst in Nairobi, do not pay much attention to it.

She says: “My self-esteem hasn’t been affected. But I do not like the acne because it makes me uncomfortable. And so, whenever possible, I seek treatment. I still do a few things here and there to control it.”
Kamara and Kaderbhai advise that an acne patient should avoid self-medication and first seek a professional opinion.