For the majority of people, acne comes, stays for a month or so, and then passes peacefully away. There's some looks and comments to put up with but, for the most part, the whole experience is painless. But for those of you who are unlucky, the comments and behavior toward you are cruel. This is more likely when a mild outbreak refuses to clear up, or the outbreak is more severe. Then those whose mouths are bigger than their brains will suggest you have hygiene problems or start treating you as if you have leprosy or some serious contagious disease. This can cause emotional scarring. No matter how you prepare yourself when you leave home every morning, there's a sense of dread you can never shake off as you approach school or work. It passes beyond self-consciousness. It becomes a fear of being seen in public. Left untreated, this can become social anxiety disorder or, in the worst cases, agoraphobia. In theory, schools and colleges are supposed to have policies in place to deal with bullying. Workplaces are supposed to have codes to deal with harassment. But the reality is that pieces of paper cannot stop a group of fellow students or colleagues from making your life a misery. Because your emotional health is at risk, this is not a time to be slow in coming forward. You need to get protection and support. Failure to confront the problem now simply stores up the problem for you in the future.

When it comes to physical scars, only a small number of people have levels of inflammation or skin irritation sufficiently severe to leave blemishes as the acne heals. No one is sure why some people scar and others do not. It seems to be something to do with the way the collagen in your skin reacts, causing a change in the texture or coloring of the skin around the site of the inflammation. This can show as small pits or holes in the skin. These are not usually deep and have smooth edges, but one variety is called "ice pick" where the hole is deeper, has steeper sides, and has more defined edges. Or there can be slightly raised, thicker scar tissue on the chest or back. These scars are more common on those with darker skin so if you are African American or Asian, you should have early treatment to reduce the risk.

Physical scars can be a permanent mark, but you can have them removed by dermabrasion - a procedure that removes the top layers of skin. This can be painful for ice pick scars and a local anesthetic is used. If deep abrasion is required, there can be risks of even further damage to the skin, so take proper medical advice before consenting to the treatment. This should emphasize the importance of early treatment to prevent the acne from growing severe. If the other treatments fail, Accutane will restore unblemished skin. But do remember the risks. Do not use Accutane for more than three months in any one session. If you can have children, take every possible precaution to prevent pregnancy.