A student with cystic acne hopes to empower fellow sufferers by appearing without make up in candid Instagram snaps.

Tara Johnston's acne is so severe that an ignorant stranger asked if she had been “punched in the face”.

Breaking out in painful lumps “virtually overnight” when she turned 16, the# English literature student, who is now 20, experiences such virulent outbreaks that it even hurts when she smiles.

Enduring confidence-shattering taunts down the years because of her skin, last year Tara made the brave decision to appear bare-faced on Instagram, instead of camouflaging her spots with make up, hoping to embolden other people to follow suit.

Tara's skin during a flare up

She said: “One thing people don’t realise about acne is how much it can affect your mental health. You can get past the way you look, but you’re still reminded of it because the condition causes constant pain.

“Things like talking, smiling and eating all hurt – but they’re also things I can’t avoid. I did feel vulnerable putting myself out there on Instagram, but it’s been empowering to help others.”

Diagnosed with cystic acne aged 17, which the NHS describes as pus-filled lumps that look similar to boils and can cause permanent scarring, Tara, who works part-time in a bar, remembers first developing “a smattering of spots” when she was 13.

“They almost looked like boils and were on my chin,” she said.

When the growths became infected, Tara’s doctor prescribed antibiotics, which cleared them, leaving her with relatively clear skin for the next three years.

“My skin was never great, but it was more or less just normal teenage spots,” she said.

All that changed virtually overnight, when she turned 16 and joined sixth form.

She said: “My whole face broke out. I was given antibiotics again, but they didn’t make much difference, so I was referred to a dermatologist and told I had cystic acne.

“It’s very different to what most people think of as acne. With the odd spot, you can get on with your day and not think much of it, but cystic acne impacts everything.”

She added: “It’s painful and takes much longer to go away. When I first broke out, I had these two lumps on my forehead that didn’t go away for nine months.”

She said: “At school, people didn’t say much about it. It was more what was going on in my head that was the problem. I’d be talking to people and feel worried they were staring at me.”

She continued. “As I’ve got older, people have said some nasty things, though. I was in a shop last year during a bad flare up when a lady said, ‘What’s wrong with your skin? I feel really sorry for you.’

Tara's skin during a flare up

“Another time, I was at work, in a bar, when a customer asked what had happened to me and told me, ‘I thought you’d been punched in the face.’

“I awkwardly laughed it off and went back to work, but it can be difficult not to let it get to you.”

Over the years, Tara has tried different antibiotic treatments, including Roaccutane – a drug often used as a last resort for severe acne, due to the risk of serious side effects, including dry skin and lips, increased sensitivity to sunlight and anxiety.

She found it very helpful, but it is so strong that prolonged usage is not recommended. She said: “My skin cleared up, which I hoped would be for good – but once I stopped using it, the acne came back.

“That was really disheartening. I really thought if anything would work, Roaccutane would.”

Aside from cold weather, she has been unable to identify any triggers for her break outs.

But, she is currently awaiting tests to see if the acne could be linked to the hormonal condition polycystic ovary syndrome (PCOS), which the NHS says can have symptoms including irregular periods, thinning hair, oily skin and acne.

“If it is PCOS, then at least I’ll have an answer, but if it’s not, it’s back to trying to work out what it is that triggers these break outs,” said Tara. “I have to be really careful with the skincare I use. I stick to gentle products that won’t clog up my pores.”

“In the past, when my skin was bad, I would layer on foundation in an attempt to hide away,” she said. “But now I feel more comfortable going make up free – plus I know that clogging up my skin with foundation isn’t going to help.”

In October last year, Tara experienced a severe break out, which she found particularly upsetting, as her skin had been clear for around eight months.

Tara

This time, instead of hiding, she decided to use her experience to help others – launching an Instagram account dedicated to her acne journey.

Now boasting more than 700 followers, she regularly shares honest, au naturel photos in a bid to normalise acne and shine a light on the reality of the condition.

“I never expected my page to take off,” she said. “At the end of the day, acne is normal, and there are so many people out there living with it. It can feel a bit daunting to show myself off to the world like that, especially on Instagram where everything is so edited.

“But I have connected with so many other people who know what I’m going through and get messages all the time to say my posts have helped. The other day, I was tagged in someone else’s barefaced selfie, and they said I’d inspired them to do it. That was an amazing moment.”

Tara, who continues to build her Instagram, while trying to avoid potential acne triggers, says the mandatory wearing of masks has been tricky – resulting in spots forming around her mouth and chin.

“I’m still happy to wear one, but it can be difficult,” she said. “Obviously pubs are closed again now, but when I was working between lockdowns and would wear one all day, I’d notice spots around where the mask had been.

“I did apply for one of the lanyards that show I am exempt, but I do worry people may think it’s a bit of a petty reason. I would love people to understand more about cystic acne and just how much it impacts your daily life. It’s much more than just a couple of spots.”

By sharing her story, Tara hopes to encourage fellow acne sufferers to embrace their skin, as well as raising awareness of the condition in general.

She concluded: “There seems to be a stigma around having acne. People assume it comes from having dirty skin, when in reality, it can’t be helped.

“I’d like to see people have a little more understanding, and not ask unnecessary or rude questions. There is nothing I can do about having acne, so I have learned to accept it, and really want to help others do the same.”