There is a culture of shame and stigma around acne, and though adolescents can and do face bullying and stigma of their own, there are different social factors at play when your skin erupts later in life. "It's hard enough to talk about your experience when you're a teenager, but it's intensified for adults because in many cases you're high-functioning, you're in control of your life, you're used to finding solutions for your problems, but acne is not always easy to solve," Traube says. "It doesn't always respond to treatments the way that it 'should,' so people feel a massive lack of control, and then they internalise that and beat themselves up over it and think something's wrong with them and they've caused it." In turn, he adds, those thought patterns make people less inclined to do things that could actually benefit and enrich their lives in the long run, like going on a first date or pursuing a job opportunity.