Melissa Todd: Out damned spot…

Costume of choice

I suffered horrific acne for 20 odd years. Not the odd annoying pimple: proper, huge, blistering, scarring, dribbling, lesions. Then I found a dermatologist kind enough to prescribe me Roaccutane, which is an expensive last resort, a beast of a drug, with jaw-dropping, life-altering side-effects, but nonetheless, for me a total Godsend. The wretched acne gasped its last. But I’m left with scarring, all over my cheeks and chin, which I’m forever trying to fix. I dread natural light, wear stage make up every day.

I know, there are worse problems to have. But I’m committed to having no problems at all, which is why I signed up for a course of micro-needling. I know, I know,  I am vain and shallow. In fact, I am now considerably shallower, having had several inches of skin scraped off my face. Judge away. My self-esteem is at an all time high: I can handle it.

You turn up at a clinic and have a sickly-smelling anaesthetic cream smothered thick on your features. Then you must sit for 90 minutes waiting for it to take effect. Remember your book. Remember too your best apologetic grin when children bumble into the waiting room, scream at your mummified visage and run back to their parents, sobbing.

At last your therapist calls you back to her cubbyhole office. You settle yourself anxiously on the couch, trying to think of small talk, while she ferrets in her bag of tricks to extract a medieval torture device. Imagine a thousand tiny needles on a tiny little doll’s house paint roller. It hurts. The anaesthetic may make some small difference; certainly I wouldn’t want to try it without; but Lordy, how it hurts, all the same. The roller squeaks, the needles saw into your flesh: the useless anaesthetic stinks and mocks with its stink, adding to a vague, ominous nausea, a sense you are doing something pointless and very expensive which will totally ruin your week, if you’re lucky, and if you’re not lucky, your looks, permanently.

My therapist is in a temper. Her house sale fell through this morning, she explains. Automatically my lips form soothing sympathetic sounds, even as I silently will her not to take her troubles out on my face. My face has never gazumped you, lady, nor does it plan to: my face is very much not the enemy here. As she scrapes angrily at my crows’ feet I indulge in a brief nightmarish fantasy that her fingers might slip and take out an eyeball. Oddly, the most fearsome element of this prospect, rather than the pain or blindness, is the embarrassing anecdote it will generate. How did you lose your vision, Melissa? Humanitarian efforts in a war zone, rescuing puppies from a burning farm? Oh no. I paid an angry woman an obscene sum of money to repeatedly stab my head, out of misguided vanity. Well then, clearly you deserve to have your eyeballs perforated. You’re an idiot.

But for all her rage, her hand stays steady, and the terror passes.

When she’s worked off her mood she hands me a mirror. I am very, very red, like I’ve sprinted at top speed from something mightily embarrassing. I thank her effusively for this effect, because I’m English, and then I hand over a heap of cash, and reach for my hat, scarf and sunglasses, the costume of choice for the shallow on clinic day. Outside, the cold whips at my new skin and leaves me faint and shaky. The sickly sweet anaesthetic scent lingers. In the car I examine myself minutely. I look horrific, like a rash riddled burns victim, and I’m not allowed make up for 48 hours. 48! For a woman who applies and reapplies at least every two hours, regular as a tic, this would be torture enough, but whilst looking like this, it’s simply inconceivable. I manage twelve hours before I cave. Make up increases the risk of infection, so I buy new foundation and a new applicator and slather on the E45 before I use it.  I’m lucky. Two days later, the redness is barely perceptible, and no infection has come to claim its penance for my vanity.

Two weeks later, the acne scarring on my cheeks and chin is disappearing almost before my eyes. The micro needling damages the skin, forcing new collagen to be produced and repair it. The results take several months to reach their peak, but even now, three weeks after my final treatment, my face looks younger, smoother, clearer. I’m erasing my past, making myself afresh, photoshopping my past to reflect my present: my acne belongs to a different era, and I’m damned if I’m keeping its calling card: not if there’s any way to discard it, however expensive or painful. I’d do it all again, and indeed might, once this has settled. They say you become an entirely new person every seven years: I’m too impatient and too old to wait that long. With a thousand tiny needles, you can have a whole new face in a fortnight.


  1. Thank you for sharing. This is a very important subject, for many your entire self esteem and identity is your face, and when it is altered for any reason it can cause huge psychological problems.
    It’s good to hear that persistence with your GP has finally given you some hope, for further help and advise I would contact the charity Changing Faces who have a wealth of knowledge and experience in this field, and will be only to pleased to hear your concerns and do everything to make you more comfortable and confident about your face. Good luck! Dan

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