I Didn’t Apply To Dermatology Initially Because Of Acne

I didn’t apply to dermatology initially because I had a face full of acne. 

Apply anyway: why acne should not deter you from a career in dermatology 

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Recently, a PGY-3 dermatology resident posted a video advising medical students that “you do need to get your acne together” before starting away rotations.  

Acne carries a huge psychosocial burden and is linked to higher rates of depression and anxiety, so offhand comments can be damaging and can deter talented medical students from applying to dermatology. This was almost the case for me.  

In this post I will: 

1. share my experience as a matched dermatology resident with terrible acne

2. offer a charitable interpretation of the resident’s message 

3. give [better] advice to all medical students and aspiring dermatologists.  

I did not apply to dermatology residency as a medical student, in part, because I had a face full of acne and acne scars. 

Instead, I applied to a different specialty that I assumed would accept my acne,  only to realize partway through intern year that I was in the wrong specialty. 

So I quit, and finally applied to dermatology, resulting in a 2-year delay to my career.  

So yes, despite having a gorgeous dermatology application that would earn me a spot into a stellar dermatology program (I had the letters, grades, board scores,  mentors, research, awards, passion and excellence in patient care), I had crippling imposter syndrome because there was one piece of my CV that was missing — glowing skin.  

I, like many medical students, found myself developing a face full of acne as an adult. Acne carries signficant psychosocial impacts and can be very tricky to treat, so telling someone with acne to just “get your acne together” is unnecessarily harsh.

One of my TikTok followers tagged me in the original video, which has since been taken down. As someone who did not apply to dermatology the first time around because I had internalized this type of messaging—that dermatologists can’t have dermatologic conditions—I want to be crystal clear: you can and should apply to whichever specialty you want, even if you suffer from a medical condition that your specialty treats.  

What I wish I had internalized as a medical student instead is this: acne is a chronic inflammatory dermatologic disease—yes, a disease, like any others we learn about in medical school. You can’t control whether you get most medical conditions, and acne is no exception. Acne can be extremely difficult to treat despite the fact that it is one of the most common diseases. Not only do factors outside our control like genetics play a role, but acne can also be a medication side effect or result from another medical condition. 

No, we cannot just “get [our] acne together.” 

A charitable interpretation of what the PGY-3 dermatology resident was intending with her video was to warn medical students about the halo vs. the horn effect. The resident caveats her video by prefacing that “I am generalizing tremendously” and “I have incredible bias” and “humans have incredible bias.” 

In psychology, the halo effect refers to when a positive trait (like being well spoken, attractive, or confident) creates a favorable overall impression that spills over into how people judge unrelated qualities. The horn effect is the opposite: a single perceived flaw, such as acne, colors someone’s whole impression of you in a negative way. 

This resident has given us a peek into her private thoughts and has shown us that some physicians (perhaps because of their own insecurities) judge others’  imperfections more harshly.  

Instead, here is my advice. 

1. Don’t make the mistake I made: please apply to dermatology (or whichever specialty you are passionate about) even if you have a dermatologic condition like acne. We need talented, compassionate physicians in every field and physicians who have suffered from medical conditions can bring even more empathy.  

2. Pay attention to culture & vibes on your away rotations and your interviews.  This video went viral because it had unkind and unfair messaging. But please know that there are so many compassionate dermatologists,  residency programs and co-residents who value you for who you are. Kind,  hard-working and dedicated medical students who treat others well will rise to the top. 

3. On a personal note, know that your self-worth and your intelligence is not tied to your acne. My acne held me back for years. I didn’t attend parties,  was terrified to date, and didn’t let myself be photographed because I felt ugly and unworthy. Even worse, I almost made a huge career mistake by internalizing the type of messaging this video was promoting: having bad skin makes you less deserving of a career in dermatology—but this is not true.  

So for all my fellow acne sufferers out there, go out and show everyone how loving, compassionate and talented you are. The world needs you <3 

With gratitude,  

Dr. Liv, MD 

P.S., if you had a similar experience, email or DM me. Let’s build a kinder culture together.

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