Your class is in your skin: What are your experiences?

45 thoughts on Your class is in your skin: What are your experiences?

1. I always thought that seeing a doctor for acne was purely cosmetic, as well. Like you, I viewed it as an annoyance (that I was fortunate enough not to have to deal with in a significant way). But after reading SweetMachine’s post, and the comments that followed, I learned that sometimes acne can be really painful, and really affect your quality of life in ways that are not merely cosmetic – like it being too painful to smile or touch your face. I guess I’m bringing this up to say that seeing a dermatologist for acne isn’t always something you do because you want to be cuter, sometimes it’s something you do cause you want to be free of the pain its causing you.

   But I agree its a class-related privilege. I’m lucky (and my sister) didn’t need braces, because I don’t think we’d have been able to afford them without some major sacrifices. Likewise with acne, although I’m not sure we would have tried to go to the dermatologist even if our acne was much worse, unless it was super-serious.

2. Yeah, I was trying my hardest to make it clear that I’m not trying to say acne can’t be a serious issue, or to buy into the “cosmetic” criticism (which is incredibly problematic from a variety of viewpoints, feminist, fat and otherwise). I’m trying to unpack my experiences and see what others’ have been.

   In the happy sun-shiny dreamworld AmandaLand we would cover health issues period — which means dental and vision and mental health and things like dermatology — but in this world we split these things off into their own little realms and try to split off who has access to which, which makes things all kinds of fucked up.

3. I think you might be a little too hard on dermatologists. Yeah, most of their patients are cosmetic, but that line can be difficult to draw and most general doctors simply aren’t qualified to deal with skin conditions. I grew up with eczema and I still struggle with it today. While you could certainly see it as a cosmetic condition (it is ugly) its a lot more than that. Bad eczema is painful: it stings, it burns, it itches so bad you scratch until you bleed, as it heals the dry dead skin cracks and tears (often taking the weak new skin with it). As a kid I just got used to the idea of always having a dozen open wounds at any given time, and it was rare for me to have a day when I didn’t scratch myself bloody. Those wounds get infected, which is cosmetically disgusting but which is also painful and dangerous. Even with a skilled dermatologist its taken me more than two decades to get to the point where its under control. Not cured, but under control. I still have flare ups that make taking a shower, walking, or being active enough that I sweat an exercise in pain tolerance.

   To this day I have facial hair at least partly to cover up the scars some particularly bad flare ups left. I’m just now getting to the point where I can wear sandals in public and not feel like a leper. I can go swimming without being quizzed as to whether or not I’m contagious (and the idea of going into water doesn’t make me reflexively wince in the anticipation of pain). I have scars from bad spots, wrinkles and lines that put a decade on my face, and an emergency tube of expensive ointment that feels like a chemical burn but will stop a flare up before it gets infected.

   Still, I get what you’re saying. As a kid I always wondered what these other people were going to the dermatologist for. A lot of the work they do is cosmetic, and even if you have a real problem you end up getting some of that because it jsut how the doctor is used to working. I guess I’d say I’m torn.

4. William, you know what? You struck a chord there.

   There are a LOT of conditions that are looked upon as frivolous even when they are anything-but. CFS, the “sister disease” to fibro, is also commonly called the yuppie flu. I’m sure the implications there are obvious. I’m gonna have to try to organize my thoughts on the matter because it’s something that needs to be explored.

   I was trying my damnedest not to fall into saying that people with these conditions are wrong to call them for what they are and seek treatment for them. It sounds like I did though. I do apologize for that.

5. I was lucky not to be bothered with acne too much as a kid. My teeth are another story, and they were bad. I really didn’t have a chance in hell of doing anything about it when I lived with my parents, but after I moved in with my grandparents when I was 12, they really tried to get me to agree to braces. I refused. My teeth are pretty straight and white, but I have a huge overbite, and that’s what I would need corrected. When we went in for a consultation, the dentist was talking things like five years in braces and headgear, and possibly breaking and realigning my jaw.

   No frickin’ way was I going to go for that. And the real kicker? For me it was the headgear. I had seen kids in that crap before. I had heard the teasing. By the time I was 12, I had been to 7 different schools. I knew all about how hard it was to be the new kid, and try to fit in. Headgear would have just destroyed any chance of me “making it” at my new school.

   When I was in my 20’s, I briefly flirted with the idea of braces, but my then-husband was dealing with some major braces-induced problems with his teeth at that time, so I backed off that again. My teeth are very healthy- the only cavity I’ve had in my adult teeth was a tiny one that formed after my pregnancy, which I hear is pretty common. I didn’t feel like messing that up for cosmetic reasons.

   I have some major issues with orthodonty for these reasons, not to mention the fact that some of the results look a bit odd. It seems strange to me to inflict humiliation on children at their most vulnerable period just so they can have straight teeth as adults, when frankly, most people never notice. I think it’s almost criminal to compromise the strength and health of a child’s teeth for cosmetic reasons. All this being said, my son looks to have inherited the problem that caused my ex to need braces, and it is serious enough (it affects function as well as looks) that I will consider braces for him. But no crazy shit like headgear, and we’re going to keep a sharp eye out for enamel issues. And frankly, I’m not made of money, so the cost will factor in as well.

6. I grew up in Florida with practically all my older relatives having to go to the dermatologist once every six months to get cancerous and pre-cancerous spots removed. I think dermatologists never really struck me as a fancy-pants rich-people specialty thanks to that; I mean, it never occurs to you to think of someone’s ability to get fucking cancer removed as a luxury. Especially since, well, it shouldn’t be.

   My brother wound up with really, really bad acne when he hit puberty, so it’s kind of hard for me to think of dermatological care for that as much of a luxury, either. He doesn’t get flare-ups as often now that he’s in his 20s, but the scar tissue he’s been left with would probably be considered disfiguring if he were female. As it is, it’s still so thick, knotted, and angry-looking that I don’t see how it could possibly be comfortable.

7. Couldn’t help resisting this, especially in the discussion of the intersection of gender and class.

   People who say that going to a dermatologist is a class privilege are correct. Dermatologists are incredibly expensive and basically cost-prohibitive without insurance. But that is true for pretty much true about any medical services for a person without insurance. Everyone should be able to get treatment for any medical condition they have, be it acne or a broken arm or the flu. So, lets focus on arguing universal health care for all.

   I also think people without severe acne has a tendency to downplay its social and psychological consequences of it. I have moderate-to-severe acne, and I know firsthand how crappy and inadequate it can make you feel. A little anecdote: I’m a confident, 23-year-old women, and my mission in life is social and political chance. But when I had a terrible, painful breakout at my political group’s national conference (basically the highlight of my year), all I wanted to do was hide in my hotel room until it was over. It took all I could do to force myself out of the room. But even then, I sat in sessions feeling my face burning and pulsating, and i had trouble focusing on what the speakers were saying.

   So, it is true that, right now, many poor people (and people without insurance) can’t go to the doctor for a condition like acne. But I know they damn well should be.

8. For me, it was the move from a working class neighborhood to a liberal arts private college that made me realize how one’s skin, hair and teeth suddenly become an identifier of one’s class. Ever since I hit puberty I struggled with severe acne. Now that I’ve reached my early 20s it has gotten better, but it is still more severe than the average person’s. I got teased pretty badly in highschool for it, so once I found out about dermatologists I always wanted to go to one but could never afford it. I still can’t. Now that I’m in college I don’t get teased for my acne, but I’ve always felt that it sets me apart from other people – like my first roommate – who could and did go to the dermatologist to successfully get rid of her acne, even more than my clothes do. It’s another element of the whole package – clothes, hair, teeth, body weight (my roommate never drank kool-aid or ate wonderbread in her life) that subtly show others what your means are.

9. Wow. I’ve never even thought about that. *smacks privilege*

   I had braces for four years (my top teeth were very crooked) and still wear a retainer to keep my overbite from coming back. I never questioned it. At that age pretty much everyone I knew had braces. A friend of mine who has the most perfect teeth I have ever seen has been wearing braces for the past two years. There’s a lot of pressure. Even now my mother is always bothering me about getting freaking laser surgery because my gums are a bit uneven.

   I also have pretty bad acne, to the point where it does hurt to touch my face during a flare-up, and I’ve been on increasingly strong medication for the past few years. My doctor has suggested that I think about taking BC for it. I think my mother, at least, sees it as a cosmetic concern. (And it’s been getting worse and worse.) For me, though, it hurts rather a lot to wash my face, which could possibly help with the problem.

10. Given past history in class warfare over occupations, I wonder how long it will be before dentists and doctors are thought of as the province of rich people.

    The exchange of political sentiments between people who think of health care as a primary good and/or right, and people who think of health care as a sumptuary good has always been interesting.

    Doctors that both treat tuberculosis and attempts to stimulate symptoms of tuberculosis for the fashionable pallor is a wierd twist in the head.

    That being said, I wonder what would have happened to AmandaW if she had moved to Brazil instead of Penn. I have heard it said that there is a huge interest in cosmetic interventions there.

11. and oh yes, family members who are just a little excessively concerned with how you look have taken their toll on kids everywheres. My rather well intentioned mother definitly pushed me to get in-the-ear hearing aids rather than behind-the-ear hearing aids despite the fact that they slightly lack the power to correct my hearing (hearing aids are limited by how big a battery it can use). I wasn’t particularly hurt by that choice, but I can imagine that there are many many children out there who get treated according to looks instead of health needs because their parents wanted that picture perfect photo.

12. Recently in a store, a little boy (maybe 4?) asked me if my front tooth was loose. I answered no, it just isn’t straight. He asked me if it hurt, and I laughed and said no.

    His mother appeared, profusely apologized and explained matter-of-factly that her kids hadn’t seen adults who didn’t have straight teeth before they had moved to South Carolina; they were originally from California.

    I couldn’t manage anything but “Wow!”…still can’t, really.

13. I consider my upbringing to be upper middle class. We certainly did not want for anything. But I also grew up in a primarily rural area in a very small speck of a town with a blinking yellow light at the center of town (the intersection of Grandma and Grandpa’s Corner Store, the town hall, the post office, and Hamlet Farms). My parents were both teachers in a rural school district and my sister and I are both adopted, a sure sign of middle-class status. Poor families that are infertile just deal with it because we as a society don’t truly value the right to parent. But add to this cultural context that my sister and I are the only Asian-Americans in my town and my parents are white. Most of my friends in elementary school were from the grape farms or low-income families in my school district. Being the privilidged one in this situation, I didn’t notice that some of my friends had crooked teeth or dirty clothes or whathaveyou or that my life was so much different that theirs. I didn’t notice it any more than I noticed that I looked different, that is to say, unless someone else pointed it out.

    When the class issue clicked for me was when I changed schools in 7th grade, from a small “farmer” school to the “preppy” school in the center of the commercial district. I became acutely aware of how I needed to look and act to fit in. My parents understood and bought me the things I needed to be acceptable in my new school. I distinctly remember a classmate saying that I was their “favorite new kid because [I] wasn’t ‘scummy’.”

    When I first seriously started pondering social justice in college, I tried my best to reject my class status. I was really happy when a friend that knew me from several campus organizations told me they were surprised I grew up in a family with money. Now, as I’m coming to terms with my class guilt genuinely, I’ve realized that pretending not to be middle-class is more offensive than just being honest and humble about where I came from. That doesn’t mean that I should not try to be aware of class and how it impacts me and those around me as much as I can be. I do have one crooked tooth that I’ve made the choice to not straighten, but I can’t pretend that I am not class-privilidged, even while I’m living paycheck-to-paycheck, and I try to be as aware of it as possible.

    Thanks for this forum for discussion. I think it is more than just about whether dermatology is classist or not, but about the linkage between skin, geographic culture, and societal projections of wealth and beauty.

14. I had (and to some extent still have) bad skin. Teeth are okay, I guess. I had headgear for a year or so (worn at night). I grew up in the midwest, and teeth were more a class marker than skin, I think, but bad skin was more shameful or disgusting. Maybe because of the “dirt” factor. Crooked teeth are crooked, not “dirty.” And I’ve never heard of a place where zits, despite being so common among adolescents, are “okay” or “no big deal.” It’s a bigger deal, though, for girls than for boys.

    My bro had red spots that responded to OTC stuff, but I had cystic acne that never healed, leaving raw spots and/or deep black bruises, and my mom took me to a derm and I went through a course of Accutane, which helped some. I still have some bumps under the skin along my jaw, and my treatment was 15 years ago! I’m still very self-conscious about my complexion, and beautiful skin is the thing I always dream/ed of and will never have.

15. You have to imagine things are going to be FUBAR when leg hair on women is considered unsanitary… not just unpleasant in appearance, but actually UNSANITARY.

    I’m glad to see some people searching out privilege in this thread… obvs. I still have some of my own to deal with.

    I want to reiterate that I think people should be entitled to the health care they need – period. And I have a pretty broad definition of “need” — social issues can’t be neglected. And there are obvs. some huge misconceptions about certain conditions, reducing them to frivolity when they actually do have serious implications (LeilaK, I’ve had those moments too!) whether social or medical or, as it usually is, a complex mix of both.

    This does seem to be a regional thing in addition to a class thing. I’m definitely interested to hear more stories.

16. Thanks for the link, amandaw! I was happy to see that you’re a guest poster here.

    One thing I didn’t mention in my original post but that seems relevant is that most of the acne treatments I’ve undergone were actually under GP supervision, and not from a dermatologist. I always had health insurance when I was a kid, which of course was an extreme privilege; since I got sick every couple of months with throat/sinus stff, the only specialists I ever went to were ENTs. But almost every time I went to a GP for a checkup, they’d throw some acne meds at me to see what sticks. None of it did, so it really wasn’t until I was in my mid-20s, thrilled to be insured after having a few years with no insurance, that it even occurred to me that I could go to the doctor just for acne.

    Thanks for starting this discussion — it’s a great thread.

17. My zits, fwiw, are always those painful cystic ones. The ones that just sort o stew under your skin for a week, and never come to a whitehead — it’s just this painful inflamed ball of sebum sticking out like a sore thumb.

    And fwiw, I’ve discovered that the most painful place to get a zit (on the face)? is on your lip line. OH GOD OW. My biggest pimple to date was right on my lip line on the right side, and it took a couple months to clear — during those couple months the top lip was about twice as big on the right as on the left. And I have really fatty, full lips to begin with. It was a total mess, and it actually deformed the line my lip takes in that area, even now.

    My successor on the HS newspaper was one of those boys whose entire face is acne scars. Seriously, not a square millimeter uncovered. I actually found it kind of cool, though I’m sure he didn’t feel that way about it 🙂 I have that scarry skin on my chin, though I’m fortunate that it’s very inconspicuous.

    Now, sebaceous cysts in other areas? THOSE are a huge problem for me, hygiene regardless. I have some serious scarring in a couple areas from those, and they’ve impacted my ability to walk in the past.

    And someone mentioned birth control. Just make sure you know you may have to try several different kinds. Some BCPs make acne worse, others clear it up. People tend to have success on one or the other kind of BCP: triphasic or monophasic (that is, whether the hormone levels are, respectively, varied every week or the same through the whole pack). I was started out on Ortho Tri-Cyclen Lo and I had worse acne than I’d ever had (including that lip incident). It also made me a raving bitch. Switched to Yasmine, then Mircette/Kariva, and I did wonderfully. I get fewer pimples and other related problems than I ever did without the pill, it doesn’t affect my mood at all, etc. Ignoring the whole endo thing, it was great.

    The common wisdom is that you give a new BCP three months before you determine how it works — some of them give side effects that flare up in the first months but tend not to show at all after that third month. (Happened to me with the OTC Lo and the Yasmin.) So if you get awful nausea or acne or what have you, don’t be too discouraged — wait it out for those few months. If the symptoms continue, then consider switching. There are any number of different pills out there, so don’t assume that a bad experience with one pill means you can’t take the pill at all. (though some people still can’t.)

18. So, I had braces, which were forced on me at such a young age that I didn’t really have choice in the matter, but apparently the dentist predicted painful problems in the future.

    What’s interesting is when my parents met my current boyfriend, probably future husband. He’s from a different part of the country and didn’t grow up as privileged as I did. He didn’t see a dentist as a child, and certainly not an orthodontist for braces. His teeth are a bit crooked (of course, I think it’s quite charming on him!). My parents actually disapprove of him based on the condition of his teeth. There I was, totally in love with the guy, anticipating rave reviews from the folks, and they couldn’t see past his teeth. My heart broke that day, and ever since, I’ve had to look at them through a different lens. It’s amazing how some people judge others based on such superficial qualities.

19. I was blessed not to struggle with acne beyond the occasional zit or four, and I not only didn’t need braces; I didn’t even need a retainer in order to have straight teeth.
    What was a privilege for me was having health insurance cover a breast reduction when I was 18. There were medical indications for it – I was in physical therapy for back pain as a teenager, and it only would have gotten worse (from the POV of insurance, worse = more costly). But honestly, from the perspective of my teenage self, the pain was incidental – the reason I wanted it so desperately was appearance, pure and simple. I wanted clothes that fit me “normallly.” I wanted boys to stop staring like I was a freakshow. I wanted to wear a bikini without self-consciousness (well, that one will always be something of a pipe dream, but wevs – that was what I was thinking). Etc. And although I don’t know if I would do it again or if it was the right decision, being able to have insurance that covered the procedure made it possible for me to do, and I was (and still am) grateful that my mom had it.
    However, I’ve always been aware of orthodontia as a class privilege. One of my best friends in high school worked 20 hours a week in order to pay for her own braces (while also getting As in AP classes and doing a time-consuming extracurricular). It made a huge impression on me.

20. amandaw: ugh, yes. I used to get normal pimples, but now I have loads of the awful cystic ones on my forehead. Thanks for the BC info!

21. i grew up in a more-or-less middle class family in a very small rural agricultural town. my father was a dentist so we were never in need of anything, but our town was so small, remote, and poor that our life in no way resembled a typical middle-class or upper-middle-class suburban lifestyle.

    i’m the youngest of a large family, and the acne lottery was more or less 50/50 in our family. i got lucky and didn’t have a problem but my several of my older sisters and brothers did have terrible terrible acne.

    as far as treatment goes, it wasn’t a money thing but an age thing. my next oldest brother was a teenager when accutane was developed (i’m the youngest of nine). so for the older siblings who had the bad acne, there was no point in going to a dermatologist to treat acne because there quite simply was no medical treatment for it. when accutane was developed, my parents drove my brother the nearly 300 miles to the nearest dermatologist so he could get treatment. and yes we had insurance.

    but i’m curious about something. this was in the very late 70’s. i’m under the impression that having medical insurance was much less of a privilege then compared to now. am i wrong about that? what made my brother privileged was probably my family’s being able to afford to drive the long distance to a dermatologist, not so much the medical bill for the accutane itself.

    but the big realisation that i’m coming away from all this is the one of generational privilege. that we are talking about the option of medical treatment for acne, whether or not it can be afforded, is a privilege in and of itself compared to the baby boom generation, who just had to deal with the condition regardless of how bad it was.

22. Speaking of leg hair being unsanitary, I was listening to the Savage Lovecast and a caller said that he didn’t now how to broach the topic with his girlfriend that he wanted her to shave or get a brazilian wax because having hair there is unsanitary. A perfect man about bodies he is not, but Dan shot that down with a quickness.

    I’ve always had very clear skin, maybe a lifetime total of a dozen zits (all of them annoying third nipple zits that last forever) but I do have problem with my teeth which are straight but have some discoloration from injury in my teens. It makes me feel incredibly incredibly self conscious. When I was in college a guy friend told me that wearing red lipstick just made my teeth look screwed up, so I too end up doing the creepy cracked joker smile and I hate seeing my teeth in the mirror or in pictures.

23. Braces were a necessity for me–I have big teeth and a small mouth, and if it hadn’t been oral surgery (to remove 11 teeth) and braces, it probably would have been shattered teeth and emergency surgery. I also had some other weird dental problems–baby teeth grown into my jawbone–and certainly no room for wisdom teeth to come in. My teeth LOOKED good–I had a tiny crossbite, but that was it–but that didn’t make room for them in my mouth. I wore the braces for two and a half years, and the retainer for another two (I should probably still be wearing it at night–I don’t, and I have some odd gaps between my remaining premolars and my molars.

    So–there are other reasons besides cosmetic to get braces. Quite a lot of them, and my orthodontist didn’t pressure us about cosmetic fixes. My dentist wouldn’t have referred me over cosmetic issues. I don’t know how common that is. But of course, I was lucky to be from a middle-class family that could afford regular dental care and oral surgery and braces.

    I grew up in Oregon, where crooked teeth weren’t common, but they weren’t incredibly uncommon–I don’t recall them being a major status marker, but I may just have been oblivious (I don’t make a habit of looking at people’s teeth). I didn’t get teased about braces (or glasses)–both were not uncommon, but also not ubiquitous. The main issue I had with braces was the associated pain, since I had the space of a whole adult premolar to close on the bottom.

    I just suffered through acne (moderate, in my case)–it’s still a minor problem for me, but since it’s stress-induced, I’d rather learn to not be stressed than throw medication at it. But for people with severe acne, I think it is definitely not “cosmetic.”

24. that we are talking about the option of medical treatment for acne, whether or not it can be afforded, is a privilege in and of itself compared to the baby boom generation, who just had to deal with the condition regardless of how bad it was.

    Well, my grandma had acne as a teenager (everyone on my dad’s side clearly inherited it from her!) in the late ’20s/early ’30s, and they gave her x-rays as treatment. When she was an adult, guess what? She got skin cancer. So there were treatments for previous generations, but some of them were way worse than the disease.

25. My acne was never really a big deal, but my partner’s was– we are in our mid-20s and his is still kind of bad, after a couple of rounds of accutane. Its definitely genetic for him– his dad had the same thing. According to what his dermatologist told him, it has to do with his native american ancestery (not even that much of it, but its apparently a dominant gene) where its common for the oil your skin produces to be thicker than normal so it clogs more easily. I can actually see this though, cause if I watch a movie with my face against his bare skin, he’ll clog my pores with his oil too at the point of contact, and I hardly ever get zits anymore. Accutane was the only thing that ever helped him and he still has some scarring and stuff like reduced night vision, etc. but at least its not as bad as his dad’s.

    Actually, I was curious what the relationship was, if any, between racial issues and perception of acne– in areas where there are a lot of native americans is having acne percieved differently? (actually, I’m assuming here that what the dermatologist told my partner is accurate, I don’t really know if it is)

26. My current boyfriend had some horrible type of acne as a teenager (nodal acne, maybe?). It hurt him just to wear clothes, and he still has the scars all over his back. Certainly he was privileged enough to go to a dermatologist, but I would hardly classify that as cosmetic. Even just normal zits or cystic ones as described upthread can be very painful. I haven’t been to a dermatologist for the mild acne I have, but I get zit headaches from the deep ones on my forehead all the time. Not life-ending, but it is a pain in the ass. In Dreamworld, of course, we’d fix all that.

    Regarding crooked teeth, I declined a second round of braces as a kid because they were annoying the first time, and I have heard no end of mockery from my family about my one crooked tooth (named “The Snaggletooth”). It is a tiny crooked tooth that most people don’t notice, but my family absolutely can’t believe I would voluntarily allow that in my mouth!

    Also, I am a Californian who recently spent three months in England. I found the stereotypes about crooked British teeth to be rather true, and I remember that it was a bit confusing to me, because in California, crooked teeth are such a class indicator. It was weird to think, “You have one of the nicest houses I’ve ever seen, but your teeth tell me you are really poor!”

27. I come from a middle class, midwestern background (my mothers are schoolteachers). I was offered braces when I was 12 or 13. My parents told me the dentist said it wasn’t strictly necessary, but that I could have them if I wanted. I took a while, thought about it, and decided it was an awful large amount of money for what amounted to essentially a cosmetic decision. I felt pretty good about the decision then and was grateful to my parents for waiting until I was old enough to decide and letting me have the decision of whether to change my body. And then I got old enough to really start noticing the people around me. Straightening teeth isn’t specific to California. The vast majority of kids in my high school had these preternaturally straight, white teeth, except for some lower income folk who were considered a little gross, the same ones who were made fun of for putting on way more makeup to hide their acne scars while the other girls tried to wear as much makeup as possible while not actually looking like they were wearing makeup, or for being super into dirtbikes in elementary school while the other boys brought in pictures of sportscars. My teeth aren’t horrendously crooked, but enough so that I am self-conscious still and have some thoughts towards possibly correcting them someday. I’m temporarily post-college poor at the moment, but in the priviledged, after-I-do-even-more-school-I-will-become-a-professor-and-be-financially-secure kind of way.

    I had acne that was painful, but mostly just butt ugly, and I went to a dermatologist a few times a year throughout highschool, culminating in a round of accutane that reduced my acne to a few pimples here and there a pretty good sprinkling around my period (thanks, btw, period, for piling on the insecurity factors. Not only do I have to be bloated and moody and horny before my period, I have to have pimples, too? Aren’t I too old for this?). Anyway, I stopped going to the dermatologist after I no longer qualified for the insurance that covered it. I’m without health insurance currently, so my only medical care has been getting the ladyparts checked up at a planned parenthood with a sliding pay scale (Planned Parenthood, I love you so much).

28. side note: my mothers, in addition to being schoolteachers, are also feminists and taught me pretty young that not only do I not have to conform to societal standards of beauty, but that I should consciously avoid conforming until I’d had a chance to evaluate them. This lead to some pretty awkward years when I started growing body hair and didn’t shave it off, which the kids at school and the pool found “gross.” I actually just started shaving my legs and underarms in my last year of college, though I succombed to shaving around the lady parts a little younger due to pressure from Shitty Ex Boyfriend.

    Mostly, their giving me the choice (and my being priviledged enough to have it) of whether to accept or reject certain beauty standards that are also class markers meant that I simultaneously felt good about myself for making what I considered to be feminist choices (not getting my teeth straightened or whitened, dressing comfortably and usually in second-hand clothing, never wearing heels, not shaving body hair, not plucking my enormously bushy eyebrows, never wearing makeup, etc.) but simultaneously felt (and feel!) insecure amongst my preppy, upper-middle-class, immaculately-made-up peers, and I actually worried about appearance way more than my appearance let on.

29. Sorry, ridiculously long comments . . . fascinating thread!!

30. North-of-Pittsburgher here, and you now have me seriously wondering about the brace thing. I think you’ve articulated the ways in which it’s not just a class thing, but I don’t think it’s just an area thing either.

    All of my family has been within an hour’s drive of where I’m living now for generations, but I know my mother got braces in her early thirties for roughly the same feelings you had. On the other hand, my cousins mostly got them for the purpose of having painfully squeezed in teeth sorted out and I put them off all through high school so I could play trumpet without having to worry about cutting my lips up. Obviously none of us cared that much, which makes me wonder if it’s generational.

    The only other thing I can think of is what keeps coming up in my mind as “percieved class.”* Regardless of what the reality of the situation might be, California is percieved as inhabited with middle-class people where Pennsylvania is seen as being generally poor. So people in areas that are seen as higher-income may be expected to look the class that “most people there” are seen as being. Similarly, my mother got her braces when she began working as a businesswoman, an occupation that is seen as being strictly middle-class and where there’s a lot of pressure to look the part. Of course, I’m not particularly sure what I’m trying to say here, so this paragraph may make absolutely no sense to anyone but me.

    *I’m not exactly sure how to say what I want to say here….

31. William, you know what? You struck a chord there.

    There are a LOT of conditions that are looked upon as frivolous even when they are anything-but. CFS, the “sister disease” to fibro, is also commonly called the yuppie flu. I’m sure the implications there are obvious.

    I think a lot of that is because we don’t really take pain seriously in this culture, be it physical or emotional. Its hard to tell someone with cancer that they’re being a baby because you can see a picture of the tumor or the hair falling out from chemo, but someone who has a series of cuts an eighth of an inch deep that they inflicted because they just couldn’t resist scratching gets seen as poor self control. You can’t take a picture or provide a simple medical explanation for an itch so bad that your fingernails dig little crescents into your palm because your fists are balled up to stop yourself from lathing the flesh off whatever itches. Emotional pain is an even harder sell because we’re just expected to buck up and fight on. I mean, hey, all kids get teased in school, is being called an ugly leper for a decade really THAT bad?

    I was trying my damnedest not to fall into saying that people with these conditions are wrong to call them for what they are and seek treatment for them. It sounds like I did though. I do apologize for that.

    Ahh, I wouldn’t go that far. We all see the world through the lens of our own personal experience, and yours is just as valid as anyone else’s. No need to apologize, especially when you’re more than willing to see how the other half lives. Good post, btw.

32. Although acne and teeth alignment are considered cosmetic problems, the truth of the matter is, to people who have these conditions, it is anything but (though I do consider acne to be more serious- you can always close your mouth, but short of cosmetics or a paper bag, it’s hard to completely cover your face).

    Given the often times hot and humid conditions here in Asia, I have observed that the severity of acne, both in condition and quantity of cases seem to be somewhat higher than that of countries with a cooler, drier climate (although dry skin is prone to acne as well). Acne is also more prevalent in boys, due to the increased testosterone levels. Having severe acne is considered a handicap, and in some cases, especially if the entire face is affected, the person may end up as a social pariah…which is especially true given Asia’s incredible love affair with the superficial. Make no mistake, the anguish and pain caused by acne is magnified several folds in such an environment.

    Here, skin (and to a lesser extent, teeth) is deemed to be an indicator of your class. The perfect skin in Asian countries would be: smooth, blemish free, invisible pores and most importantly FAIR skin. There are plenty of products out there that tout being able to give you FAIR skin (with all the whitening agents, etc), and the most expensive can cost beyond USD 200-300. Due to the humid weather, almost everyone who can afford it go for facials. I used to go to facials every two to three weeks (before I left for Australia), and there are a sizeable (and increasing) number of cosmetic salons that are exclusively for men only (I went to one of these…being around women inside there made me and most of the men feel uncomfortable). Seaweed masks, kaolin clay, Pulse Light treatment, seaweed essence, exfoliating masks, whitening washes, cold irons…….these are just some of the many treatments the therapists and beauticians try and get you to buy (usually in batches of 10 or 20) when you go in for your weekly/fortnightly/monthly treatments.

    And I will not even go into other cosmetic procedures like Botox shots, nose jobs, eyelid jobs, etc…..most of these are used to give a younger, often times WHITER (Caucasian) look.

    I read an articles several years ago, on how cosmetic procedures such as I have listed above is becoming increasingly common-place in Asia, affecting BOTH women and men…and the reason cited is that most people do it because they feel that if they looked better and nicer, they would have an advantage in securing jobs (and hence, securing money).

    So, all these does point to a sign of class/privilege. If you’re poor, or even not so well-off, you get your products from generic pharmacy brands. The well-off can buy their products from their beauticians, and the really rich can even afford surgeries and other procedures to alter their faces.

33. I grew up middle class, had braces, and was treated for acne. My parents had both had bad acne as kids and not been treated (they grew up poor, and I don’t even know what sort of dermatological treatments were available at the time) and were very insecure about it, so they didn’t want me to grow up with all the self-confidence issues that could result. In retrospect I’m glad we did it, because I didn’t need anything else to be insecure about at that age, but it wasn’t something I’d ever considered before my mom brought it up — it was her idea entirely.

    As for the braces . . . well, I get a lot of commentary on my “perfect” teeth which frankly weirds me out. My mom decided I should get braces, and I was okay with that because I thought braces were cute. I hated the rubber bands I had to wear to correct my overbite, because those were not cute, and I hate that I can still feel little scarry spots on the insides of my lips where the braces cut sometimes, but I’m an actor and straight, white teeth are indeed an asset in the theatrical world, so I’m not complaining.

    My mom got braces at the same time I did, since she had always wanted straight teeth but her family couldn’t afford them when she was young. When she was looking into insurance coverage for mine, she realized it would cover hers too, and went for it immediately. It was really important to her to straighten her teeth, and I do wonder if it was in part because she felt they were a marker showing she’d grown up poor. She’s pretty fierce when it comes to telling off people who make classist remarks, but I think she did internalize a lot of classism as a kid, and feels more comfortable being “read” as purely middle-class.

34. I was lucky to have straight teeth and mild acne as a teen — my issues were more with weight than with skin or orthodonture.

    But now, I must see a dermatologist twice a year. I have huge skin cancer issues, with many basal cell cancers needing to be excised. I grew up burning off a layer of skin every summer of my adolescence; my Northern and Central European ancestors were designed for mists, not the California summers.

    I didn’t go to a dermatologist untii I was 30. I often, I note, am the oldest patient in the waiting room, however!

    And on another note, I don’t see the awful acne on my students that I saw on my classmates when I was in high school a quarter century ago. My students aren’t prosperous, but they clearly are getting access to some basic drugs/OTC remedies that were not available in the past.

35. I am glad that PA helped you find some acceptance of your teeth. Mine are slightly crooked with an overbite, but I never had braces. I never got any shit for it. I grew up in western PA. Maybe there is something to that.

36. Lauren O. is right on. I most definitely would have considered the dermatologist a luxury if i had not suffered from disfiguring acne. Like crooked teeth, severe acne can limit a person–I sure felt crippled in some ways and was (in regard to scars, I still am) always self-conscious. But unlike teeth, bad acne can’t be covered up (women may have makeup, but this only works to a point; men have it worse).

    Besides acne, dermatologists treat everything from hair loss, nail fungus, psoriasis, eczema, etc. Each of these conditions is limiting in its own way. I know in my case, even though my family was not at all well-off, but just lucky enough not to be poor. It was a bit of a financial hardship to go through treatment (including Accutane), but I know I would have done it if it were even remotely possible. I think it’s one of those things where you can’t imagine yourself in such a position and so you think it’s superfluous and cosmetic. But dermatologists exist for a reason, whether or not you happen to be aware of the reason.

37. My parents fought for years about getting braces for myself or my brother. My father thought straight teeth were more important for a girl, my mother insisted it the right of the eldest to have his teeth done first. In the end, neither of us got our teeth straightened. Now in our 50’s it just doesn’t seem to matter.

    I was lucky not to have to deal with acne as a teenager but now as an adult have developed rosacea. I would not be able to lead any thing resembling a normal life without treatment. Being able to “fix” cosmetic problems is definitely a class issue. I dread the time we seem to be coming into when only the wealthy will be able to afford medical care of any sort.

38. wow, this was so interesting …

    I had both – bad skin and bad teeth – but thank god for canadian medicare vis-a-vis the skin – becuase you know what, bad skin can impact your LIFE when you’re hitting puberty. I mean, not a few pimples, but ACNE – so bad that you look in the mirror and want to die becuas all you see are oozing craters, red angry mountains and on top of that – it HURTS.

    But medicare dealt with the dermotologist. My second daughter hit puberty at 9 – by 10 her skin was so bad that there were days I let her stay home from school – again, thank god for medicare – AND no scarring either! It affects self-esteem, sense of self – and I am eternally grateful for our canadian medical system.

    I also had braces back in the late 60s, early 70s when no-one did – and yes, it was unusual and we were FAR from rich – but we lived on a tiny island in the caribbean at the time and one of our neighbours was an orthodontist … my father worked out a deal with him that he would design his cottage back in canada for the price of the braces. When we moved back to Canada, I spent years going back and forth (3 hour drive each way) to him while my dad finished up the plans for his cottage (and no, my dad was not rich, he was a great architect and a REALLY REALLY LOUSY businessman!).

    All four of my kids had them – and no, they weren’t covered – but again, had I left them, I truly believe their sense of self would have been massively, negatively impacted – becuase like me, their teeth are big and there are too many of them in a small mouth – you end up not with just crooked teeth, but teeth growing in front, behind each other, twisting to one side … etc.

    I worked lots and lots of overtime to ensure they were given a chance to have them – and have no regrets at all.

    and it is interesting that while it was totally unsual to have them when I was a kid – and was in fact TORMENTED (railway tracks, metal mouth, you name it was called) – it was almost seen as a rite of passage now – and really a “cool” thing!

    mind you, they look a hell of a lot better now too!

39. I both got braces and took acne medication after my mom persuaded me to. I wouldn’t have thought to on my own. I figured the acne would just go away and my teeth weren’t so bad. Now that I have mostly clear skin I must say it’s nice to be able to scratch my back without worrying about a bit of blood going on my shirt. My back is a lot less itchy now anyway.

    On a sidenote, I’m surprised so many people go to a dermatologist for acne. My family doctor prescribed me medication for that as well as birth control pills. I’ve only ever seen an ear specialist.

    To anyone with psoriasis or something like it, a cousin of mine had pretty bad psoriasis which no doctor can get rid of and finally she tried a natural soap that is supposed to help and she says it’s gone.

40. I’m from a pretty agro area of northern california, and my extremely class-conscious mother was insistent about my dental/acne treatment. I had braces for five years, oral surgery because one tooth grew in weird, and pre-emptive acne treatment where I went on accutane at age 11. I still got acne, because I basically stopped taking the medication when the skin on my face fell off. I remember going to the dermatologist with my mom and her pointing out this scar I have on my arm (I think I tried to shave my arms when I was like 7 and cut myself pretty badly – a result of my interpretation that girls should be hairless) and the dermatologist was like, “well, we can’t all be perfect!” and said he couldn’t really do anything about it. My mom was super offended – he basically illustrated the fact that I was a kid and she was trying to perfect all my flaws. Pretty amazing for a dermatologist, who’s survival depends on people like her.

41. first off – and please note, this is only my experience. but, the question above:
    in areas where there are a lot of native americans is having acne percieved differently?

    erm… i don’t know what tribe your guy is, no one in my family really had much acne, and to be honest (which is kinda cringe worthy) on this is one i was able to win – the more acne someone had, the more “white” they were, and while i was really really pale as a teen (not when i was little, i was really dark as a kid, but my porphyria kicked in when i was 9-10 and by the time i was 12 i was PALE), i didn’t have acne, so my cousins were therefor somewhat more willing to treat less as a Pariah. i don’t actually really know any Native Americans that aren’t Cherokee, so maybe its different for other tribes??

42. If I had to guess about Native American ancestry and any relationship to acne, it would be that certain minor allergies are somewhat more prevalent than in folks of Anglo stock. One of the more common things they tell you if you’ve got problematic breakouts is to try cutting back on things dairy. Supposedly the reaction a mild intolerance can produce is capable of throwing your sebaceous glands into overdrive.

43. Straight teeth are totally a mark of privilege, you will get no arguments from me there. Reading this thread, I get the feeling that many people see crooked teeth as not just a sign of poverty, but also no big deal medically speaking. I have to disagree with that one. Crooked teeth, especially overbites and underbites, can cause trouble with chewing later in life. A person with severely misaligned teeth has a good chance of eating mush when they are elderly, and there are serious health and nourishment consequences (not to mention quality of life) from limiting your diet to food which has to be gummed. I’ve been there with the head gear, something called a lip bumper, brackets, and a retainer. I’ve had stuff glued to my teeth for longer than I didn’t have stuff glued to my teeth, and in my uncool middle-age, I realize that all the teasing was totally worth it for the way my teeth fit together. I really wish more people would see crooked teeth as a medical problem with possible deleterious effects and treat it if they gain the means.

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