Three rounds of Accutane before I was old enough to drink in America

There is a particular seat in every meeting room, and by twenty-three I could find it in about four seconds.

Left side to the wall. Back to the window, never facing it. If the only light came in behind the chair at the head of the table I would take the far end and angle myself fifteen degrees off centre, and I would hold that angle for an hour.

Nobody teaches you this. You work it out on your own, quietly, over years. And then one day you are a grown man with a salary and a gym membership doing geometry in a doorway before a Tuesday morning stand-up.

Isotretinoin at seventeen. Accutane, Roaccutane, whatever the box said that year. Six months of it, and for the first time since I was thirteen I had a face that did not do anything unexpected overnight.

It came back at nineteen.

So: again at twenty. And when that one faded out too, again at twenty-one. Three rounds before I was old enough to drink in America.

The dryness you can explain to people — lips, eyes, the inside of your nose. The joint aches you can explain. What I could never explain properly was the flatness. Not sadness, which people understand. Flatness, like someone had turned the contrast down on the whole world. I remember sitting in a car park deciding whether to go into the gym and feeling nothing either way about it, and that frightened me more than anything on my face ever had.

And here is the cruel part, the part that kept sending me back. It worked. Eighteen to twenty, and the three or four months after each course — those are the only stretches of my adult life when I looked in a mirror and did not immediately start planning around what I saw. I know exactly what that is worth. I have had it, and I have had it taken off me, three separate times.

I am not going to sit here and tell you to avoid it. If your acne is severe, go and see a dermatologist and take seriously what they give you, because scarring is permanent in a way that a bad six months is not. What I will say is that I went into all three rounds without asking a single question about what came afterwards. I was nineteen, someone in a white coat said this will fix it, and I heard the word fix and stopped listening. I assumed somebody somewhere had thought about the rest of me. That is the part I would do differently.

The last bad run left scarring down my right side, in that strip between the hairline and the eye where side-on light catches everything. The breakouts went. The record of them did not.

I did not have a word for it then. I assumed the acne simply had not finished with me. It took an embarrassingly long time to work out that I was looking at two entirely separate problems — that the spots had been over for months, and the thing I was still checking for every morning was something else, with its own biology and its own miserable timeline. Hold onto that, because it turns out to be the whole thing.

I bought the products. You know the ones. The brands with the ad budget, the ones that follow you around the internet for a fortnight after you so much as think the word acne. I have had most of them in a bathroom cabinet at some point, usually three at a time.

And every single one of them did the same thing, which was the strangest part of it. Two good weeks. A third week where you catch yourself in a lift mirror thinking this might actually be it. Then the drift back — never a crash, always a drift — to roughly where you started. Sometimes a fraction better. Never enough to matter.

I did that for four years, and the money is not the part worth talking about. What four years of that does is teach you that this is simply your face now, and that every new bottle is you being naive again. Eventually you stop trying things — not because you have run out of options, but because you cannot face another third week.

I changed how I ate for the gym. That is the entire reason. Keto first, because everyone in that corner of the internet was doing keto. Then a stint of carnivore, which I would not recommend to anybody as a permanent way to live but which taught me a great deal. Then settling into animal-based and whole foods, which is roughly where I still am.

Training was the point. My skin was not on the list. My skin had not been on any list for years — I had taken it off.

I cannot tell you the day I noticed, because it does not arrive like that. What I can tell you is that some time in the third or fourth month I was shaving, and I realised I was not doing the thing. The inventory. The lean-in, the tilt, the tally of what was new since yesterday. I was just shaving. And I stood there trying to put a date on my last real breakout and could not.

My first thought was coincidence, because I had never eaten badly. I had eaten like someone who lifts — chicken, rice, oats, shakes, the whole boring apparatus — for years, and it had never once made the slightest difference. If eating well were the answer, I should have had the answer at nineteen.

So it was not eating well. It was something far more specific than that. And I went and found out exactly what it was.

I have written the whole thing up — the two things going on underneath all of this, the levers in the order they actually mattered, what I eat more of now, what I cut, and the handful of things I deliberately stopped being precious about. It is on the other side of this page and it costs nothing.

There are two minutes of work first, and not to make you jump through a hoop. It is because of the thing I asked you to hold onto — the spot and what the spot leaves being two different problems. Which of those you are dealing with right now changes what matters, changes what is even possible, and for some of you the honest answer is a dermatologist rather than a shopping list. Five questions sorts it.

You are not the exception you think you are. In the largest survey of its kind, 42.5% of men in their twenties reported having acne. Not as teenagers — then, in their twenties. Nearly half the room.

I think about that number a lot, because the shame of adult acne is built almost entirely on the assumption that everybody else grew out of it and you are the one who did not. Enormous numbers of them did not either. They have just got very good at finding the seat against the wall.