Most of us have something about our appearance we might change if given the chance – but what if that thing is a long-term condition that doesn't respond to many conventional treatments?
A new BBC Three series, Skin, meets several young adults with skin complaints ranging from cysts and birthmarks to acne, to find out how their lives have been affected and attempt to solve the problem with private treatment.
A small online trend for 'skin positivity' exists on some platforms – the hashtag on Instagram has over 87,000 posts – but for some people their skin conditions are too severe for them to be positive about.
Two of the show's contributors explain what it's like living with a chronic complaint and how appearing on the show changed their outlook.
Megan, 22: 'People don't realise how much it affects your life'
"I was diagnosed with psoriasis when I was 9. When I was a kid it didn't really affect me, it just looked like a constant batch of chicken pox. I had creams, ointments – anything they could throw at me. A lot was steroid-based to try and make it go away. It got to the point that none of those were working so I had my first phototherapy treatment when I was about 10. It was really scary for me. You have to go on a massive tanning bed and it's really noisy. You go in naked and your parents aren't allowed in the room. They have to stay behind a curtain because of the UV rays.
"I got into a relationship in 2015 and he loved my skin. He always used to say it was really nice then about four or five months into the relationship my psoriasis started and as a young woman you deal with it in a completely different way. I felt I had to explain my psoriasis.
"I remember becoming really self-conscious from then on. I'm a plus-sized girl – I've got enough to be self conscious about on a bad day – but adding scaly chicken pox skin on top of that was really difficult. I became really anxious and ended up getting depression. It limits the social aspect of life because I didn't want to go out.
"I remember my A-level results, there's a photo of me dressed up to go out and my legs are all scales. The same with my prom photo. There's so much psoriasis, I was putting fake tan on at the time and it clings to dry skin. I tried to not let it affect me but deep down it did. The light treatments weren't touching it.
"Then I went to uni and I ended up missing out on a lot because of the treatments I was having – with some, you have to stay indoors for 24 hours because it weakens the skin. I finished my degree this year with a 2:1 which is unbelievable because I had that worst batch of psoriasis at the beginning of this year. I wasn't going into uni, I was staying at home and teaching myself. I didn't want to go anywhere unless I had to.
"What really helped me was changing my diet at the start of this year. I've already cut out dairy and I don't drink a lot of alcohol and a nutritionist suggested I go gluten-free. I haven't had a flare-up since, which is amazing.
"I believe things are being thrown at me for a reason. I was more than happy to go on the show and spread awareness. I don't feel like psoriasis is talked about enough because it's not a killer disease – people don't understand how much it ruins someone's life. I'd rather share my story with the whole world and help two people than keep it to myself."
What is psoriasis?
Psoriasis is diagnosed with a skin biopsy. Treatment will usually involve creams, some containing steroids, but if these don't work light therapy might be recommended.
Research has not found a definite link between diet and psoriasis but a 2018 study suggested that some people who followed a diet rich in fruit, veg, nuts and fish experienced fewer severe flare-ups.
Ivy, 25: 'You can feel very alone and isolated'
"All through school, my childhood and teenage years, I never had acne. I broke out when I was 21, so that was 4 years ago now. I'd dropped out of uni and was having a bit of a stressful time and I thought, 'Ah, it's just stress, it'll go away.' But it never did.
"I was back and forward to the doctors quite a lot and it just kept getting worse. I tried a lot of things and nothing seemed to be helping. I started developing anxiety as well. Going to the shop, people would look at me but children – I know they don't mean any harm – they'd be like, 'What’s wrong with that girl's face?’ I just became a hermit.
"I tried antibiotics, all the creams, and I just wasn't living a life. One day I posted a photo on my Instagram saying I suffer with acne because I'd just reached a point where I felt I was tired of explaining all the time what was wrong with my face. There's a constant need to explain yourself, especially with wearing makeup. You'd get people saying, 'All that makeup isn't helping,' but if you didn't wear makeup you'd get people saying, 'Cover that up.'
"I started posting online and I was contacted asking if I wanted to be part of the show. I was so fed up of being trapped by something I couldn't control. I decided to start saying yes to things outside my comfort zone – I went to a music festival, for example, which was something I never could have done before because I felt like waking up in a sweaty tent, I'd be itching. Eventually I realised that it wasn't my skin that was holding me back, it was the way I thought about it.
"I think going on the show helped boost my confidence. I was very nervous at the whole concept but it was freeing, even walking around London with no makeup on. Talking to other people who had totally different conditions, I found what they were saying was very much how I felt. When you suffer from something like that you feel very alone and isolated but there are loads of people that feel that way too. You're not on your own. If you didn't isolate yourself you'd realise that.
"Talking to people about my skin was something I'd never done before. I've started working with brands doing makeup, doing online adverts. I never thought a makeup brand would want to work with someone with acne.
"I realised the problem was in my head. I was surrounded by people who didn't actually care what was going on with my skin, it was more I felt that they cared. So now that I've stopped explaining myself I realise that you feel other people care more than they do."
What is acne?
Acne is a common condition that causes spots, oily skin and sometimes pain. It can be mild or severe, and can leave scars.
Treatment is usually with creams, medicated ointments, or oral antibiotics – or a combination of them all.
It's sometimes thought of as something mainly affecting teenagers, but for 5% of all women with acne, it can carry on into their 20s, 30s and 40s.
If you have been affected by the issues mentioned related to anxiety and depression, help and advice can be found here.