Low self esteem is often a problem with acne sufferers, especially those whose acne first appeared during their teen years. At this age, we are most influenced by our peers. Their opinions, and thoughts, tend to matter more, as it is with our friends (and 'enemies') that we begin to define a clearer sense of our own identity.

Our society places a great emphasis on ideals of physical perfection. This ideal demonstrates not only a slim figure, but perfect skin. It is only natural that this is reflected, even if subconsciously, in the way we think about ourselves, and the way we believe others measure us.

Having acne, particularly moderate to severe cases, can have an effect on our confidence, and self belief. We can become so preoccupied with our own acne, imperfections, or shortcomings (compared to this ideal), that we come to judge ourselves as something like second class. So when we meet people, when we encounter new situations, new environments, or members of the opposite sex, we may hold ourselves back. Our manner will reflect this lack of self belief. And if others pick up on this, in the non-verbal way we convey so much, and subconsciously react to it, it can seem like we were 'right all along' with regards any negative dialogue the mind throws at us.

Acne sufferers with low self esteem may have some of these characteristics:

• overly concerned with the image that other people see of them
• withdrawing from challenges
• blaming everything on themselves
• not willing to take on responsibilities
• lack of confidence
• emotional confusion
• mental confusion
• depression
• anxiety

So, what can you do about low self esteem?

Central to the process, is changing the ideas, or filters, that we are viewing ourselves (and the world) with. But before you can change these, you have to become aware of them. So many of our thoughts and beliefs run on auto pilot. Something happens, and we react to it. The first thing we need to do is notice what situation, comment, or other catalyst, is causing us to react. Over time, a pattern will emerge.

Once we begin to be more self aware around this, we can start to take action when this program emerges. Instead of passively letting the negative self-talk continue, we can say to ourselves, 'Okay, this may not actually be true, no matter what my emotions are telling me right now.'

Resisting the pull of our emotions, we can start to look at something, both in our lives or ourselves, that we feel gratitude for. It can be as simple as hearing a great song on the radio, or just enjoying the sun that day. The more we cultivate a sense of gratitude for what is in our life, and us, the more we can free ourselves from any 'inner tyrants' we may have. If we start to see beyond our skin, to the many good qualities and talents we have, we will no longer be defining ourselves by what we feel is a limitation, or fault.