Exploring how and why young adult women with acne share their lived experience on Instagram : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Auckland, New Zealand

Abstract

Acne vulgaris can affect people of all ages and is classed as dermatological by the medical field. Yet the condition’s complexities and effects extend beyond physiology to quality-of-life concerns. Acne experiences are deeply entwined with societal influences and structures like health misconceptions, stigma, beauty standards and social media. In this qualitative study, I explored young adult women’s acne experiences on Instagram, investigating how and why they constructed and navigated their experiences online. Seventeen women participated in an open-ended online survey, and 30 screenshots were analysed from fifteen participants’ acne related accounts. Screenshots and survey responses were analysed separately using reflexive thematic analysis through a critical realist lens. Three key themes were developed from the screenshot data: (1) engaging with others; (2) the implicit pursuit of the clear skin goal; (3) pressures of the acne positivity imperative, and from the survey data: (1) social connection in the acne community; (2) navigating online pressure and potential (3); reconstructing the typical acne experience. Participants had highly individualised experiences, contextualised by different psychosocial pressures pertaining to Instagram. Even though engaging in acne related online health communities can create new negative experiences, actively participating appeared to foster nuanced and beneficial e-health affordances for participants. Several reasons were consequently provided as to why they shared their acne experience online. In combination, the screenshots and responses demonstrated social connection was a key motivator, and this extended to group collaboration efforts to raise awareness about acne. Participants wrote about challenging acne misconceptions in a way that aligned with 4th wave feminism. The term 'acne positivity' was presented in their Instagram posts to positively reappraise their negative acne experiences, but some found this challenging to achieve, indicating a need for a positive-negative dialectic to fully explore acne experiences. Alternatively, acne neutrality seemed more attainable, and beneficial in having shifted participant’s attention towards skin health. Indeed, although a focus on appearance existed in the screenshots, some participants’ largely rejected beauty standards, suggesting that young adult women with acne are active and critical social media users. Despite a continued desire to achieve acne-free skin, young adult women with acne cope well with the condition when intentionally and cautiously sharing their experiences online.