PHOTO: Ben Gabbe/Getty Images

This probably goes without saying, but Lena Dunham has made a welcome habit of getting real. The actress and activist is refreshingly open about everything from her political opinions and feminist philosophy to the chronic endometriosis she’s struggled with for years. And in this week’s issue of her newsletter, Lenny Letter, the Girls creator and star reveals the latest health issue that has her grappling with a familiar insecurity: uneven skin.

In a powerful essay, Dunham details how, unknowingly at the time, her complexion was keeping her self-esteem together as she struggled with endometriosis in her late 20s. But when she recently contracted rosacea, that last vestige of confidence went out the window and caused her to reconsider the worth she’d placed in her skin.

“Chronic illness—endometriosis, along with an accompanying autoimmune disease that gives me chronic joint pain and fatigue—has made my body far less predictable to me, and in far more frightening ways than whether I’ll wake up able to fit into my high-waisted jeans. And a few weeks ago, a course of steroids to treat a massive flare of joint pain and instability led to rosacea’s appearing overnight, making me look like a scary Victorian doll, two perfect pink circles painted on her porcelain face,” Dunham wrote. “Then, after a long, sweaty night shoot in which I was covered in strange makeup, I washed my face to reveal that the rosacea had become hundreds of tiny pimple-blisters that covered me from forehead to neck…My face burned, but not as badly as my pride.”

She continued: “I found myself [age] 31 and hysterical, in the dermatologist’s chair as she extracted infected areas, applied an antibiotic cream, and explained that rosacea is another chronic condition: once the cat’s out of the bag, there’s no guarantee she’s headed back in. The acne on my shoulders and back was also steroid induced, she explained. (I hadn’t even noticed the bacne yet. FML.)”

This sudden hit to her health wasn’t just an annoyance, she explains, rather, it made her realize how intrinsic her appearance was to her identity. Even as she’d been vocal about her love and pride for her body, it struck her that her normally clear complexion had been the one thing buoying her self-image—its loss became a catalyst for self-doubt.

“Seven years of being treated in the public eye like a punch line about female imperfection may not have felt like it was wearing me down, but it had actually forced me to rely emotionally on my one area of fully conventional beauty: my perfect f-cking skin,” she wrote. “They could tag me in a picture of a beached whale. They could call me a bag of cottage cheese. But they couldn’t take away the fact that I was able to eat seven slices of pizza, a wine spritzer, and three quarters of a chocolate cake and still look like my face was kissed by sweet, sweet angels when I woke up. I wasn’t just mourning my easy skin-care routine or my ‘No filter? No problem’ lifestyle. I was mourning a life raft that had kept me, silly as it was, bobbing above the fray.”

Dunham went on to write that she’s still coming to terms with her return to the skin of her teenage years. “I have been forced to finally mourn the long, slow hit on my self-image. I thought my adolescent attitude, the take-no-prisoners approach to my own look and form, could carry me through the onslaught of critical attention. I thought I could intellectualize it away. But I can’t.”

There is a silver lining to her story, though, and it’s the kind of real and honest advice you can only get from someone who’s been through the same emotionally exhausting situation. “I’m starting to believe that speaking this pain aloud isn’t just good for my own healing: it allows any young woman who might be watching to understand that nobody is immune from feeling bad about hateful attention. If it took spelling my pain across my face to admit it, then so be it. I’m oddly grateful. ‘I don’t give a shit’ only translates into isolation; it prevents the people who love you from reaching out their hand to remind you of what’s real.”

You can read the essay in full here. Trust, it’s worth the click.

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