And we go on and on about inner beauty.

We try not to “judge a book by its cover.”

But realistically? We really do care what we look like!

Twenty-one-year-old Rebecca Shealy has learned the hard way that her self-image can’t be grounded in what’s on the outside. She’s currently a senior at Georgia Southern University, but her story begins a year earlier.

“Last May, I took summer classes and also worked a part-time job as a waitress in a local upscale restaurant. I’d waitressed before, but not at this level. So I had a full summer schedule: Classes and working 4 p.m. to 11 p.m. every day except Sundays and Wednesdays,” Rebecca says.

Yes, she was stressed, but she’d handled stress before. During May, however, Rebecca noticed that her skin was breaking out.

“I didn’t think too much of it,” she says. “When I started college, I had an acne breakout and got a prescription that seemed to control it.”

But Rebecca was still on her prescription when this new breakout occurred. Things got worse.

“By the end of June, my face looked really bad,” she recalls. “My dermatologist put me on stronger meds and also instructed me to use creams. He seemed to think it was simply a result of stress and I’d be back to normal in a few weeks.”

Downhill
Weeks passed, though, and Rebecca continued to get worse. “My face turned increasingly red, I had huge patches of breakouts on my chin, lower cheek and on my swollen face,” she says. “It got so bad, I couldn’t cover it up with makeup. I was embarrassed, and I tried to hide behind hats and sunglasses. I was too ashamed to even look at people. I could only imagine what they were thinking.”

Obviously, Rebecca’s medicines weren’t working. She continued to see her dermatologist and tried approximately nine different meds under his care, but her self-esteem was going downhill fast.

“I’d look at myself in the mirror and just break down,” she says. I’d always struggled loving myself as God made me. And seeing me as His perfect creation just didn’t seem to make sense.”

What Now?
In July, Rebecca was hired to teach a high school band in another part of Georgia, so she didn’t take any more summer school classes.

“By the time I arrived at the high school, my face was full of cystic acne,” she says. “This is a type of acne that causes cysts under the skin that don’t form a head. The stuff inside the cyst is highly infectious, and if it erupts, it can infect your whole face.”

By now, Rebecca had three nodules (large cysts) underneath the skin.

“One was hard; the other two were mushy and nasty,” she says. “The hard one hurt. My dermatologist removed the hard one, and it was as big as my thumb knuckle. I had to have three stitches in my face.”

You can imagine how awkward she felt trying to teach high school students in a new environment where she didn’t know anyone except the band director. “It was hard to have confidence in my teaching because of how I looked on the outside.”

The Summer Continues
When Rebecca returned from teaching, the cyst on her left cheek was huge. Her dermatologist gave her cortisone shots directly into the nodules in her face. But two weeks later, there was still no improvement.

On her return to the doctor, he sliced, mashed and drained the cyst. But a few weeks later, it came back in the same place! Once again, he sliced, mashed and drained. And like clockwork, the cyst returned.

“I was desperate! I couldn’t understand why God was allowing this to happen to me,” she recalls. “But my faith remained strong. My self-esteem, however, was another story!”

“I finally planned a date night with God, and I poured out my heart to Him. ‘I’m doing everything I know to do,’ I pleaded. ‘And nothing’s working!’

“He began to show me that a lot of people view others from only what’s on the outside. Measuring others by how skinny they are, how they dress or what they look like is just wrong. And God showed me that I even judged myself by those standards. I had a lot to learn!”

Rebecca now sought a new dermatologist, and she sent Rebecca to a plastic surgeon to slice, drain and remove all the tissue surrounding the cyst. Though her face was numbed, she was awake during the process. Unfortunately, this area on Rebecca’s face became infected only a few weeks after surgery. “I think the infection was due to being cut three times,” she says. “I went back to the plastic surgeon, and he cut it again, leaving it open to heal.

A New School Year
Rebecca began her junior year of college last September, continuing to deal with the ups and downs of a variety of medications and the determination to clear her face.

“By the second week of December, I was out of school for Christmas break,” she says. “My new dermatologist took me off all medications and prescribed only one—Accutane—the strongest acne medicine available. It’s so strong, it comes with requirements. I have to have blood drawn each month, I have to be on birth-control pills, I have to see my doctor each month, and I’m required to take two pills at the same time every day. This particular medication is so strong, that if someone becomes pregnant while taking it, it’s likely the baby will have severe birth defects or even die.”

Within three days of beginning Accutane, all the other cysts on Rebecca’s face started rupturing by themselves and clearing up.

“It’s a long process,” she says. “It’s taking months, but at least I’m seeing some progress.”

An Up-to-Date Glance
Rebecca’s excited about beginning her senior year at Georgia Southern University, and though her face still isn’t completely clear, she no longer hides behind hats.

“Makeup will cover what’s left,” she says. “A lot of what I have now is simply scarring, because I had the acne for so long, and because I was on so many different meds. When I finish the Accutane, I’ll probably have laser surgery to remove the scars.”

Rebecca says she’s learned two lessons from this journey. “First, I had to see myself as the creation He made me to be. I’ve had to allow Psalm 139:14 saturate my mind: ‘I praise you because I am fearfully and wonderfully made.’ I kept telling God that I wasn’t able to see it. But He kept telling me, ‘No, no, Rebecca. You have so much to learn. Trust Me on this.’

“I’ve also taken to heart 1 Peter 3:3-4: ‘Your beauty should not come from outward adornment, such as braided hair and the wearing of gold jewelry and fine clothes. Instead, it should be that of your inner self, the unfading beauty of a gentle and quiet spirit, which is of great worth in God’s sight.’

“I’m realizing that learning this truth is a process. Daily I have to lay down my view of myself and sacrifice it, taking His view of me. I’ve never had a problem of viewing others from an outer appearance; I’ve never judged anyone because of what he or she looked like, but this has deepened my love for others. I’m consciously taking time to get to know a person’s heart.”

Rebecca leads a Bible study for college freshman girls, and one of the gals in her group recently shared that she was struggling with cystic acne.

“I was so excited to let her know how beautiful she is!” Rebecca says. “If I had to endure all I’ve gone through just to help this one girl, I can honestly say it was worth it, and I’d do it again.”

Inner vs. Outer
“I want to make it clear that when I’m talking about inner beauty, I’m not saying, ‘Don’t wear makeup.’ I’m encouraging girls to search for the beauty in others that comes from within. Proverbs 31:30 talks about how fleeting outer beauty is. How we look on the outside is only temporary, but things like our character and integrity are what last.

“I like to look fashionable, and I wear makeup. We can have inner beauty and still care about looking our best on the outside. We just can’t let someone’s appearance determine what we think about her or whether we’ll become her friend.”