can I call in sick from work because of acne?

A reader writes:

I have cystic acne that I have been able to keep under control for the most part, but once in a while it flares up and is horrifically painful and embarrassing. Most managers understand calling in because of sickness, but is it reasonable to call in when I get a flare-up? It happens maybe twice a year for reasons I haven’t figured out yet.

If you’re asking if you can tell your manager that you’re calling out because of acne, the answer to that is no. It won’t come across as enough of a reason to miss work. It’s a little too close to calling out for a bad hair day. It’s not quite that, obviously, but it’s in that neighborhood.

But if you hardly ever take sick days for other things and you’re asking if it would be a terrible sin to occasionally just say that you’re under the weather without mentioning acne … well, no one’s going to be the wiser if you do that. (Just like no one will be the wiser if you hardly ever use sick days but occasionally take one because you’re exhausted or simply cannot face the world. You just can’t do it regularly. Like once or twice a year, max, and only when you haven’t used a lot of sick leave previously.)

I feel like the answer I’m supposed to give you is that the acne doesn’t matter and you shouldn’t be bothered by it and blah blah … but it is legitimately upsetting when you feel something has randomly grown out of your face overnight and is red and glaring and painful. You’re allowed to have feelings about that. You can’t necessarily act on those feelings in the way you want, but you’re not wrong to find it upsetting.

That said, it really is true that most people aren’t scrutinizing your appearance anywhere near as much as you are. That doesn’t necessarily mean that a giant red zit smack in the middle of your nose won’t register with them, but if it does, they’re highly unlikely to have any particular thoughts about it (other than perhaps a moment of sympathy because most of us know how much it sucks).

Updated to add: Many commenters have pointed out that cystic acne can be so painful that it’s more akin to a migraine or another condition that would make it difficult to focus on work. I didn’t realize that and am glad to be corrected! If that’s the case, I still wouldn’t say you’re calling out because of an acne flare-up (because many managers will be like me and not realize the pain level we’re talking about), but you could say something like “a flare-up of a chronic condition that’s usually under control.”

{ 224 comments… read them below }

  1. Greg NY*

    Alison, you’re wrong on this. It’s not just an appearance issue like most acne is. (I, like most teenagers, had pimples.) The LW describes her cystic acne (which is probably a different, more severe form) as “horrifically painful”. So how you approach it from a work standpoint is more like a migraine, not like a bad hair day.

    1. Princess Consuela Banana Hammock*

      Alison isn’t saying she can’t call out—she’s saying she can’t tell her boss that acne is the reason she’s calling out. Unfortunately, I agree that most bosses will not understand calling out because of a cystic acne flare up (as Alison’s advice shows, most folks don’t understand that it’s categorically different from normal acne).

      You’re right that it’s not analogous to a bad hair day, but I suspect most managers would treat it that way because they won’t understand that it’s distinct. I think calling out because you’re “under the weather” is a safer explanation than calling out because of horrific pain from cystic acne (even though I recognize cystic acne is indeed horrifically painful and nearly impossible to deal with).

      I’m really sorry OP has to deal with this.

      1. Greg NY*

        By the same token though, others really don’t “see” migraines, yet the pain from them are there.

        1. Scarlet*

          And that’s the reason why I generally say I’m sick rather than saying I have a migraine. At the end of the day, it’s nobody’s business. You can’t come in because you’re not feeling well, period. You don’t have to go into details about it.
          Alison isn’t saying cystic acne isn’t a valid reason to miss work, she’s saying that mentioning it as a reason for taking a sick day probably won’t come across well, because most people think “regular pimples” when they hear “acne”, just like they think “regular headache that just goes away with ibuprofen” when they hear “migraine”. It’s ignorant and unfortunate, but that’s just the way it is.

          1. Antilles*

            Right. The point Alison and PCBH are making is that a significant number of managers would wonder about the ‘acne’ as your excuse for taking a sick day. Headaches are actually a good comparison here because they have that exact same issue – a lot of people (who have never experienced them) don’t understand the seriousness and mentally go “not a good enough reason”.
            It doesn’t mean it’s not a legitimate excuse for taking time off, it just means that it’s easier to avoid the judgment by using a more generic “under the weather” without going into details.

            1. JD*

              It rubbed me the wrong way that Alison addressed the “embarrassing” part but not the “horrifically painful” part. Like, this obviously isn’t normal acne, the response should acknowledge that.

                1. Becca*

                  I mean, I had no idea what “horrifically painful” actually meant or how debilitating it is, but I was sort of confused that it wasn’t addressed at all (in the section before the update) since I figured the LW wouldn’t have mentioned it if they didn’t think it was painful enough to be relevant to whether they can call out for it.

                  That said, it doesn’t really change the advice since most *won’t* understand just how bad it is and the response does demonstrate that. People miss things or interpret things differently.

              1. pleaset*

                “Horrifically painful” to me means extremely painful, which for most people precludes working effectively for an extended period of time. That seems pretty clear.

                But there is a lot of hyperbole here – too much IMO – and I think AAM’s initial reaction reflects that. I try to take people at their word, and if it turns out they’re being hyperbolic, I just don’t take them seriously.

                I don’t think that’s the situation with this OP – I took her at her word. Matter-of-fact language gets more respect from me.

            2. Flash Bristow*

              Another good comparison is period pain. Some people have a slight nagging ache for a few hours a day. I – and a friend – had the kind of stabbing pain that makes you collapse into a crying, gibbering ball. At 11 I was put on opiods to help with it; by 13 I was put on the pill. It really is horrendous *when it’s bad* yet I know many women who barely notice it. And of course, many men in the workplace who can’t relate (although most are kind and sympathetic).

              I have never had cystic acne but I can imagine there’s a very painful skin condition that prevents people from working that day, and I’d hate to judge. As a disabled person I know that there’s no hierarchy of pain or struggle, and that we cannot know what another is feeling.

              But I understand “acne” sounding like “I’m feeling self conscious over a few spots”. OP could you maybe describe it as an incredibly painful skin condition, which renders you unable to do anything other than rest up?

              I hope you find a solution. And there’s certainly no point in forcing yourself to work when you’re in pain – the commute will be awful, and you won’t do your best work. Good luck in finding a way forward.

              1. Amelia Pond*

                It was the same with me for my period pain and same treatments, though blessedly I’m now cured of the disease that caused it. (I still have other health issues but I’m still damn glad it’s gone because even WITH treatment it was awful.) I’m constantly baffled when women treat other women as if they’re either being whiny babies or are exaggerating their pain. Why on earth do they think because their period is one level of pain that ALL period pain is at that level? That every woman is exactly the same? I cut men a tiny (very tiny) bit more slack, because they really don’t have anything to compare it to, but it really is the women that confuses me.

          2. Pimple LW*

            Thats what i thought, that saying acne would paint me in a wrong light. Im female and my boss is male. He’s pretty cool sometimes but i didnt want to come across as vain because i have a skin issue.

            1. JSPA*

              As cystic acne involves localized / regional infection (as well as inflammation), it’s not misleading to say that you’re dealing with “an infection.” Whether it’s strep throat or cystic acne really isn’t anyone’s business, and people tend to be pretty clear on staying out with an “infection.”

              1. Ego Chamber*

                Don’t know whether you’re female and if you are whether you’ve ever cited “an infection” as a reason for calling out of work, but my experience as a woman is that the one time I called out because of an infection, I got no end of shit for it because word got around and it was assumed I had an STI. (I did not. I got a bad cut on my hand over the weekend that I needed antibiotics for.)

            2. TardyTardis*

              But it sound like Shingles Jr. when it happens; just mention you’re having horrific pain and can’t come in and let the manager guess you’re hinting at something else (since you say you’re female). If you do this only a couple of times a year, he’ll think you’re a Brave Soldier the rest of the time.

        2. Lilly*

          As someone with chronic and debilitating migraines I am with you. If I come in with a migraine my boss rolls his eyes because he thinks I’m being dense when I can barely push through the pain and disorientation.
          I also get flack for calling out for a migraine… to everyone it is just a headache, if I’m not visually ill then I should be at work in my desk.

          The overall idea should be not to disclose your illness unless pushed into it – most bosses won’t ask serious follow up when you explain you are too sick to come into work for one day… and if they do that is when you get vague with how you’re in a lot of pain and need to rest.

          1. Christmas Carol*

            I used to get flack from a certain manager for calling out with a migraine, until the time I tried to push through one and ended up throwing up on his shoes.

            1. Amelia Pond*

              I’m very sorry you had to go both through the migraine and that boss, but I had to laugh out loud at throwing up on his shoes! People that do things that should get thrown up on way more often, but sadly, they rarely do.

          2. LSP*

            I also suffer from migraines and have been very upfront about it with my managers over the years, and have finally started viewing them myself as a disability (because that is what they are). I have asked for reasonable accommodations for my migraines (which really just means being able to take unpaid days off if I have some especially bad migraines that take 2 days to get better, since I only have 5 sick days a year.

            Not everyone is comfortable with being a spokesperson for their particular ailment, and while migraines in recent years have begun to be “seen” more, cystic acne I don’t think has. Either way, calling out as under the weather or working from home (unless the pain makes that impossible as well) is a reasonable solution.

          3. Jessen*

            I often play up the other symptoms of a migraine. I tend to get nausea, dizziness, and light/sound sensitivity. Dizzy and nauseated often come across as “better” reasons to call out, even when the migraine pain is worse.

            1. Random Commenter*

              Yes I agree. As someone with migraines I often find playing up (not faking) the other symptoms like dizzyness and light sensitivity has worked for me as well. Once my boss sent me home because I couldn’t stop blinking at the lights in the office.

        3. samiratou*

          If the LW’s boss is unlikely to accept migraine as an excuse for calling in sick, then acne won’t be any better.

          I agree with you that from the LW’s perspective, the condition is closer to “migraine” than bad hair day, but not many people understand how bad cystic acne can get, so from a boss/coworker perspective, they’ll think of it as closer to a bad hair day than a migraine. Probably, anyway.

          Which is why Alison’s advice not to mention the acne part is legit, not that she should never, ever call in for it.

        4. ToS*

          To your point, and consistent with Alison’s advice, you would say “migraine” to indicate severity, and not just “headache” which might confuse it with the mundane.

          For flare-up conditions, if the employer is large enough for serious health conditions to fall under FMLA, intermittent leave of that sort might have protections, check with HR. This does not apply to smaller employers (under 50 employees), and employees who are new.

          For some conditions, people hit the Extreme Version jackpot. Managers do need to listen for that, and employees need to provide just enough information to create mutual understanding.

          1. Scarlet*

            “To your point, and consistent with Alison’s advice, you would say “migraine” to indicate severity, and not just “headache” which might confuse it with the mundane.”

            Yeah, but my point was that because “migraine” is sometimes incorrectly used by people to mean “headaches”, a lot of people don’t realize there’s a big difference between them.

            It’s great when managers are understanding but a lot of people don’t care or have no empathy and there’s absolutely no obligation for an employee to divulge personal information in order to “create mutual understanding” when the specific reason why you’re calling in sick is *nobody’s business*. If people call in sick because of explosive diarrhea, they don’t get into details and wouldn’t be expected to. People with chronic diseases don’t have a duty to educate their managers or coworkers.

    2. Baby Fishmouth*

      Yeah, I got horrible cystic acne briefly right after I finished university – it really is terribly, terribly painful and hard not to think about constantly. I was lucky I could get it under control for the most parts, and now my breakouts are more run-of-the-mill acne, but every once and a while I’ll still get a cystic zit and it’s astonishing how painful it can be and how much more self-conscious I am about it than a regular zit.

      Beyond that, I think Alison’s answer is pretty fair. Call in sick if you need to, but don’t tell them it is because of acne. Don’t do it anymore than a few times a year, and really only if you don’t take a lot of other sick days.

    3. DaffyDuck*

      I think most folks hear acne and think of teenagers with pimples. I would suggest pleading pain instead of acne if they really need to know why. Tell your boss a flare-up of a painful skin condition that is normally under control.
      BTW, my boss told us she doesn’t need details as to why we are calling out. She doesn’t need to know what the doctor appointment is for – just that you are going to one.

    4. Jaguar*

      Yeah, the “horrifically painful” part changes this (hopefully that’s really exaggerated language by the OP).

      If you have a medical condition that is causing you a significant amount of pain, use your sick time, OP. You might not want to say “acne” because people won’t understand the pain associated with that (I didn’t), and even if you don’t care about sharing that with your boss, you could tell him afterwards when you have a chance to explain that it’s not typical acne and has extreme effects.

      1. tink*

        It not exaggerated language, cystic acne can be extremely painful. If you’ve ever had any sort of benign cyst or extremely inflamed ingrown hair then you’re familiar with some of the pain… but magnified depending on how bad a breakout is.

        1. grey*

          +1 I rarely get cystic acne; but just dealt with a single instance – the pain was real (it was on my chin, so anytime I moved my mouth). This sounds like its all over her face; in which case, yeah, that could be distressing enough, pain wise, to warrant wanting to stay home.

      2. Pimple LW*

        Not exaggerating!!! A lot of people are correct when they compare it to a migraine. So painful. I couldnt sleep because my nose (where it was) was throbbing.

    5. Lucille2*

      Totally agree with this. Though I am a migraine sufferer, and have been reluctant to use my migraine as a reason to call out. Too many people, I believe, think a migraine is a severe headache when it something else entirely. And, for me, the frequency of my migraines has varied from a once a year type thing to every 10 days or so. It doesn’t help that a former coworker of mine and fellow migraine sufferer got a lot of flak from coworkers for taking unplanned days off to recover from a migraine.

    6. Elizabeth*

      Nah, I agree with Alison. I totally get that the LW has very painful acne (I’ve had it too, and it sucks). But if you call in and tell your boss that, they are going to see it as you calling in because you’ve got one little zit (hence the bad hair day analogy). Of course, it’s much worse than that, but it won’t register that way. And if the boss happens to be someone who’s never had acne in their life, they won’t get it at all.

      Do what Alison says. Call in and say you aren’t feeling well (which is totally true when your face hurts like hell). They don’t need any more information than that.

      1. RUKiddingMe*

        Never having had it doesnt mean not understanding. I never had acne. I managed puberty with maybe a total of 10 zits.

        My sister on the other hand had bad, bad, bad cystic acne. Huge zits way under the skin. So bad they had to have medical intervention.

        Even today, she is 51 years old and still gets them occasionally.

      2. Pimple LW*

        Yea, that was my concern. I dont think my boss would understand i dont mean little dot on my face but im talking about monster mountain taking over my nose.

        1. Airy*

          Having had cystic acne myself (and still on rare occasions getting a painful relapse cyst) I really hope it heals up soon and you feel better.

        2. uranus wars*

          I hope it gets better soon! I used to get it on my chin and knock on wood I haven’t had it flare up in about 5 years. It would flare so bad sometimes I couldn’t eat or talk without pain.

          I made it through puberty with no acne at all so when this started in my mid-20s it took me a few flare ups to understand what it was. At the time I talked to my boss about it and all she heard was acne and gave me a really hard time about taking off or trying to avoid the phones because it was just a pimple. I realize a lot has changed in 15 years but looking back I wish I had kept my mouth shut and just called in sick with no reason, which was never questioned.

          Whatever you do, don’t think you can do any kind of home remedy to permanently suck out the pain. I did get a few days off of work for that shenanigan – I ripped several layers of skin right off my face with a heated bottle. Just when I thought it couldn’t get more painful……

    7. Thursday Next*

      GregNY, I actually agree with you—before the update, the end of Alison’s answer focused on the question of appearance, and for many people with cystic acne, appearance is often less of a problem than the pain.

      I do agree with Alison and other commenters advising not to offer acne as the reason for calling out sick. I also think that in most cases, the specific nature of the illness doesn’t need to be disclosed. There are exceptions, like something that will keep an employee out a while, or something with a high risk of contagion. (Of course it’s different in workplaces that require documentation for illness.) But generally, I don’t think anyone needs to explain that they have a stomach bug or migraine or threw their back out.

      1. Elizabeth*

        By the way, thank you for all the work you do and for bringing Jane and Rochester their happiness.

    8. Trees*

      Cystic acne can be painful, especially if you touch but comparing it to migraines? I think that’s dishonest. I used to get a lot of cystic acne and it wasn’t fun but it’s not even close to regular headaches, let alone migraines

      1. Pimple LW*

        It’s not dishonest. I have had migraines and would rather a migraine than another cystic acne breakout. It really is comparable for some

      2. Thursday Next*

        I think it’s fair to say people have different experiences with it, as they do with many medical issues.

      3. smoke tree*

        I think all of these things vary. I’ve had both cystic acne and migraines, but neither was terribly painful. There isn’t really a universal benchmark for pain, but if it makes it hard to work, to me it’s a valid reason to stay home.

      4. HannahS*

        Things vary in severity. The majority of my migraines have been so mild that I grimaced, went to bed, and woke up fine. I’m sure you’d find it unfair if I told you that, based on my experience, your migraines can’t possibly be as painful as an infection deep within your skin.

      5. Gazebo Slayer*

        I had an ocular migraine once that really wasn’t horrifically painful – just disturbing, because it felt like a pain directly in my eyeball, and lasted several days. (I got checked out for glaucoma and such and my eye was totally normal.) Aside from the time I took off to go to the eye doctor, I was able to work through it. But many other people have far, far worse. I expect acne is the same in terms of variation! Sometimes even my regular acne has hurt.

      6. WS*

        It differs. I get migraines and they’re less painful than sinus headaches to me, but come with a bunch of other horrible symptoms that affect me much more than a plain sinus headache. I don’t have cystic acne but two family members do and can differ wildly in pain levels depending greatly on location, size and depth of the cysts, and number of cysts, plus of course it’s an actual infection often needing medical treatment.

      7. Amelia Pond*

        Just because your experience wasn’t so horrible doesn’t mean that the LW (or anyone else with cystic acne) had the same experience. Not everyone has the exact same experience, the exact same amount of pain. It’s the same way no migraine is example the same for everyone or period pain is the exactly the same for all women. Why on earth would you think would you think your case is universal is beyond me. Calling the LW a liar is so incredibly rude and so is being this judgemental.

        1. Amelia Pond*

          Dangit, I wish there was an edit button. *No migraine is exactly the same. *Why on earth you think your case is universal.

  2. Murphy*

    My experience as a woman with occasional acne is that it would take a few days to go away. Would OP be taking multiple days in a row? Is working from home an option if you really feel like you can’t go into the office?

    1. Seriously?*

      That’s what I was wondering. If it is one day then it won’t register. Multiple days in a row would.

    2. BottleBlonde*

      I deal with cystic acne – my dermatologist will give me a cortisone shot into the inflamed area if the pain/swelling is bad enough. In my experience they usually start to help within just a few hours, and helps massively within 24 hours. Could be a 24-hr solution for the OP if they have a similar treatment available.

    3. Pimple LW*

      I cant work from home. I felt this coming on a day before it got real bad. I stayed home one day and by the next, the redness had decreased and the pain was manageable. It took about 4 days to go away and now i got a scar as a souvenir

      1. fellow sufferer*

        If you’re not already and have the insurance and means to do so you really should get the cysts treated with a cortisone shot. They will not scar as badly.

  3. Jacque of All Trades*

    Cystic acne is very painful. Even if not in a visible site, the pain is mind-consuming, like a toothache.

    1. Detective Amy Santiago*

      I was wondering about this. The LW mentioned pain and this isn’t something I have experience with. I’d say being in pain is definitely a fair reason to use a sick day though I agree with Alison that you don’t need to get into those details.

      1. Princess Consuela Banana Hammock*

        I agree that taking a sick day is completely justified in this case, regardless whether OP has taken other sick days. Horrific pain is horrific pain, and no one should have to try to power through that if they have the ability to take sick leave. And I agree that it will go more smoothly for OP to not go into details.

    2. Ask a Manager* Post author

      I’m glad to have been corrected on this! I didn’t realize that cystic acne was that level of painful (and took the OP’s description as more like colorful language than literal truth). If that’s the case, I’m in full agreement with others that it’s fine to refer to a flare-up of a chronic condition that causes pain (although still wouldn’t explain it’s acne because I think a lot of people will be like me and not realize the pain level we’re talking about).

      1. Tara R.*

        Also, if OP’s flare-ups are in a visible area, the boss will almost certainly notice. It’s not a couple of pimples— when my roommate was struggling with it, his whole face was red and swollen. I never thought about it beyond “ouch, that looks painful!” and offering to pick up some painkillers, but it’s definitely noticeable and the boss will probably put two and two together with “painful chronic condition” or whatever language OP uses.

      2. Acne-haver*

        Yes! I get cystic acne flareups occasionally on my thighs. Obviously nobody can see so it’s not really about it being embarrassing (even though it is), but getting dressed and walking around is so painful I can barely do it!

        1. Elizabeth*

          My husband gets cystic acne on–of all places–his stomach. I help him put medicine on it every night. So, I definitely feel you, just from what I’ve seen with him. It does cause him a lot of pain when it gets bad.

          I told him that I’ve never seen anyone who gets acne on other parts of their body like that (it was all face for me), but apparently it’s more common than I realized.

          1. WS*

            It’s uncommon to have thigh acne in adolescence but unfortunately that’s not the case for adults!

      3. Elizabeth*

        It’s okay, many people don’t know this if they haven’t dealt with it. That’s why I’m not sure that LW should mention acne if she calls in–her boss is likely to think that she’s being dramatic (which is not true, but still).

        So, I agree, if I were here, I’d stick to saying she wasn’t feeling well and leave it at that. That gives her time to go to the dermatologist that day if she wants to, since most of them will give you a shot that helps a lot over the next few hours.

      4. CM*

        Would you consider updating your answer to the letter? It sounds like you’re assuming the OP is mainly embarrassed about her appearance, which comes off as a little dismissive to me.

        1. Princess Consuela Banana Hammock*

          I agree that it would be helpful to update the letter, as it sounds like Alison is kind of missing OP’s point re: the pain. It’s definitely not an exaggeration.

          1. Princess Consuela Banana Hammock*

            Sorry, I realized that sounds harsh. I’m not saying Alison doesn’t get it—just saying that the current frame does not have the benefit of the additional information she received from commenters re: the pain.

      5. JD*

        Thank you for the correction. I don’t have this condition, but I have another chronic condition. In my experience, people with my condition are frequently assumed to be exaggerating how bad it is (in part because there’s nothing visible) but again in my experience are actually more likely to be *understating* how bad it is. Eg, we don’t want to admit how much time we spend asleep, or we have trouble acknowledging to ourselves how little we can actually do. Assuming that someone with a medical condition is exaggerating is often a false assumption. Lots of people downplay severe, debilitating problems.

        (I’m not trying to pile on, you’ve already fixed this particular situation. It’s more a PSA: people, please believe people when they tell you how bad things are!)

      6. Pimple LW*

        Im not a wimp but this pain was like a 8/10. I couldnt sleep because the throbbing kept me awake. :(

    3. Thursday Next*

      I’ve found the ones on my forehead or temples to be the most painful, making it difficult to concentrate. Cortisone shots were an amazing help to get through the worst of the swelling and the pain.

      This is probably one of many things that it’s hard for people to understand unless they’ve experienced; for most people, “acne” = whiteheads, and those are different.

      I think the best workaround is not to attempt to get people to understand the specifics of the situation, but to ask for what you need* to cope with it. In this case, that’s a sick day.

      *”What you need” has to be feasible and reasonable.

  4. DaffyDuck*

    If it is horrifically painful that will impact your work focus, it is OK to call out. I agree in NOT telling them you are calling out due to acne, there is just to much room for misunderstanding, but calling out due to pain is what sick days are for IMO.

    1. CM*

      Agreed, and it’s only a few days a year so I don’t think the OP needs to do anything more than say she’s sick.

  5. CatCat*

    Horrific pain is a good reason to call out sick. You don’t need to elaborate though as to this or any other condition. Nobody else’s business! If your manager probes (why?! who knows, such people do exist) and you feel like you have to say something, “I have a chronic condition that causes severe pain when it flares up on rare occasion. Now is one of those occasions.”

  6. rj*

    If you have sick time allotted to you doesn’t matter why you’re taking it. It’s your time. And it’s not your boss’ business specifically why you’re taking it. If you are out for several days or need time beyond what you’re allotted then that’s when you have to give cause. But 1-3 days? Take them. Get through the flare, feel better, and you’ll be able to concentrate on your work.

  7. Gloria*

    You can call in sick for any reason. So if you think that you need to use a sick day on the acne, that’s fine. I agree, it’s way more than a big zit in the middle of your face. Why do so many people have to say why they call out? I don’t think you need to share that information. Just say you’re taking a sick day.

    1. mark132*

      +1, I usually don’t say why, I don’t think my boss really wants to know anyways. I’ve used sick days for mental health days as well. And I definitely don’t tell my boss that either.

      Of course if you are going to miss a week, you may want to be less vague.

    2. Andrew*

      I have this question, too; any time I’ve taken a sick day, my note just says, “not feeling well, taking a sick day. Will be checking email periodically, but text if [etc etc etc].” I don’t feel the need to tell people what I’m taking the day for. And by the same token, if my colleague or report is having a sad day, or a splitting migraine, or explosive diarrhea — please keep that to yourself. All I want to know is that you’re taking a sick day, and if you’re feeling capable of fielding emergency questions. You’re grown-ups. I trust you!

      1. starsaphire*

        Not to mention that all those gory details can give people the impression that you’re being less than truthful.

        And, dear God, I really don’t want to hear the details regardless! I know what “a stomach bug” is and I don’t want to know ANYthing else! :P

      2. sam*

        it really depends on the boss – my boss will get annoyed at too much information – he just really doesn’t want or need to know, and trusts us to use our judgment on when we’re actually sick (it also “helps” that we’re generally the type of people that probably don’t take enough sick days – yes, I’m the person who only came in LATE the day I ended up getting ambulanced to the hospital after falling down a flight of subway stairs and landing on my head on my way to work).

        But I know there are some bosses out there that will give you the third degree and expect a doctor’s note if you have the temerity to call in.

      3. pleaset*

        I do that sometimes similar to this because I don’t view illness as binary – 100% on or 100% off – and with some minor stuff just not commuting and working only an hour to two is enough for me to beat the illness and be good to go the next day.

        If we have something important coming up where a minor intervention from me would help, I’ll check email when out sick. Not all day. But once or twice when I feel good. And ignore non-important stuff.

    3. Laura H.*

      I tell my boss why- just as a matter of a sort of heads up/ duration- but I volunteer the info, they don’t pry it outta me. But I’ve only been sick once or twice (flu once) and it’s part time retail. For me, it’s a matter of keeping the people who need to know that I’m not there in the loop. But that’s a work quirk I have and the minute I’m told to stop/ we really don’t need that much, I’ll adjust accordingly.

    4. mcr-red*

      I had a boss who basically would try to convince you to come in no matter what and would badger you. I think people just started telling him graphic details so maybe he’d stop or he’d be convinced and let us be sick in peace? He was the one that also wanted a doctor’s note if you were absent more than two days in a row, which meant people would be sick for two days, then come back to work (still sick) infect the rest of us, and then be off sick again to get around the doctor’s note thing and the costly doctor’s visit – we have expensive and crappy insurance. I have noticed since he has left, I’ve been less sick and I really think it’s because people stay home now when sick!

      I’ve had too much experience with bosses who don’t believe you are sick or who try to convince you that you’re not sick enough to use a sick day. I’ve also become paranoid of being sick and being “out” somewhere – for example, being sick and going to the store for cold medicine, food, whatever, because my “you’re not sick enough to be sick” boss once saw someone out and was convinced they were just skipping out on work.

      I also suffer from migraines and RA. And I try really hard to not take off time for them because I once worked with someone who had migraines and a chronic pain disorder and both that boss and my other coworkers complained constantly if she had to work from home or take a sick day.

      So in three words why do people do those things? Toxic work environment.

    5. Pimple LW*

      Its our work culture i think. Everyone feels tjat they have to have an excuse. I felt like i did but just gave a vague emergency excuse

    6. Jennifer Juniper*

      I had severe acne as a teen that only went away with Accutane my freshman year of college. I am privileged that I never had any pain with it, however.

  8. Lisa*

    I know how painful cystic acne can be. When I get a flare-up, I end up needing to go to my dermatologist for cortisone injections—otherwise the pain is so bad that I literally can’t focus on anything else.

    LW, if you are also seeing your derm for treatment, you have even more cover: “I’m not feeling well today but I’m seeing my doctor and expect to be feeling better after treatment.”

    1. Middle School Teacher*

      Yes, me too. And if you get the shot early enough, you really only need one day off. It starts working pretty fast (in my cystic acne experience).

  9. the_scientist*

    As a former sufferer of cystic acne I have a lot of sympathy for the OP. I think people who’ve never experienced this type of acne don’t really understand how painful a flare-up can be. As a result of cystic acne, I had a severe deep-tissue infection that permanently compromised my lymphatic drainage system, leading me to be more susceptible to re-occurrences of this infection….which I have called in sick for, as it’s pretty unsightly and alarming to observers (although not contagious).

    That being said, I think the advice here is accurate. Also, I won’t give any specific advice as I’m sure you’ve tried every at home, over-the-counter or prescription remedy available to you (I certainly did) but I will say: please speak to your primary care doctor (if, of course, you have one, and you haven’t already done so). They should take your concerns seriously, and if they don’t, you are allowed to advocate for yourself and/or to find a doctor who does and who will support you in resolving this problem!

  10. Some Sort of Management consultant*

    I never thought much about acne being an actual disease until I started watching pimple popping videos (my guilty pleasure!). I always thought of it as somewhat painful and noticeable but not much more than that. And then I saw all these videos of the sometimes horrific, swollen cysts of cystic acne and felt very chastised.
    I could also vividly imagine how painful it must’ve been before antibiotics.

    If OP’s problems are anything even remotely close, then wow do I understand why they would need a sick day.

    Take care of yourself, OP!

      1. mrs__peel*

        I was lucky to not have much acne in my younger days, but I’m now starting to get the painful cystic kind occasionally (due to creeping middle age and rosacea). I would definitely feel sympathetic towards a coworker who had to deal with it regularly!

  11. mrs__peel*

    I would think many bosses would be sympathetic if you described it more vaguely as “a painful chronic medical issue that comes up occasionally”. I’ve done that when I was dealing with severe cramps, had male bosses, and didn’t want to get into a huge amount of detail. (And it wasn’t a big deal, fortunately, because I was otherwise a good worker with pretty minimal absences).

  12. Syfygeek*

    I dealt with this in my 20’s, and OP, you have my sympathy! I was actually sent home from work once because of how bad my face looked. Acne makes you think of a few pimples, or a big zit, but it can be raw places that hurt like the dickens.

    OP, I’d call in if you have the time available.

    1. Dust Bunny*

      Mine didn’t go as far as cystic but it was pretty bad, and some of the treatments available at the time caused mild chemical burns (but didn’t clear anything up, of course). It had a really terrible impact on my self-esteem.

  13. Jessie the First (or second)*

    I feel like it would have been kinder to the LW for the answer to acknowledge that this is cystic acne – not acne, not a bad hair day, not just feeling blah. The end result is the same (yes, call out sick, no, don’t tell them the precise reason, because they won’t understand). But the LW clearly feels odd and guilty and embarrassed. Some kind of recognition that the reality of her situation is actually legitimate – more than simply having pimples – would’ve been helpful for her .

    1. Audra*

      I agree. It isn’t really a case of a normal zit and being slightly embarrassed but moreso like, wow, my face hurts really bad and it’s covered in nodules that can’t be hidden by makeup. I totally get this.

    2. Pimple LW*

      I have normal zits all the time that are minor and not that noticeable. It never bothers me. This thing was a monster. Thats why i felt so conflicted about calling in. Im glad i did

  14. Sara*

    As a manager, I had an employee come to me asking for the time to run to the doctor because of a cystic acne flare up two weeks ago and I was… fine with it? I didn’t actually need to know the why, it was just volunteered. All I ever care about is when and how we were dealing with any outages, but knowing what it was for didn’t change anything for me.

  15. Lucille2*

    I agree with Alison here, maybe don’t tell your boss you’re calling out because of acne, but calling out for being unwell is totally appropriate. Mainly, I just came here to sympathize. I have worked from home due to acne. Acne is not always simply a cosmetic problem.

    1. the_scientist*

      I have to be honest that I’m really heartened to see the compassionate responses here. Cystic acne is far beyond a simple cosmetic issue. I really under-estimated the impact that it had on my mental health and overall self-esteem until I completed my treatment and found myself with clear skin for the first time in over a decade. Effective treatment made me more confident in my appearance, which in turn made me more confident socially and professionally, and it also just freed up a lot of mental space and energy. I didn’t get effective treatment until I was in my late 20s and I regret waiting so long to do so- there was no reason I couldn’t have done it much earlier.

        1. the_scientist*

          For me, it was Accutane and it was a magic bullet. I understand it’s not for everyone, but I would 100% do it again if I had to, even with the bad side effects (and I had many side effects).

        2. uranus wars*

          I had a estitichian once do a laser treatment during my last flare up that seems to have worked for me. I haven’t had a flare up in about 5 years. Mine used to occur in the same spot on my chin, though, so it was a one-time spot treatment.

    1. Anonymops*

      I worked from home at the onset of a cold sore. I also was feeling kind of crummy so used that as an excuse but it was so painful and SO ugly (I felt like a monster) that I could not bring myself to work. Thankfully it calmed down and I went in the rest of the week.

    2. Bea*

      Seriously. If you’re in pain and you have sick leave, use it.

      I’m sad so many people weigh what’s worthy of sick time. Unless you have attendance issues or on a performance plan, I’ve had people call in for everything. Nothing is an issue unless you’re calling in chronically and missing a ton of work, causing more work for the office.

    3. Jaybeetee*

      I’m not sure it would be feasible unless yours tend to heal fast. I went through a weird phase of having cold sores several times per year for awhile (seemed to be connected to humidity/seasonal changes), and if I didn’t get ointment on those buggers right away and they “blew up”, I was stuck with them for about a week. I would have loved to have never left my house during those times.

  16. Tammy*

    I don’t know anything about cystic acne specifically, but I agree with the others who say if you’ve got a medical thing that’s impairing your ability to work to that extent…well, that’s what sick days are for.

    If it’s a chronic condition, it’s also probably not a bad idea to give your boss a heads-up. Something like, “Hey, just wanted to let you know that I have a chronic health condition which flares up really badly a couple times a year. It’s quite painful when it does, so you can expect that when that happens I’ll need to take a sick day.” This isn’t strictly necessary, but if your boss has this in her mind it makes it more routine and normal when you do have to take time off. (I have a member of my team who has something like this, and it helps me to remember, “oh, yeah…he’s got that thing” when he’s not here.) It also primes me to be ready for a conversation about intermittent FMLA leave if he runs out of sick days.

    1. Could be Anyone*

      This is what I came here to say. Nobody needs to know my specific health issues. I certainly don’t elaborate when I come in late after a routine gynecological exam.

  17. Kale Bee*

    Cystic acne sufferer here (though knock on all the wood, it’s been like, 3 years since I’ve had one on my face). It is /not/ the kind of acne that people won’t notice or think much of. I’ve had ones the size of a large marble festering under the skin, and people definitely notice. And, yes, I’ve called in sick due to them, but did not state that as the reason for calling in sick, just said I wasn’t feeling well. And, yes, I’m someone who rarely calls in sick, if ever.

    So, OP, go ahead and do it, as long as you meet the above criteria. And find a doctor who will administer a cortisone shot for you in these extreme circumstances! They may be pricey ($~100), but I can’t put into words how worth it they are. You will see significant improvement by the next morning. I swear by them. Please, please look into it.

    1. Dee*

      Please do not give medical advice to strangers on the internet. It’s inappropriate at best, and potentially dangerous.

      Accutane doesn’t work for everyone, and cannot be given to everyone. It also has some significant side-effects. It’s not a miracle drug.

      1. Allison*


        I had severe acne, but my dermatologist wanted Accutane to be a last resort, because of the severe side effects and lasting damage it can do on your body (my mom knows someone with a permanent digestive issue that resulted from taking Accutane). There are some very powerful topical stuff you can use, Tazorac worked for me along with a few other creams; a good dermatologist will know what’ll work best for you.

        When I had bad acne, before I got on the regimen that really did help, people kept telling me what I “had” to take because it’d work wonders and honestly, I hated it. I knew not everything worked for everyone, and my friends and I were all in high school, none of us were qualified to dispense that kind of medical advice. I now have products I swear by and sometimes I’m itching to yell them out, but I only recommend them when someone wants a recommendation.

      2. Courageous cat*

        Well, it’s also not like you can just get it over the counter either – she would obviously have to be taking it at her doctor’s (literal, physical) recommendation, so I don’t see much harm here.

    2. Detective Amy Santiago*

      It’s really not appropriate to offer medical advice to strangers on the internet.

      1. CMart*

        I know Ann Nonymous was probably trying to be helpful/maybe had Accutane work for them but yeah… no.

        I’ve never had an issue with even run of the mill acne and I’ve heard of Accutane. I can’t imagine someone who battles cystic acne hasn’t ever considered it.

        1. Ann Nonymous*

          Actually, 3 of my 4 kids took it (4th one didn’t need to) and they have beautiful skin now. Unfortunately it came out after I no longer needed it. I’m just afraid that LW has been unduly swayed by people for whom it didn’t work or who had side effects that overwhelmed the message that Accutane has been a miracle drug for so many. It’s kind of like listening to labor horror stories which drown out the not-bad ones.

          1. Bea*

            You don’t know the OPs medical history. There are reasons why a doctor has to see a person and only then prescribe things with risks associated with them. You sound like an infomercial.

          2. Andraste's Knicker Weasels*

            My husband took it as a teenager and he still has acne along with permanently damaged night vision. Fun!

            1. Nita*

              My husband too! It’s been surprisingly life-changing – his lack of night vision is a big factor in where we can live. We really want to get out of the city, but he doesn’t feel safe driving after dark, so we’re limited to places with good public transportation. And the acne still stuck around for years after he tried Accutane. Of course it was taken on a doctor’s recommendation, but doctor’s can’t always know how a specific person will respond to medication, and whether, to that specific person, the potential side effects are worth the potential cure.

            2. Goya de la Mancha*

              I took it twice in my high school/college years. It cleared up my skin AMAZINGLY….for about 6 months. So my doctor suggested a second round. My mom thinks the 1st round was when anxiety REALLY decided to amp itself up. She wouldn’t even let me start the 2nd treatment unless I was home for the summer.

    3. MechanicalPencil*

      That also comes with some major risks — I’ll avoid the “my best friend took this” story even though I have one. Go with medical advice.

      1. Nita*

        Agreed. The really bad side effects are pretty well known, so I won’t go into listing them, but it’s definitely not for everyone. And it doesn’t help everyone, or it can help only a little and only while you’re taking it. In the experience of a close family member, totally not worth it.

      2. soon 2be former fed*

        YES! A dear friend of mine is recovering from liver damage caused by an unknown allergy to Bactrim, which of course was prescribed by a doctor. Unless you have risk factors that can be prescreened for, drug response is highly individualistic.

    4. Leanne*

      Yep. I didn’t get around to doing this until I was 28yo, after 15 miserable years of suffering from cystic acne on my face and being bullied for it. Four months of treatment changed my life.

  18. KP*

    LW, I had cystic acne too. It started in my early teens. I got flare-ups through my twenties but it mostly stopped once I hit 30.

    I get the occasional break-out now, but nothing like before. My worst times when I was flaring were around May into July and Sept-Nov. I never found the exact cause, but remember I wanted to hide my face constantly. It didn’t feel professional and I felt “dirty” and exposed. There were a few times my face bled at work and I had to excuse myself to the bathroom.

    However, I promise you that no one is thinking about you as much as you’re thinking about you. Yes, your face looks (and feels) painful. No one is going to comment on it or think poorly of you unless they are big dumb jerks. If you need to take a personal day when you’re still in the overwhelming phase, I think it’s fine to take a day or two. You don’t have to mention why. Just say you don’t feel well.

    If you wear make-up, I found that powder foundation was my best friend (like Tarte, BareMinerals, IT, etc) The coverage isn’t as good as a liquid matte, and it’s not a cure all, but it seemed to help my skin a lot.

    Good luck!

    1. KP*

      P.S. It’s okay to be self-conscious about this. But, it’s also okay to NOT be self-conscious about it. My cheeks and my chin (and back) are scarred. A lot of days I don’t wear make-up at all. On the days that I do wear make-up, it’s because I want to.

      You don’t need to feel like you’ve failed at being an adult. You don’t need to feel ashamed. You are dealing with a medical condition and there is nothing at all wrong with that.

    2. voluptuousfire*

      Former cystic acne sufferer here and +1 for BareMinerals Mineral Veil. Helped with horrible oiliness and just enough coverage to not look like I had sunburn (cystic acne plus slight case of rosacea could look easily like sunburn on me).

      1. grey*

        I rarely have cystic acne but yes to BareMinerals for the regular kind of acne that I deal with.

      2. Hills to Die on*

        You can also use a green-tinted primer to get rid of the redness. I use a pink one because my skin has a sallow tone to it and the pink helps to neutralize it. You will still be able to see some redness, but it won’t be as dramatic.

    3. Pimple LW*

      Oh everyone comments on it. It was on my nose. Last time i went into work my one on my nose i got asked “whats wrong with your nose”. Idk why but its the most favorite place on my fave for cystic acne. Ive had this job for two years and have had cystic ance on my nose 3x and each time i got stupid comments. Probaby because it looked so bad :(

      1. KP*

        Those jerks!

        “What’s wrong with your nose?” is a question I’ve gotten from a literal five year old. Adults should not be commenting on your appearance unless it’s to help (like, you’re bleeding to death)

        1. Former Admin Turned Project Manager*

          I had a perfect storm of skin conditions one time (my eczema, rosacea, and psoriasis all decided to flare at once and they all like to emerge around my jawline and cheeks). My own father looked at me and asked “What’s wrong with your face?!” I’m sure he didn’t mean it to sound so harsh, he was probably concerned that the inflammation was painful, but still…I wanted to joke back, “Well, folks tell me I look just like you, so this is just the face you gave me.” Instead I paraphrased a quote from Sports Night (“I have a couple of recurring nervous skin conditions; they recurred.”

      2. knitcrazybooknut*

        “What’s wrong with your politeness?”

        Boundaries, sense of decency, etc. “Your rudeness is not accepted. RETURN TO SENDER.”

        Or you can just think these. Just wanted you to know that’s RUDE.

      3. Amelia Pond*

        That is so incredibly rude! Is this the type of work atmosphere at this office, people asking rude, personal questions? Boundry issues? I can’t help but think this probably isn’t the only time they acted like that.

  19. theletter*

    I’m definitely in the camp of adult should trust adults to be able to say if they’re sick enough to call out without having to share TMI to justify why. But to make this work we have to make a habit of it: Don’t say you have the sniffles, don’t say you have a migraine, don’t say you’re getting this-or-that removed. Just say you’re not feeling well enough to work and you think conditions will improve with appropriate rest and care.

    1. Lucille2*

      Couldn’t agree more! As a manager, I can’t tell you how many times I’ve been given gruesome details I don’t want to know about how sick an employee was. All I need to know is you’re unwell and won’t be making it in. No details, please. If it’s the flu, or otherwise contagious, a heads up isn’t bad since it’s likely to affect others, but not a requirement IMO.

      I think this problem persists from the kind of jobs that are dependent on a certain number of staff present to get through the work for that day. Where being short-staffed has the potential to cause issues in getting through the work for that day, unlike an environment where deadlines might have a little more flexibility. For example, restaurant, retail, healthcare. Even in those cases, people should have the right to say they’re unwell and take a sick day. But, too often in practice, that’s not acceptable by management.

      1. Ego Chamber*

        Yeah, this is definitely another thing to blame on retail, food service, call centers, etc (I couldn’t understand why so many people called in sick to The Taco Place I Worked At who said to tell the manager they were vomiting blood but then it turned out anything less than that wasn’t acceptable, so that’s the lie we all went with).

        Anyone who works as a Real Manager(TM) at a Real Job(TM): I recommend you include the bit about not needed details when people call in sick in the new hire training, and then remind them at least the first time they call in. Most of us have worked retail/food service/call centers/etc at some point and those scars don’t fade easy or fast.

  20. Anna Held*

    Just for comparison’s sake, I am allowed to use two sick days a year as personal days. This is on top of my PTO (and we’re encouraged to use all our leave). It’s worth checking your employee handbook or asking around to see what the norms are at your shop. It might not be so far off to take a day even if it IS just normal acne.

    Also, I don’t think you should feel guilty about taking random mental health days off! If it’ll help you focus and be more productive, it’s legit. Too many people soldier through the blues and take on additional stress when a day or two off could make a big difference. Take care of yourself.

    Sorry this is slightly OT.

  21. The Other Dawn*

    Cystic acne really isn’t in the same neighborhood as a bad hair day. Sure, appearance is part of it, but pain is a much bigger part usually. My older sister had it for many years. She had it on her back, shoulders and face, and she’s got a lot of scars from it, which are 30+ years old at this point. (I’ve seen the large scars and I can’t even imagine the pain that came with those breakouts.) Due to our big age gap I wasn’t around to witness a lot of it, but she told me about it. She said it was incredibly painful and she couldn’t focus at times. If the OP needs to call out, she can just say she’s dealing with a painful skin condition. Or she can just say she’s under the weather.

    1. Hills to Die on*

      Ugh. I had scars on my upper arms from acne that was so bad that people asked me if I was a burn victim. Um, no, but thanks for asking.

  22. Icontroltherobots*

    Yes – yes you can. You can call out sick for any reason you need to. How “honest” you are will depend on to what extend your employer encourages sick days.

    Standing “personal days” – use one!
    Mental health days – Use one!
    Actual Sick days – Use one!

    If you have a policy where you receive no paid sick time, personal time, ect. you’ll have to decide if it’s worth it financially to you, to skip out on the pay.

    I have personally, taken a sick day because of acne. Mine is brought on my dietary choices, and when I call in with “food poisoning” I mean it in the figurative sense. I did get poisoned with food, it’s just my face that’s throwing up.

      1. Icontroltherobots*

        lol it’s mine too! I’be gotten mine mostly under control (at this point) thanks to some serious prescriptions. Back when my cystic acne was bad, I would 100% stay home.

    1. Pimple LW*

      I found that sugar sometimes triggers it. Or lack of sleep, stress, dairy……really anything can cause my acne.

      1. Icontroltherobots*

        I feel you – I gave up dairy for an entire year, it was the only thing that stopped the cysts. Then my face transitions to just being filled with dozens of tiny pimples, and now with the help of a dermatologist I am (mostly) acne free.

        It was a long road, and I hope you can get there one day too!!

      2. Ciara Amberlie*

        Sugar for me too. A couple of cookie’s worth a week is fine, but any more than that? Guaranteed cystic acne 2-4 weeks later. Sometimes it’s worth it, but most of the time it’s not. You have all of my sympathy, I hope you find something that helps!

  23. Dealtwiththis*

    Vitamin B6 and Renee Rouleau Anti Cyst treatment have changed my life. Look into them!

    1. Julia*

      Vitamin B actually breaks some people out, so as always, this is extremely YMMV – plus OP didn’t ask for treatment options.

  24. Bea*

    If you’re in a state with sick leave, you don’t need to tell them why and they can’t require it.

    If you do give an excuse, say you’ve got a cyst that’s causing pain. You’re not lying. Then you don’t have to deal with judgy people hearing acne and thinking you’re just embarrassed by a pimple.

  25. KattyKat*

    Alison, you are wrong on this. It is not regular acne. It is extremely painful and can require dr visits, as stated by sufferers above.

    I would call out and stay home. You cant focus or be productive when you are in pain

  26. Chaordic One*

    These have certainly been informative responses in this thread to the question asked. I had no idea about cystic acne being painful as well as unsightly, and under the circumstances it would certainly be O.K. to call in sick.

  27. nnn*

    It would be useful to get in the habit of simply saying “I’m going to have to take a sick day today” without elaborating.

    If that sounds brusque, you can add more words by elaborating on useful things unrelated to the cause of your sick day. Example: “I’m going to have to take a sick day today. I don’t have anything due today, and my deadlines for the rest of the week are under control.”

    1. Pimple LW*

      That wouldnt work for my boss. He’s nosy and would expect a why. Even a vague why. I just said i had an emergency which was true for me.

  28. Amelia Pond*

    I agree with Allison. I definitely would not tell your boss the reason why. Because most people really are more worried about how they themselves look, I fear it would taken as a lack of professionalism that you’re “allowing” yourself to be distracted to due vanity. I don’t think it’s vanity, just that some people would feel that way.

    I very much understand how you feel, though acne isn’t my problem. Mine started with thinning hair all over but worst at the front of my head, due to health issues and some skin-picking on my face. It wasn’t too horrible until last December and now the dermatillomania is out of control. My depression and anxiety got to the point I don’t get out of bed 99.9% of the time. A new mystery issue caused sores on my scalp and I can’t leave them be. The picking means I now have not just thinning hair, but big hairless scabby spots. I can’t go out much and the only time I do is for doctors appointments to try and solve everything mentioned and things I didn’t. Hats are my new best friend but they don’t cover my face and makeup is useless. We get conflicting messages. How you look on the outside doesn’t matter! Except when it does! And no one gives us a rulebook to follow.

    If you need to take a a couple days a year, take them. Be kind to yourself on those days. Curl up in bed and binge watch your favorite movie or TV show. Maybe read that book you’ve been meaning to check out but haven’t gotten around to. Order some take-out! Whatever it is that helps you destress.

    1. Amelia Pond*

      Oh my lord, I didn’t realize that was so much bad.. Someone should take my phone away when I’ve been awake so long and recently took pain medication. If that’s too much awful for a comment, feel free to delete it. I’m just going to go back to lurking until the heat death of the universe.

      1. Pimple LW*

        Your response was fine! I thought it would make me look vain because i dont know if my boss understands what cystic acne is and im too embarrassed to say anything. I took the day off but did say something like i have an emergency

        1. Amelia Pond*

          Yeah, an unfortunate amount of people really don’t know how bad cystic acne can be. They hear “acne” and they think of a normal breakout. It similar to when people hear “headache” when you talk about a migraine and hahahaha, no, not the same.

          The emergency part worked this time but I’d caution you to stick with language of being sick (hopefully your office isn’t one where you’re pressured to give a ton of detail, like some letters have been) such as a cold/flu or a medical issue that very rarely flares up. If you use “emergency” too much, it may make people curious as to why you have them more often than other people. Totally not a fair thing, because problems don’t work on a reliable schedule, but people can be unconsciously judgemental about things. It can be extra hard with co-workers since most professional people aren’t over sharing about their personal problems at work, so it can invite speculation. Human behavior can be really odd sometimes, but it’s definitely fascinating. That’s probably why I’m so addicted to advice columns. AAM and Captain Awkward are by far the best out there, both in terms of actual advice and amazing commenters.

    2. Thursday Next*

      I hope you can find a successful treatment soon…it sounds like you’re dealing with a lot of pain. Internet hugs if they’d be welcome.

      1. Amelia Pond*

        I’m awful at figuring out threading so I don’t know this is a reply to me or the LW! If it is, thank you, internet hugs are most welcome. If it’s to the LW, I second internet hugs! Actually, internet hugs anyway. The past couple of weeks have been extra stressful, especially for women and I think we could all use comfort.

  29. sheworkshardforthemoney*

    I feel your pain. I have psoriasis. I’ve called in sick because my skin felt like it was on fire and I wanted to claw it off. I’d just say that you feel under the weather.

  30. CupcakeCounter*

    My sister has cystic acne and her face gets visibly swollen if she has a particularly bad breakout. Like just had your wisdom teeth pulled swollen. She’s been sent home a couple of time because of it so I can absolutely see taking a day or two off to let things calm down.
    I also agree that the reality of the situation is probably closer to a migraine than a bad hair day but can see how people who have never had either will roll their eyes. I don’t have migraines but my best friend and husband do – Hubs will absolutely puke if he eats anything at its peak or can’t get to a dark, quiet place. Before meeting him though it didn’t compute with me that a migraine isn’t just a bad headache.

    If you are going to go the sick day route I would get something set up with a dermatologist to get the cortisone shot – both for your healing/comfort and if boss or coworker say something you can say that yes, you saw a doctor about the issue.

  31. Allison*

    Here’s my general take on sick days: If you have a set number of sick days per year, it’s up to you how, when, and why you take them, as long as you’re taking them for something related to health or wellness. Cold, flu, stomach bug, bad period cramps, doctors appointment, hangover, mental health day due to a known mental illness, mental health day due to a bad breakup, bad rash due to an allergy, you name it. You know better than anyone else what kinds of issues you can suck up, and what’s going to impede your ability to work. Just say you’re not feeling well or you’re under the weather, most reasonable managers won’t ask questions, especially if you’ve earned their trust and generally do good work. I just recommend some budgeting so you always have at least one day in your sick bank, especially during cold and flu season!

    Obviously there are some caveats here. If taking a last-minute day off would throw your whole team into chaos, then yeah, you probably should reserve sick days for debilitating conditions and work from home if you can. If your company has “unlimited” sick days, or gives you so many that you’d only need them if you had a serious or chronic condition, you should be a bit conservative with your use, lest your supervisor become suspicious that something’s up. Otherwise, you’re an adult, use them at your own discretion.

  32. BeenThere*

    I feel so fortunate to work in an environment where the “rule” is, if you have sick time on the books, you can take sick time. You don’t have to explain it. If it’s over 3 days in a row, they can ask for a doc’s note, but I don’t know that they do since it’s never happened to me. I guess if you habitual about calling out every Monday, they might say something but … as I said, because I rarely call off, I just have to shoot my boss an email and let her know I’m taking a sick day. Aaaahhh… it’s good to be treated like a grown up!

  33. Pimple LW*

    Thank you for answering my question Alison!!! And thank you for everyone being so kind. I see that I’m not alone in this. The pimple in question was on my nose, very noticeable and had my entire nose red hot. The closest pain that I can conpare it to is being stung by multiple bees in the same area. It was throbbing. I felt it come on over the weekend but it turned ugly on Monday morning. I took the day off and said that i had “emergency pop up” (lol). I took the day resting and drinking lots of water (that helped in the past). I tried everything. Aloe vera, face masks, past from crushed aspirin and water, ice packs, lemon juice. I went overboard because i was so obsessed to get this thing gone! It’s gone but i have a scar now because i was too aggressive with it. I know have one on my chin but im covering it with a scarf. Thanks again for all the kind replies. I rarely take off work (2-3 times a year) and i felt bad about calling in because i didnt think this would be considered a real excuse but im glad i did!!

    1. Amber Rose*

      If you’re calling in that rarely, maybe take a moment and consider whether you’re really doing everything you can for you health. Some people just don’t get sick and that’s fine if that’s you, but the average person will take quite a few more than just two or three days off sick in a year. You don’t need to push yourself to shrink your sick days to nothing if that’s not what’s best for your health.

      1. Pimple LW*

        Hmm i didnt know that. Someone that never gets sick told me i get sick too much! Im usually healthy. I take a couple of vacation days here and there and one 2 week vacation to rest up

        1. Bea*

          Don’t listen busybodies about your health and wellness. Listen to your body and medical professionals when necessary.

          My sick days are spent by routine doctor visits and when my immediate family needs surgery. I’ll tell anyone saying someone is “sick to much” to task because they’re massively overstepping and rude AF.

          They’re policing your body and I’m not here for it.

        2. chickaletta*

          The average person takes quite a few more than two to three days a year? Not sure about that…. I’ve probably taken 2-3 days off for being sick in the last five or ten years. I just don’t get sick often. Everyone has a different normal – some people will be sick for a 2-3 weeks a year, some people none.

          1. NewJobWendy*

            Some people don’t HAVE sick days. I have been at my job 13 months and I haven’t taken a sick day because I only get 10 paid days off (for whatever reason). I have vacations planned, so I just show up to work sick. Thankfully I’ve not yet experienced an illness that *requires* me to stay home but I have come in to work with fevers, sniffles, coughs, etc. I’m not giving up a day at Disney World because my employer has a stingy PTO policy!

    2. Icontroltherobots*

      yeap – I totally did this as well. I had one on my upper lip that looked like the most horrific cold sore, I am not sorry I skipped looking like that at work.

      Another commenter suggested cortisone shots, those do actually work. I’d look into them. Also, if you don’t have a dermatologist, I recommend seeking one out. I didn’t get control over my face until I started on some prescription products.

    3. Trees*

      OP, have you tried using benzoyl peroxide? 2.5% is all you need. In order for it to work, you’ll need to use it every night on your whole face. It prevents breakouts very well, especially if you’re consistent. It also helps reduce the size of already existing pimples.

      Another good ingredient you can use – niacinamide. I use it in the morning, it’s in my moisturizer. It really helps with scars, too.

      I’ve tried so many other things and benzoyl peroxide is the true miracle drug and it’s cheap.

    4. Julia*

      I’m sorry, this isn’t what you asked for, and I just told someone above not to give you medical advice, but I had to say this. Lemon juice is too acidic to put on human skin and may be why yours is scarred now. Please feel free to ignore what I’m saying, or to get angry with me, but as someone who struggled and still struggled with acne (I have two big ones on each of my temples, right where my glasses sit -.-) and who has started reading a lot about treatments and skincare online, I thought I’d leave this here for you to do how you see fit.
      For me, personally, what works – and you may have tried this already, sorry! – are azelaic acid (like Skinoren or similar), retinol (Differin is OTC now) and, when it’s really bad, an antibiotic gel from the dermatologist. (He offered me antibiotic pills, but my case feels too mild to bring out the big guns.) I apologize sincerely if I’ve overstepped here, but lemon juice on your face can be dangerous, so I felt like I had to say this.

      1. Pimple LW*

        You’re good! I realized how bad lemon juice was after i put it on. I was looking up remedies and well….the internet told me to try it so i did. Lol. Wont do that again

        1. Julia*

          Next time, go on reddit’s skincareaddiction and either read through the sidebar or ask for help. The people are surprisingly nice for reddit, and you’ll get better solutions. That is, if you can’t see a doctor, which would be my first choice.

          1. penelope*

            +1 r/skincareaddiction. Also, the r/asianbeauty group is really good, and was my entrypoint into better skincare and skincare products! My routine is very minimal at this point, but learning about what makes for actually effective skincare means I have clear skin for the first time in 15 years! I’ve actually gotten compliments at this point, which me of several years ago would never have believed.

        2. CupcakeCounter*

          Try tea tree oil or find a dermatologist or esthetician who can get you a sulfa based cream. Works great unless you are allergic to sulfa drugs (which I am).

    5. valentine*

      My threshold for using a day of sick leave is whether I can do not just the job but everything required to do the job. For you, can you safely get to/from work, be there, and work safely and without crying out or needing to lie down or to assume positions that would look odd in your office? Can you sort food and medication in ways that don’t add to your troubles? Can you think properly, and make decisions as well as you need to? If you feel up to it and it’s possible, you could work a different day, but I consider that defeating the purpose because you’re likely behind on life stuff, since being off sick means you can’t do anything except recuperate, which we don’t hold in high enough esteem. It’s okay to look after yourself and it’s your primary job, that your paying job depends on.

  34. Magenta*

    I suffer from Hidradenitis Suppurativa it causes incredibly painful cysts ranging from the size of half a pea to bigger than half a tennis ball in various intimate areas. I’m usually in some pain but when I have a flare up I can’t move or sit still without horrific pain. It can also make me really sick, I get tired, run down, achy and run a temperature.
    I’m also really embarrassed about it, if I need to call in sick I tend to just say something vague, no one has really asked anything further. If I’ve ever had to explain it though I’ve described it as an “acne-like condition” that causes pain and people have been really sympathetic because they can imagine that being painful.

    1. voluptuousfire*

      Oof! I have a mild version of HS so I can relate to an extent. :\

      :solidarity fistbump for HS sufferers:

    2. miss_chevious*

      I also have HS and have literally never thought about taking a sick day for it although I definitely should have at times. Thanks for reminding me!

      1. Magenta*

        I refused to take sick time for it for years out of a combination of embarrassment and denial, because I developed it really early (age 9) so I feel like I’ve always had it so I was determined not to “give in”. Frankly I was pretty messed up about it.
        I did some therapy a few years back and now whilst I’m not happy about it I am much more accepting, I realise that actually sometime it is ok to take some time to feel better. I know that I can’t function at my best when I am fuzzy from a bad infection and I can’t always be fair to the people I manage if I am short tempered because I am in bad pain.
        But most of all I deserve to look after myself, so do you.

  35. dawbs*

    There’s also a distinct difference, IME, between pain and chronic pain.

    I’ll use me as an example, bbecause, why not. I have chronic migraine (I had more than 20 days of migraine in July, clearly this is a thing). I know that every time I “soldier through” and force myself to work through, I make myself worse. If I work at full capacity through a mild migraine on Thursday and Friday, i can expect to be in “spoon debt” (if that doesn’t make sense, Google “spoon theory”) and br in hellish most severe levelmigraines on Saturday (while going to bed for a half day on Wednesday might have stopped it in its tracks). The cycles of chronic pain are weird, and pain leads to more pain.

    My other health issues aren’t like that. If I go to work with a cold, it doesn’t have the same long term repercussions.

    If being off and relaxing breaks the cycle, totally worth the day off.

  36. Liz*

    I agree with others who have said that pain is enough of a reason to call in sick. I get cystic acne once in a while, and it is truly very painful, sometimes requiring intervention from a doctor.

    One general rule of thumb I try to use is to use sick time for issues where, if I were asked to provide a doctor’s note, I could reasonably do that. My employer would never ask for a doctor’s note, but I find it to be a helpful litmus test.

  37. MissDisplaced*

    My roommate had cystic acne and it looked incredibly painful and uncomfortable when it flared up (think along the lines of psoriasis or eczema or shingles). So, yes, you shouldn’t feel bad about calling out sick, but I wouldn’t elaborate on the why part too much if possible.
    Alternatively, do you have any work at home options? Since I do have the ability to work at home, if I have mild illness such as headache, mild cold/allergies, I work from home. If this happens often, you may want to propose working at home when you have flare ups.

    1. Pimple LW*

      The nature of my job requires me to be in the office. There’s no way that i can bring work home. I wish

  38. Like what even*

    wait am I misreading this or is Alison really saying it’s only okay to take a sick day for mental health day once or twice a year?

    1. Dino*

      She said it’s okay to take a sick day once or twice a year if it’s something like not being able to face the world or you’re exhausted. She didn’t say “mental health day only twice per year”. Mental health day means different things to different people.

  39. Indie*

    When I was in agony due to a particularly bad phase of psoriasis (think: bones on fire and weeping acid leaking out of your pores, while itching and not being able to sleep unless doused in wet flannel and wrapped in cling film as protection from the sheets chafing) I came to realise that most people see this condition as ‘don’t be vain, it’s a bit of flaky skin’ and I was one of those people too especially when the condition was as mild as that. Skin is an organ. An organ going haywire can be mild but it can also be seriously bad news. I had better luck with ‘Chronic skin condition kept me up all night in pain’ than with naming the condition.

  40. Knitting Cat Lady*

    A colleague had to be hospitalised due to cystic acne. She even needed surgery to clean out infected sites.

    Not fun.

  41. KT*

    Alison you mentioned using 1-2 sick days a year when you feel “exhausted and cannot face the world”. I would think that this constitutes a mental health issue and should be treated just the same as a physical health issue. If you’re lucky enough to not have any physical health issues but have mental health issues, surely it’s okay to use as many sick days as you need to handle that? It sounded like you were saying we should limit use of sick days for mental illness to 1-2 per year?

    1. KattyKat*

      It’s not technically about mental health. It would cover the day after a break up when you feel like you can’t function without crying. Maybe a really stressful encounter at work makes you need a day to decompress. Maybe something happened in your life that a typical sick day doesnt cover.

      The term “mental health day” has long been used as a catch-all for the days that aren’t typical sick days and aren’t easily explainable.

  42. metzengerstein*

    I am so sorry you are having to deal with acne. My face broke out for about twenty-five years, and I called in sick to work a few times when I was just too ashamed to leave the house. I was also embarraseed to see a doctor; I didn’t think anyone would want to help an ugly monster like me! Just wanted to recommend the book Acne RX by James E. Fulton, Jr. M.D., Ph.D. Dr. Fulton suffered from cystic acne and became a dermatologist to help other sufferers. He co-developed Retin-A® as well as other treatments for acne. His book “details causes, cures, and coping strategies for eliminating the physical and emotional effects of acne.” His company, Vivant Skin Care, also has information on their blog about dealing with acne. Good luck!

  43. Lilivati*

    I’ve had to call out due to horrific menstrual cramps. I couldn’t sustain a sitting posture and would occasionally throw up. But I never stated I had cramps, even to female managers, because nobody ever believes they can be that bad unless they’ve personally experienced it. I always had a migraine or stomach flu- something people could get their arms around without requiring me to over-justify my sick day. I don’t feel the least bit bad about it. I took care of myself as my condition required without jeopardizing my reputation at work.

    It’s not our duty to correct every idiotic medical misconception our coworkers have for the sake of absolute honesty.

  44. Anonama doo doo doo doo do*

    I’m glad to see the update added about understanding cystic acne. I’ve been alfficted for 20+ years, and fortunately it’s under control at the moment. When i have a recurrence, the only way to get rid of the cysts is have them injected with saline by my dermatologist, and a course of several antibiotics for more than 2 weeks. I’ve had cysts affect how I speak or move my face! Thank being said, I’ve only missed work to go to the doctor for a needle to the face. Good luck getting it under control! It can be done!

  45. buttercup*

    There is no reason why you can’t categorize this as a chronic health issue flare up. If you are legitimately in pain, you can just cite that as the reason you’re calling out. Most managers, in my experience, don’t expect people to get too specific and literal about their health issues when calling out sick, especially if that health issue is personal (like if it were something related to your private body parts.) A good manager will take you at your word and not probe for detail.

  46. always in email jail*

    I appreciate Alison’s update to her answer. Luckily Accutane got rid of my cystic acne in my mid-20s, but I vividly remember how much it HURT! Talking on the phone (a critical component of many jobs) was often the worst, because if the phone accidentally hit it it resulted in excruciating pain!
    Coming from someone who understands, I wouldn’t call out of an important meeting or event for it (just as I personally wouldn’t call out of one of those unless I absolutely cannot help it or would get others ill), but if you have the sick leave it’s yours to use!

    1. always in email jail*

      PS I do agree with the advice not to say the reason. I use that advice for anything, really. Unless I have to communicate “I literally cannot leave my bathroom and nothing short of that would stop me from missing today’s meeting”, as far as I’m concerned “I’m sick and unable to come in today” is as much information as a manager needs.

  47. DeColores*

    So much sympathy LW! I nearly called out with the last cyst I had, it was on the side of my nose and caused swelling all around one eye. I was able to get in to my dermatologist to help take care of it but if I hadn’t I probably would have called out sick anyway since it hurt so much and was starting to affect my vision.

  48. Blue*

    If you’re physically suffering, that’s a valid reason to call in sick, end of.
    I do think you might be better off using my favourite trick of briefly describing the condition rather than using its proper name, though – it’s frustrating but most people will hear “acne” and not “cystic”, and however much you try to explain that this is not what you’re thinking of when you think of acne, they won’t be able to get past it. It’s the same problem I have as a chronically ill person trying to explain that “fatigue” doesn’t mean “tired” – language lets us down. I might say something like, “a condition that causes recurring abscesses”, or “severe recurrent skin infections.” That’s the truth, and it bypasses the problem of peoples’ ingrained preconceptions about what acne is.

  49. WorkLady*

    I’m late to this but I wanted to add another vote for NOT telling your manager why you’re calling out sick. There is no need to go into the kind of detail suggested above. Please, just say you’re not feeling well and need to take a sick day. If your manager is like me, they are mildly embarrassed/uncomfortable to be involved in anyone’s medical details. I really don’t want to know, and I don’t want you to feel obliged to tell me.

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