Hi Mona,
I too think you are beautiful (even though you were not asking for my opinion, I can't help wanting to point it out).
I have had adult acne since I was about 23, on and off, I currently have 5 pimples settling down from a cystic state (and many more hyperpigmentations). They are really going down right now which makes me feel more at peace, but I try not to get excited about it because I never know if things will be clearing up or flaring up again (most likely the latter).
I agree that people are misinformed about acne, thinking it's about dirt (Mary Douglas who wrote Purity and Pollution would have interesting thoughts on it I'm sure; humans have a great need to divide the world into "clean/pure/safe" and "dirty/contaminated/dangerous"). I have had someone ask me if I'd been hitting the chocolate lately. Unfortunately, not eating chocolate has not cured my acne. I find it better not to discuss it with the general public (who would make it worse with their soaps, essential oils, and toothpaste!)
I've read that treating acne is almost more an art than a science (there or so many co-factors and even for professionals, treatment is a bit "this might work", never a certainty). I love acne.org for the real life experiences, empathy, experiments, and seriously intelligent options. There are things I haven't had the strength to try yet (like eating totally like a diabetic should, or ideal circadian rhythm practices, or a proper elimination diet - one woman found oranges were the culprit!), but knowing these options are available to me gives me some peace and hope. I won't try Accutane or birth control but I like knowing I have a choice. It makes it feel less like acne is visited on me by some malevolent force! And yes, if you look closely you will find many celebs with makeup covering pimples; (I am sure they are all expected to go on 'tane or we would see more of it). And they are still beautiful.
I follow a Paula's Choice regime, mixed with some of Dan's ideas. I try not to draw attention to my skin but if I do, people usually say it is amazing (either they mean the unblemished parts, or when my skin isn't flaring/flaking and I wear foundation, they really believe it's all great!). Except for BP (which I don't like as it flakes and oxidises my skin leaving it dull, so I use it only on active spots), the treatments acne has led me to use (BHA, AHA, occasional jojoba oil, sunscreen) keep my skin even and soft and with a good texture.
I only learnt about makeup to cover my acne. I do a clever no-makeup look and I'm proud of that knowledge. I would love to go barefaced but I also really enjoy my Holy Grail, wonderfully textured and shaded, miracle (to me) foundations.
I dream of a day when my skin stops breaking out. It has mysteriously happened before, during my first pregnancy when I quit work, and more recently when I took a trip to Sydney (I believe the extra light may have influenced my hormonal system, but acne being what it is I'll never really know!). So I live in hope.
I've always just assumed when I'm older, I'll have the means to get something cosmetic done if I have scarring (always hard to tell under the hyperpigmentation). They can do good things with lasers and maybe other treatments. So I think your worry about being old with wrinkles and scars may be solvable.