I'm 50 now and my skin is perfectly clear. I did have an issue with some cystic acne when taking Lithium (primarily jaw line). A most annoying side effect! Luckily, after about 6 to 12 months off it (about 7 years ago) it all cleared up, including the scars. I also had teen acne. It was slightly unpleasant and my mom took me to a dermatologist at one point. Not very severe, and calmed a bit by about age 18, with just a couple/few blemishes here and there...until Lithium. Sometimes blackheads were even worse. Those have also greatly subsided. Lithium also affected my skin quality in other ways, but again, it improved after going off of it. I've read that about 33% of Lithium takers experience skin-related issues.

Do you have a distinguishing physical feature (i.e. a birthmark or other)?