There are three photos that are currently saved in a folder on my iPhone. I snapped them back in January of this year, sans makeup, without my hair done, sitting at my desk in relatively awful selfie light, just a few days before I was going to meet with my dermatologist for the first time here in New York.
And God, I hated taking those photos. In fact, I can hardly look at them now.
To back up a bit, if you recall, I shared my recent struggles with hormonal acne back in February with you all. I said it in that post, and I’ll say it again in this post, it was extremely therapeutic to write and to connect with you guys in a way that went beyond what dress I was wearing or what pair of shoes I recently bought. I felt vulnerable after hitting that publish button, afraid that I might be saying all of this aloud to the internet with no one to answer me or to connect with. Afraid that I would be standing alone, no more the wiser about what I was going through and how to combat it. Afraid to admit that I was going through something different than what’s typically shared on other blogs.
And you all made me realize, I had nothing to really fear. The emails, the comments, the messages of support, of advice, of commiserating together — none of it went unnoticed or unappreciated. Which is why I wanted to check back in, exactly three months later, with an update of how things are progressing for my skin and how I’m feeling about everything. Please note, it’s a journey that’s far from over but I’m learning all the time from it and wanted to share what little newfound wisdom I could, in hopes that it might help someone else.
It all boils down to four big lifestyle and routine changes…
ONE: Found a dermatologist that I trusted, that I liked, that listened to me. I can’t emphasize this probably very obvious point enough. What’s made all the difference for me, these past few months, is having a doctor that not only knows what they’re doing, but cares about how I feel through the process of it. I’ve had a number of dermatologists in my spotty (pun intended) past, most of them would sit down with me for 10 minutes at most, mutter that my skin issues probably have something to do with hormones and write down a list quick list of cleansers and birth controls for me to try, before hopping out of the room to the next patient (one doctor barely looked at my face!). It was demoralizing and frustrating, to say the least.
So when I first met Dr. Tara Rao at TriBeCa Skin Center, I was half expecting the same rushed “get ’em in, get ’em out” sort of treatment. But the minute she sensed I was about to cry (and then eventually started to cry) in her office when I was describing to her why I was seeing her that day, she closed her folder, looked me dead in the eye and told me, “We’re going to figure this out together.” Suddenly, I felt like I had someone in my corner, rooting for me. And it’s made all the difference since then.
TWO: Started taking Spironolactone and birth control. Now, I know this next one can be rather controversial, and I’ll be the first to admit, I was really hoping for a solution that avoided a prescription of some sort, mainly because I try to solve things as naturally and as hormone-free as possible. The issue with my type of acne, as Dr. Rao pointed out, is that it’s driven by my hormone spikes, and while my many lifestyle changes (restricting dairy intake, drinking more water etc.) were all admirable steps in the right direction, my body may need a stronger kick in the butt to keep my hormones in check. She then went on to tell me that she has plenty of female patients, my age, dealing with similar severity acne as mine, and how just a few short months on spironolactone made all the difference in clearing it up for them.
So I did what any self-respecting, tech-savvy girl would do. I WebMD’ed that shit and read about all of the pros, cons, side effects and yes, horror stories (because let’s be honest, every prescription comes with a horror story or two). I wanted to be informed about what I may possibly start putting into my body before I started it. And from what I could gather and what Dr. Rao told me to expect, it seemed worth a shot, as long as I remained extremely aware of how my body was reacting over time. It’s important to note that the original usage of the drug is to treat high-blood pressure, the side effects of which may include lowering of blood pressure (and mine is already pretty low to begin with), increased urination as it’s a diuretic and it can also cause you to retain potassium (so I avoid consuming too much of it and I make a point to check in with my GP every couple of months). How does it work for acne? It essentially blocks the hormone aldosterone, an excess of which can cause acne.
I’ll stop here and remind you that I’m not a doctor by any stretch of the imagination, so you should definitely consult yours thoroughly before starting anything yourself. OK, disclaimer over.
But I’ll continue to say this: I credit much of how my skin has improved over the past few months to a combination of spironolactone at 100mg daily and a low-hormone birth control. Hands down. Granted, I will also say this, it took about three months to kick in for me. Meaning for three months, I wasn’t really seeing a huge difference. In fact, for a brief period in February (my second month in), I felt myself going through the “it’s getting worse before it gets better” phase, and started to break out even more on my cheeks and then my neck, which had never happened before. On top of that, I was using a Retin-A cream, which dries out your skin to encourage cell turnover, so my face was a hot mess of painful cystic breakouts and dry, peeling skin, all during a New York winter and Fashion Week. NOT FUN, folks.
It wasn’t until mid to late March that I remember turning a corner. I was washing my face one evening after thoroughly removing my makeup, lathering my cleanser all over my face, when I noticed that I felt FAR fewer bumps on my face. This may sound trivial, but only a few short months prior, I couldn’t run my fingertips over my cheeks and jawline without feeling a very bumpy terrain. And now, I felt nothing. NOTHING. I wanted to laugh and jump up and down at the same time, but refrained since that meant I would probably get cleanser in my eyes. But you get the picture. I felt like I was regaining control, taking back land that had been invaded, by a foreign enemy. God, I’m dramatic sometimes, but it definitely felt like a mini victory!
We’re now a total of 5 months in and combined with the birth control, I feel really happy with how things are progressing. I breakout FAR less often and when I do, the lone pimple really only lasts for a few days, as opposed to a few weeks like before. For now, I’m still at 100mg daily, but will likely reduce the dosage in a few months to start weening off of it. Dr. Rao thinks it’s worthwhile for me to stay on spironolactone for the remainder of this year, and unless anything drastic happens, I’ll stay this path.
As far as side effects, knock on wood, I’ve had minimal. The first month or so, I definitely noticed some increased fatigue at the end of the day, which Dr. Rao warned me about, as well as some frequent bathroom breaks at night, but otherwise, no complaints. A lot of the reviews I read mentioned hair loss and weight fluctuation, neither of which, I experienced. A few reviews also mentioned increased breast size, which I unfortunately, didn’t experience. Le sigh. Can’t win ’em all, right?
THREE: Bye bye dairy and hello water. I can’t say I’m perfect at either of these two changes, but they’ve been top of mind for me the past few months. I cut out dairy back in January pretty drastically, even refusing to eat foods that had been prepared with small amounts of it, which of course, makes eating out kinda tricky. Since then, I’ve relaxed, but whenever possible, I try to avoid eating excess amounts of it (so pizza is a rare indulgence for me, unfortunately). I also went on a pretty strict no soda and only one coffee a day rule, meaning, I chug A LOT of water. At first, it was cumbersome and I had to remind myself to drink it. But now, I have a rotation of six 1 liter Smart Water bottles that I fill up every day with tap water and I challenge myself to finish all of them before I go to bed that evening. My skin not only feels more supple, but I have way more energy than I recall ever having. Win, win!
OUTFIT DETAILS: Beaufille “Herse” top borrowed from Plan de Ville // Abercrombie & Fitch jeans (old, but just discovered this new brand that I’m obsessed with) // Monica Vinader necklace and bracelets // Tibi slip dress
FOUR: Exercise, exercise, exercise. During all of this skin investigation, I was also training for my Paris marathon in April, which meant, that no matter how I felt about my skin that day, I was forcing myself to head out the door and run 10, 11, 12 miles at a time. And I’m so glad I did. It was a great stress reliever for me and in some ways, when there are things you feel like you just can’t control, it’s nice to know there are some things you have absolute control over, like whether or not you kill those 10 miles today. Of course, with any regular exercise, your body starts to regroup itself, and mine did just that — I can’t say running necessarily improved my skin, but it improved my overall well-being and I think if there’s anything I’ve learned about skin, it’s all part of a very fine, lifestyle balance. The key is figuring out what levers work for you.
And there you have it — four lifestyle changes that I think have made a huge impact on my skin and my outlook. As I mentioned, my skin is far from perfect, I have a handful of scars left behind and I definitely have makeup on in these lovely photos Lydia shot for me. But I felt so confident when we were taking them, which is drastically different from the girl I snapped on my iPhone back in January. Perhaps I’ll get up the courage to share those shots here eventually. Until then, I’m always more than happy to answer whatever questions you guys may have about the above journey. Or perhaps you have other lifestyle changes that have made a difference for you and your skin that you’d like to share? Either way, let’s chat. Because you’re not alone, so there’s no reason to go through it alone.