let’s talk hormonal acne

by Krystal Bick
March 12, 2018

OUTFIT DETAILS: Kenneth Cole blazer (gifted, sold out, but similar style here)) // Leone dress (gifted, love this yellow number) // Zara boots (similar style here) // Cafune bag (gifted) // Chanel earrings // Fendi sunglasses (gifted)

This is a long overdue post.

It’s not that I’ve necessarily avoided writing this post — it’s that, for the past year or so, I haven’t been fixating on my skin. Now before some of you start scratching your head, let me back up a bit.

Back toward the end of 2015, I was approaching a pretty drawn out battle with my skin — specifically with hormonal acne. And, much to the chagrin of my wallet and probably my sanity at the time, I tried EVERYTHING. The latest product lineup. Diet changes. Lifestyle changes. Exercise routines. Heck, I was washing my sheets pretty much EVERY DAY, people. And for the record, that’s saying a lot for someone who loathes doing laundry.

But no matter how hard I tried, I couldn’t seem to get to the root of the problem. I was still breaking out — and not just common whiteheads/blackheads around my menstrual cycle — we’re talking painful, under the skin cysts along my jawline and cheeks, some of which lasted weeks. All of which, took a pretty nasty toll on my self-esteem — and I finally broke down in this post I shared with you all. For the record, I’ve never been someone who loves wearing makeup, but over the course of a few years, I suddenly found myself unable to go outside of my apartment without it — for fear someone might stare at me and my face and my latest collection of zits.

Now, before you start thinking today’s post is all doom and gloom — I’ll stop you there. It’s not. This story gets happier, I promise!

Cue the start of 2016, when I decided to up the game. I finally found a dermatologist I liked here in New York City — one that actually took the time to listen to me and more importantly, let me CRY with her — and I was put on a daily regimen of birth control pills (Yaz) and 100mg of Spironolactone. I’ll spare you all the details of how this went (because the details are here), but after 3 months, I was finally seeing a difference in my skin and my hormones were 100% the problem. I’m completely aware that both options prove to be pretty controversial amongst skincare and wholistic health purists, and I’m by no means trying to peddle drugs here. You should always consult your doctors first (a GP and a dermatologist) to see if these options even make sense for you given your hormone levels and blood work, but I can, without a doubt, sit here today and say, that they both made a huge difference for me, personally. And considering I was at the bottom of my proverbial skincare rope, it came just in time.

 

I stayed on both pills at the same dosage for the entirety of 2016, without a hitch.  My skin cleared up dramatically, I broke out FAR less, and when I did, they were easy to handle, run of the mill pimples. Imagine that — I was just happy to see a normal pimple. Not a huge, mountain-like cyst. Finally, my dermatologist and I decided it was time to perhaps discontinue the Spiro (as I really wanted to manage things longterm without it), and despite what numerous online forums recommended, I went cold turkey. Off the Spiro. And off the birth control (but that was mainly due to my inability to remember to take it, so I decided to take a break from it as well, and rely on other methods of protection).

And you know what? My skin didn’t freak out. It surprisingly was fine. No flare ups. No initial breakouts. No OH MY GOD WHAT HAVE I DONE?! moments.

Perhaps I was dreaming, but had my hormones finally decided to just cooperate with me? Had we all decided to just GET ALONG and play on the same team? Out of for fear of jinxing it, I didn’t want to assume anything, so I relied on the same morning and evening cleansing rituals and was mindful of what I ate and drank and committed to working out regularly.. The last thing I wanted was a delayed siege and for my skin to revert back to what it was.

For all of 2017, I was golden. Did that mean my skin was perfect? Far from it! I have plenty of hyper-pigmentation and leftover scarring that I was now focusing on fading, but overall, my face didn’t feel like a battleground anymore and that was reason enough for me to celebrate. For once, in a very long time, I finally felt FREE from worrying about my skin — I didn’t feel beholden to it.

But (you all knew a but was coming, right?), the end of 2017 hit. Back in December, I traveled for over a month in Australia, followed by another trip, this time back home to Reno for two weeks to help my mom recover from her hip surgery (and simultaneously pack up my childhood home so she could begin the process of putting it on the market to sell). I then returned to New York, had the pleasure of taking a Plan B pill after a broken condom and well, my skin finally decided to throw up a white flag. I was stressed, exhausted and inflated with a new surge of hormones and right after my birthday, I broke out. Along my chin (3 to be exact). Not terribly mind you, but they seemed deep enough that it reminded me of my zits of yesteryear — those uncomfortable, deep under the skin ones, that I panicked. Big time.

 

I don’t talk about this often here on This Time Tomorrow, but I’ve dealt with anxiety my whole life — my trigger points seem to just shift as I’ve gotten older. I used to deal with it in school (because I’m a perfectionist), I used to deal with it when I worked at Google (because I constantly felt the need to put in crazy hours) and finally, once my skin decided to revolt, I would obsess over the latest state of my face and anytime there was a shift, a new pimple, a new scar, a new ANYTHING on my face, I would halt in my tracks. For anyone who’s dealt with acne, especially adult acne, you know how socially crippling it can be — and doubled with my anxiety — I reached some pretty low lows when I was going through that first ordeal in 2015 and 2016. I was SO afraid of going back there and SO upset with myself for allowing it to happen. Simply put: I was getting too old for this shit.

Naturally, my anxiety enabled my panicking self to blame, well myself, and for the past few weeks, I’ve been dealing with what I’ve affectionately dubbed phantom acne. I’m still broken out in a few spots but they’re no way near the severity as to how it used to be, but in my mind, they might as well be. I started to feel all the feelings, ALL over again — of wanting to hide my face, of avoiding social situations, of feeling ashamed. I started to feel this was the beginning of a downward spiral, that I would wake up tomorrow with 4 or 5 new pimples, because I was no longer in control. Naturally, this surge of stress was not helping the state of my skin so I booked an appointment with my dermatologist and my GP.

And for the most part, I have to say, I’m largely still feeling this way — hence why I’m writing all of this out. For starters, I recall feeling tremendously better the first time I shared my experience on here — because it made me realize I’m not alone (despite how perfect everyone might appear on Instagram). Secondly, I felt that this would be a great opportunity to document my latest plan of attack, with the intention to share an update in a few months time.

So without further adieu, here’s the lay of the land, with a very important caveat to note: I’m not a doctor. I’ve never pretended to be — nor will I start now. Everything I’m detailing here (if you’re still reading that is), is mainly for me to reference later, when I’m checking back in with my doctors and my progress. I highly encourage any of you, regardless of where you are with your acne journey, to start first with a great dermatologist AND your GP, who can be really helpful in helping you get to the bottom of what your hormones may or may not be doing.

Birth control but NO Spironolactone. 

This one is two-fold for me. I think a lot of my hormonal imbalance this time around is due to the Plan B pill I took at the beginning of February. For most of my life, I’ve been off and on different BC pills, the most consistent period being more for my skincare routine than it was for sexual protection. That said, I’ve always felt more comfortable with two forms of protection, which reminds me to tell all of you, if you’re ever with someone who makes you feel bad about wanting to use a condom, even if you’re on the pill and you’ve both been tested, LEAVE THEM. No partner should EVER make you feel bad or uncomfortable about that — and the right person will be happy with whatever decision makes you feel the most at ease. End of side rant.

The second reason for going on it was there are similar androgen-suppressing properties in birth control pills as the spironolactone, and since this time around, my hormones didn’t seem to be as out of whack as before, I’ve decided to forgo the spironolactone (even though I did take a few pills initially, again, because I overreacted). It’s been about two weeks now on the birth control and the state of my skin seems to be slightly in flux, again because so many things have been happening to it. I’m hoping after two or three months, we’ll have adjusted fully and normalized somewhat.

More fiber! Drinking more green tea, less coffee. 

My diet up until this point has relatively followed the same principles since the start of 2016: reduced dairy intake, reduced sugar intake, increased water intake, opting for fish and omega-3 rich foods whenever possible, and increased fiber, all of which has made a huge difference in my energy levels and overall skin health. I’ll admit, much of 2017, I wasn’t policing my diet either, meaning, I made a lot of effort to make responsible, healthy decisions MOST of the time, but I also wasn’t going to beat myself up over having a burger and fries here and there.

This time around, I’m focusing on incorporating more green tea. Why green tea? Well, aside from all it’s miracle antioxidants, it’s been shown to reduce insulin levels, which means the skin produces less sebum. Of course, green tea has caffeine, which in turn has been shown to NOT help in the fight against acne, so everything within moderation, I suppose. I’ll aim to have at least one cup per day, in lieu of an afternoon coffee.

Working out more.

This is where I really need to tackle my anxiety and reduce my stress levels, because MAN, I can quickly become a ball of stress, if left to my own devices. I’m not currently signed up for any marathons, which I prefer honestly, as they come with their own set of unique stress — but I’m following a typical marathon training schedule at the moment. When my acne was at its worst, I remembered feeling much more in control of something if I could just manage to get out and run every day. And my overall happiness increased.

Spot treatments.

For the acne that has popped up, most are relatively normal pimples (read: not tender, under the skin cysts), but they’re more stubborn than usual, hence my concern. After a bad bout with tea tree oil a few weeks ago (I’m one of those sensitive skin people), I picked up a highly recommended acne repair kit from Mario Badescu. Now, to be clear, I’m definitely one of those people who tends to roll her eyes at products that are dubbed as “miracle” treatments, because I’m immune to marketing statements like that. I will say, after consistently using both the drying lotion and the buffering lotion, as overnight spot treatments, I did notice a significant reduction in the size of the pimples and their tenderness. Until things even out around here, I’ll be relying on these spot treatments religiously.

Chemical peels (both in office and at-home) and upping my Vitamin C serum usage.

As someone with darker, more olive-toned skin, hyper-pigmentation naturally becomes more of a concern than perhaps for my more fair-skinned friends out there. Simply put, I have more melanin in my skin, which makes getting rid of acne scars that much harder, because they’re darker. During my last consultation with my dermatologist, she felt an in-office chemical peel would best address my scars, most of which are discoloration and some more textural in nature. Hopefully after a few months time, once my acne flare ups calm down, I can book one of these treatments and report back with a review.

Additionally, I’ve been reading a lot about Vitamin C serums when it comes to helping 1. clear existing acne because it helps reduce inflammation and 2. it helps promote collagen production, to plump out skin and even tone. My good friend Keiko (who is a skin guru — she has the most beautiful skin ever), recommended one by Skinceuticals, which I’ll begin using, once it arrives.

And there you have it — I’m not introducing anything crazy product-wise, which has always been my MO since meeting my dermatologist. While expensive skincare products can really help your skin achieve it’s full potential, my focus right now is to just normalize things with consistent and thorough cleansing routines (I use a gentle face cleanser by CeraVe, again, recommended by my dermatologist, followed by a solid 30+ SPF, moisturizer and now the Vitamin C serum lineup) and better diet choices. Much cleaner diet choices. And a little BC.

Wish me luck. Expect an update on June 12 — hopefully with some good progress!

Photos by Nora Varcho

21 thoughts on “let’s talk hormonal acne

  1. Hi Krystal! Thanks for sharing. I too am/have dealt with hormonal acne and understand your pain!

    Could you share the name of your dermatologist? Been trying to find a good one for a while but haven’t had too much luck.

    Thanks!

    • Hi Sonia! Of course! I was originally seeing Dr. Tara Rao at TriBeca Skin Center on Church Street. Unfortunately, she has since left the practice (and is not a new one yet), so I’ve been seeing Dr. Erin Kil. Hope this helps! I definitely miss Dr. Rao and will try to track her down once she’s set up at a new center.

  2. I’ve been having this ingoing battle for the last two years and I finnnnnnally went to my dr to have full blood work and hormone checks. One thing that came up was my testosterone was a little high, which accounts for acne and weight gain – lovely. After a lot of research I started incorporating 2-3 cups of Spearmint tea/day in my diet, and nothing has been more effective! It doesn’t have caffeine either so I recommend giving it a try!

    • Hi Lisa! I’m getting my full blood work and hormone checked tomorrow! I like the idea of Spearmint tea, especially since it’s caffeine-free! Ordering now!! Thanks babe! How has the process been?

    • Omg yes!!!! I am 42 and my skin can still break out occasionally. Since drinking this before bed, my skin has never looked better!! It definitely helps!!

  3. First of all, thank you so much for writing about acne! I think it’s something that affects so many but only a few actually talk about it, least at length with helpful recommendations. I’ve struggled with acne since 16 and while I’m definitely not winning that battle consistently, I have found a couple of things that work for me that I want to share.
    1. Vitamin C is vital – I love love love one love organics vitamin C serum and I wear it daily with a light moisturizer. A little goes a long way with this serum as it is very concentrated
    2. Tula purifying cleanser – this brand was created by a gastrologist and contains lactic acid which I think it’s great for acne prone skin, while definitely gentle enough for daily use
    3. Skin Medica AHA/BHA Exfoliating Cleanser – this is a gentle exfoliating cleanser. I use this when my skin is not strong enough for my Clarisonic but still needs a bit of polishing
    4. Not sure if you tried prescription topical treatments but I find that tretinoin (vitamin A derivative that helps heal and renew skin) and Aczone (topical) work wonders
    5. EltaMD UV Physical Broad-Spectrum SPF 41 is an excellent non-chemical facial sunscreen. It does go on a little white but since I use prescription medication on my face, I find that a physical sunscreen works best
    I hope these will help!

    • Thanks so much, Helen! These are great tips!! I’m really looking forward to my Vitamin C serum to show up. Do you ever find that your Clarisonic is a bit too harsh on your skin?

      • Yes, a bit at times. I definitely don’t use daily, even with the sensitive brush head. I find that I reach for my Clarisonic the most after I use my prescription acne products and just want to buff the dull skin cells away so I can preserve the new layer underneath. I really love the Skin Medica AHA/BHA Exfoliating Cleanser as a sub for my Clarisonic. Side note, I always make friends with the nurses and aesthetician at my Derm office so sometimes they will give me samples of stuff to try 🙂

  4. I can totally feel your pain, hormonal acne is no fun, and it seems like everytime it gets under control, I’m just waiting for the other shoe to drop. Thanks for sharing your story!
    And I’m also really bummed that Radiohead show is sold out already.
    Chic on the Cheap

  5. Same old story for me, except I always seem to let it go too far before I break down and see the dermatologist. Just went back on spironolactone, back on some topicals, and am keeping my fingers crossed.
    On my mind now, though, is that almost none of these treatments is safe for pregnancy. I’m headed that direction and panicked that I will get it under control again only to have my skin freak out anew… more stress, more scars… ugh.

  6. Hi Krystal, sorry to hear that hormonal acne is still being a bee-atch, ugh. Just wanted to say hang in there, and re-recommend essential oils. Helichrysum for current active zits is for me awesome, I can’t overstate how effective this is for my zits, and Frankincense for purple scarring and healing a scab is miraculous ( and I am not exaggerating Frankincense for healing if you use this for cuts it heals strangely fast without a scar). Rocky Mountain oils is great and Mercola has a really good Frankincense, and both have to be diluted, so do a little reading. Both are expensive, but again for me nothing has ever helped my skin be more healthy, especially since I refuse to take medication.
    I changed up my routine now that my skin is being good, I use Frankincense in the morning, a dot for both cheeks and Helichrysum in the evening, a dot for both cheeks, and always a mild cleanser in the evening, but I don’t use any make up except concealer. I’ve also heard since acne is a condition that springs from inside our bodies, that the liver is extremely important for clearing up acne. I think mine is slightly sluggish (because I get tipsy on half a beer) hence my having acne. Anyway, cheers.

  7. Hi Krystal! Thanks for talking about this. I’ve been on the same generic yaz bc for over 7 years now. I was originally prescribed this for strictly acne reasons. In the last few years I’ve noticed some unwanted side effects aka no libido ….. just a heads up! Finally got a prescription for a different pill just last week.

  8. Hi Krystal! I also had to deal with adult acne. It’s the worst. And it makes you feel so ugly.
    For me, it started when I left behing my BC pills. I had to do a really strong treatment with pills and it was the worst, but it helped.
    Now, it comes and goes. Luckily, never like the worst time, but I really understand the anxiety whenever you find a zit, because it brings back all the fears.
    Thank you for sharing this and for sharing all the thinks that you’re doing.
    Good luck!

  9. Hi Krystal,

    Thanks for sharing. I too, just end of last year, decided to see a derma about my acne. Tried also the chemical peel thing but somehow it didn’t work 100%. The advantage of doing this though is that I felt confident more in my skin after the peel, now I hardly wear concealers/ foundation. I feel a bit cursed though because I can’t take the pills. The gyne said it would worsen the cysts that I’m currently monitoring in my breasts. 🙁 There are less breakouts though after the peel and I’m seeing my derma again soon for her last option of medication. All the best to us. 🙂

    Cassey
    http://casseycakes.blogspot.com

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