let’s talk about hormonal acne: 4 month update

by Krystal Bick
June 12, 2018

Wow. How did 3 months go by, just like that?

If I’m being honest though, as fast as it went by, it really didn’t go that quickly at all for me. The past three months have been a bit tumultuous — up and down really — in more ways than just the state of my skin (although that was certainly a large contributing factor in this equation). While I can sit here today and say I feel much better writing this post than I did 3 months ago when I was writing this particular post — that isn’t to say things are perfect either. So here goes nothing.

What the hell am I rambling about, you ask? For the sake of not boring you all to tears if you’ve been following this hormonal acne journey of mine, here’s the brief Reader’s Digest version of my less than savory journey: For the past 5 years or so, off and on, I’ve been dealing with varying degrees of hormonal acne — ranging from mild to moderate at times (although it always felt severe when I was going through it). Up until that point, for my teenage and most of my adult life, I never really experienced Acne — emphasis on the capital A, because an occasional pimple here and there does not equate Acne. When we talk about Acne, we’re talking painful, below the surface cysts that would pop up pretty consistently along my jawline and cheeks, fluctuating week over week with my ever changing womanly cycle (oh the joys of being a woman are never ending, aren’t they?).

Over that time period, I exhausted all the avenues to fixing it — diet changes, lifestyle changes, product changes, supplement changes, heck — you name it, I probably tried it. Everything short of Accutane that is, which after several months of living here in NYC, I was considering as my last ditch effort. Finally, at the beginning of 2016, I found a dermatologist here in the city who I really trusted and who listened to me (imagine that!), started a round of low hormone birth control (generic Yaz) and 100mg of Spironolactone daily as a final option before Accutane — the 3 month mark results of which, were FANTASTIC (I documented it here). My skin had finally calmed down, my breakouts were much more manageable and, for the first time in a long time, I felt in control of what was happening with my skin. I no longer felt the need to cover it all up with makeup. And best part — I didn’t have to resort to Accutane, not that I don’t think it’s a good, viable option for anyone considering it, I just personally didn’t want to try it for fear of other complications.

To speed this along, for most of 2016 I stayed on both medications without a hitch — and I no longer fixated on my skin. Then, at the recommendation of my dermatologist, I stopped both in early 2017 with no flare ups and enjoyed some proverbial smooth sailing as far as my skin was concerned. Things weren’t perfect, but they were 99% better than what I had been experiencing. Cue the end of 2017 and the beginning of 2018, which involved a lot of travel, quite a bit of stress and one fateful Plan B pill, and my skin of yesteryear started to creep back in. Painful, under the skin bumps, many of which lingered for weeks — most leaving dark red marks and scars in their wake.

Since this isn’t my first Acne rodeo, I acted fast — with this plan I detailed for you all 3 months ago. And, considering I just saw my dermatologist yesterday for my 4 month check in, I decided now was a good time for a little progress update. Spoiler alert: the jury is still out on some of these steps, but overall, I’m feeling much more hopeful about it all! One thing I would like to note before I begin though, is that if this process has taught me anything, it’s that if you’re struggling with adult hormonal acne as well, you’re certainly not alone. It’s easy to feel isolated and embarrassed when it comes to dealing with hormonal acne at any age, but certainly as an adult, especially with how picture perfect everyone looks on social media, but I’m here to assure you, it’s far more common than you think.

Oddly enough, this second time around of dealing with this has been more about my mental approach to it all  — and to touch on my initial point at the beginning of this post, I experienced my fair share of ups and extreme downs during this process. I was forced to work on my self esteem and my confidence, two things I considered to be in relatively decent shape, until this recent set back. All of this brings up points I’d like to make in an upcoming post about mental health (coming later this week), so I’ll spare you all the soapbox talk now and instead dive into my routine updates.

Oh, and one more thing to note: if there’s another thing I’ve learned throughout this process, it’s that what works for me, may not work for you and vice versa. As someone who has been on the receiving end of lots of solicited and unsolicited skincare advice, there’s nothing more frustrating than the claim, “YOU NEED TO START DOING THIS, IT’S THE ONLY THING THAT WILL WORK.” The reality is, you have to listen to your own body, give things enough time to fully work (sometimes around 3 or 4 months) and find good doctors who you trust and who listen to you. I’m merely sharing my progress here as an encouragement to you all to look into what works for you, not as a prescription or guide plan for your next steps.

Still reading? Cool, let’s dive in.

Birth control: First things first — birth control. Ah, it’s a bit controversial isn’t it? Honestly, the more I read about birth control, the more I wonder why the hell we don’t have a pill yet that men can take that essentially renders their sperm as blanks. Seriously, think about it. If I can trick my body into think it’s already pregnant, then I think we have the medical capacity to create a birth control pill for men. The question of whether men would take it or not, I’m sure is where the sexual politics of birth control gets ugly, but that’s another discussion for another day.

Back in 2016, I started the same pill I’m on now, a generic form of Yaz. For some contraception history, I’ve never been on the pill longer than a year at a time, taking several years off between pills as well, mainly because I was just never good at remembering to take it every day. Since this was the only medication I was opting for this time around (last time I combined it with Spironolactone), I became hyper aware of how my body was reacting, week over week, month over month.

Well, I’m just a few days shy of finishing my 4th pack and I have to say, the past 4 months or so haven’t been a walk in the park. Here’s the play by play, as far as my skin is concerned: the first month, I experienced minimal breakouts (most were manageable), the second month, however, was probably the worst. The breakouts transitioned to painful cysts along my jawline and my left cheek, in particular. The frequency here was also concerning. It wasn’t just around my time of the month, it was all month long, with spots going away, only to give way to new ones in the exact same area. FRUSTRATING. Month 3 was more of the same (not fun in London and Lisbon, lemme tell you!). And now, here at the end of month 4, I would like to say it’s slowing down. A bit? I only add the question mark there because I still very much feel my hormones aren’t quite synced yet. So the deal I have with my dermatologist and gynecologist at the moment is that we’ll wait it out for another 2 months and see how my body is reacting. Overall, the past few weeks, my breakouts aren’t AS often or AS severe. So, perhaps we’re on the up and up? Emphasis on that question mark.

Diet changes: There’s a long list of foods you can Google that are likely to spur hormonal acne. Usually at the top of that list is dairy, gluten and sugar. While I haven’t been 100% perfect with these eliminations, I’ve done a lot to reduce my intake of them significantly, dairy being the one I’ve given up almost entirely (except for very small trace amounts in certain dishes). I’ve also cut out all red meat and poultry — opting for fish whenever possible. I’ve incorporated far more dark green, leafy salads into my lunch routine (kale, spinach etc.) and I snack on a lot of blueberries, which are said to be great for reducing inflammation. I drink at least 2 liters of water a day and 2 cups of Spearmint tea, once in the morning and once in the evening before I go to bed (it’s been found to help reduce androgen hormones, which are typically to blame for hormonal breakouts). My original plan was to drink more green tea, which I’ll do in the afternoon, if I feel I need an extra caffeine pick me up, but in general, I rely on my one cup of coffee in the morning for my energy kick. I also made a point to cut back on my alcohol consumption — not entirely — but enough to really allow my skin to soak up all the water and good stuff I was putting into my body.

The effects? Overall, skin fluctuations aside, I just feel healthier. More alert. And more aware of the impact of food on my well being. Does it mean any of these foods or liquids are trigger points for my breakouts? Hard to say, but I do feel better about incorporating them into a long term game plan, so I’ll stay this course, regardless. I should note I also take a daily Vitamin D, fish oil and Evening Primrose Oil supplement.

Spot treatments: My little holy grail products the past few months? Well, they haven’t been able to STOP the breakouts, but the acne repair kit from Mario Badescu has been a godsend regardless for handling some of the tough, lurking pimples I’ve been getting the past few weeks. I rely mainly on the buffering lotion and the spot treatment (which I’ll layer in that order) overnight. If I have nothing that requires me to leave my desk for the day, I’ll apply in the morning and leave on all day as well. If I’m heading out for the day, I’ll apply a spot treatment of benzoyl peroxide directly to my clean skin, targeting the problem areas, before layering on my SPF, followed by moisturizer (I’ll detail my full morning and evening routine, with products, below).

Chemical peels: Full disclosure — I chickened out. Big time with this one. To the point I actually had an appointment scheduled that I canceled a few days before, because I was just, well afraid. I blame this on Googling far too many horror stories of chemical peels gone wrong that I decided if I’m going to do a big overhaul treatment like this, I wanted to wait for my skin flare ups to calm down, so as to not rock the boat too much. Perhaps I’ll pull the trigger a few months from now, perhaps not. We’ll see.

Exercise: Someone recently asked me via DM on Instagram where I found the motivation to work out most days. Don’t get me wrong, there are plenty of days (this past 3-4 month period being one of them) where I really have to drag myself out the door to get my butt moving and my heart pumping. Of course, as the days get warmer and the promise of beach vacations help with fitness goals, I still have to say my number one motivation always comes down to mood improvement. I just feel like a more pleasant human being when I fit in a work out every day, whether that’s running 3-5 miles, taking a fitness class or just opting to walk home instead of taking the subway. I’ll touch on my mental state during this process down below, but let it suffice to say, I always feel better if I exercise on a regular basis and it really helped battle some of the down periods I’ve experienced recently.

 

My skincare routine and products: So here’s the rundown, from morning to evening, of everything I’ve been using lately, including a few new additions that I hope to do a full review of in a few months time.

  • Cleanse: I rotated between two products during this time. My trusty CeraVe (a gentle foaming cleanser for sensitive skin) and Peter Thomas Roth’s Water Drench Cleanser (another gentle cleanser, ideal for dry skin — which my skin has become, since starting both the birth control and several of the drying spot treatments). To be completely honest, I didn’t notice a significant difference between either product’s ability to really cleanse my face (particular with regard to removing makeup), so I’ll probably opt to just stick with my CeraVe, as it’s much more pocket friendly. In the morning, I’ll use my hands to wash my face. In the evening, I’ll use a white washcloth to make sure I removed any and all makeup.
  • Exfoliate: I’ll do this in the evening, once a week, with Vanity Planet’s facial cleansing system, using the silicone brush head, since it has gentle brushes. Instead of using a scrub (I find these just irritate my skin), I’ll simply use my cleanser as the active scrubbing agent.
  • Toner: I use toner on a case by case basis, particularly when I feel my skin is acting up and producing more oil than usual. When that happens, I’ll swipe on Peter Thomas Roth’s Glycolic Acid Toning Complex. Fair warning, it doesn’t smell pleasant and I would recommend starting SLOW with this guy. A little goes a long way.
  • Sunscreen: After applying my BP to any problem skin areas, I allow it to dry and really soak into my skin (I’ll usually brush my teeth during this time), before applying my sunscreen for the day. It probably goes without saying, this step is SO CRUCIAL to your acne journey, as it’s likely whatever you’re doing to troubleshoot your skin, it’s making you much more sensitive to sun exposure. I recently picked up Elta MD UV Clear sunscreen, with SPF 46 for acne prone skin, at my dermatologist’s office and I lather quite liberally.
  • Moisturizer: I have two favorites at the moment, both packing a good punch of Vitamin C, which is great for promoting collagen growth (much needed for me since I have active acne and acne scars). I use Peter Thomas Roth’s Camu Camu Power C moisturizer during the day and then Peter Thomas Roth’s Potent C Power Serum at night (just ran out of this stuff, going to restock soon).

  • Masks: This is going to sound controversial, but I don’t dabble in masks all too often these days, again, mainly on a case by case basis. If my skin is feeling extra congested, I’ll use Skinceuticals Clarifying Clay Mask and if my skin is feeling a little dry/dull, I’ll use Bliss’ In The Honey Moisturizing Mask. When my skin is really acting up, I find a good light layer of raw organic honey applied all over my face, helps reduce redness and inflammation.
  • Lactic Acids: I’ve been reading a lot about both Sunday Riley’s Good Genes and Biologique’s Lotion P50 Original 1970. Both came highly recommended by skincare enthusiast friends and both I’m kinda nervous about starting. Mainly because I’ve read WAY too many reviews on Sephora that note the dreaded initial breakout phases of both products. I have a sample of Sunday Riley’s Good Genes, so perhaps I’ll start there and report back with a review. Would you guys like that? On a related note, have any of you tried either product? Thoughts?

And that’s the rundown of my routine! Of course, I should note, whenever possible, I try to skip makeup, even though I’ve vetted all products to be non-pore clogging. I think it’s important to allow your skin time to breath and to really absorb whatever you’re putting on it, product wise, without makeup interfering. I get monthly facials, opting for a more gentle procedure, for sensitive skin.

The stigma of Acne: So I’ve mentioned several times throughout this now FAR TOO LENGTHY POST, that this second time around has tested me in different ways, particularly in regard to my attitude toward acne and my self esteem. Let’s just all say it together: it’s never fun having acne, no matter what age you are. Teenage, adult, senior citizen! And no matter how many times people tell you to stop worrying about it, that it’ll eventually go away, that they hardly notice it, it often times doesn’t make you feel better. If anything, it makes you fixate even more on it, especially if those friends can’t really relate to what you’re going through.

I’ll be the first to admit, I let the state of my skin control my mood far too many times, only to feel disappointed in myself for allowing those feelings to control me in the first place, because hey, I’m a well-adjusted 32 year old woman who shouldn’t let her outward appearance dictate so much. The reality is, this cycle continued and sometimes still gets the best of me, if I’m being completely honest. I’ve had plenty of moments recently where I catch myself thinking, “Krystal, snap out of it. Things aren’t that bad.” And it’s true. Things aren’t that bad.

My dermatologist once put it into perspective for me, noting that acne usually isn’t a sign of some BIG underlying problem — there’s nothing WRONG with you. It’s just unsightly. And it’s unsightly because society tells us it is. No matter where you are with your acne journey, I didn’t want to end today’s post on a “LOOK AT ME, I FIXED MY PROBLEM” note, because I am far from having perfect skin, nor do I expect perfect skin ever. These photos here are shot in quite flattering studio lighting and thanks to some makeup coverage and intentional hair placement, the areas of my face that make me feel uncomfortable are covered up. I have plenty of flaws, and perhaps I’ll get the courage someday to share photos that highlight all of them. But I’m here to remind you, perfection is unrealistic, despite what Instagram filters might lead us all to believe. We all have flaws — zits, warts, scars and all. I wanted to end today’s post, reiterating that if you’re going through this journey, you’re not alone. There are plenty of statistics I could throw out here, but let it suffice to say, there is a huge support system out there, including the girl you see here, in these photos, who is happy to email, text and yes, chat on the phone with you about whatever state of your skin is getting you down. Seriously, just say the word.

Speaking of words, my word count is now up to over 3,000. So I think that’s my cue to wind this down. But please, sound off below. Would love to hear any thoughts/feedback/personal stories about your skincare journey.

 

Photos by Ty Johnson

10 thoughts on “let’s talk about hormonal acne: 4 month update

  1. Brittany Austin says:

    I’ve been talking to my therapist about my skin and my appearance lately, even though I really like to downplay those topics in my own mind and in my life (hey, I’m a well-adjusted 29-year-old woman who shouldn’t let her outward appearance dictate so much!). I’m finding out that my own journey with adult acne occupies a significant space in my psyche, and absolutely affects the way I look at and speak to myself. It’s all a little overwhelming and definitely discouraging, so reading these words from you feels so reassuring. Thank you so much for sharing how you feel and what is and isn’t working for you. It meant a lot to me this morning

  2. Malavika KM says:

    I’ve been a silent reader since your SF days. Love your fashion and your writing style.
    I’ve been going through acne since I was 12 and I still do. I just know how to listen to my body now but obviously it changes its mind like I change my lunch order. But I try whatever I can do to help my skin and that’s it. I don’t see the point of overthinking about it. It doesn’t help the acne or me.
    I know your job isn’t really easy when it comes to appearance but I really hope you get the strength get past it. ’cause at the end of the day you’ve got readers/followers who love what you do. That’s the best gratification you can get for all the hard work you put in.
    PS: so glad you’re writing so much more now

  3. These posts always feel so on point and come at the right time. I’m just now back on Spironolactone, which seems to do the trick every time (yes, there have been multiple).

    It is such a bummer. And none of the really good options— the Retinoids, spironolactone, birth control, of course— are available if you are pregnant, trying, or breast feeding, which is something I’m looking forward to in the near future.

    Please let it end some day… in the meantime, thanks for your candor 🙂

  4. Krystal…although I have been fortunate to avoid acne one of my sisters suffers greatly with it so I completely get. It is okay, perfection is not required. Keep being you and that is all that matters ❤️

  5. I’ve been following your journey and been on a similar one myself! I love what you have to say about the mental health aspect of it. It does feel so, so so so isolating. Side note, not sure what your derm would say, but I started using the GloPro and the results have been huge. I feel like it makes the products I’m using work better.

  6. Thank you for being so honest about this, I’ve suffered from hormonal acne in the past and it had such an effect on my mental state but also felt like such a “silly” thing to be upset over.

  7. I’m also a UNR grad who moved to NYC about 6 years ago. I never had acne until I moved to NYC but my life saver is differin (over the counter) or adapalene if you get it prescribed. Also, I was pretty nervous about the Sunday Riley good genes and luna oil because I have sensitive skin but surprisingly my skin was super soft and clear afterwards.

  8. Oh babes, luv this jacket with nothing underneath…makes my imagination running fricking wild, lovely jewelry also…God!!! You can assume the rest about sexy cleavage and stuff…oh shit!

  9. I’ve commented a couple a times before concerning your acne, since I have had acne since puberty 20 years ago at 12. So I hope in some small scope that might make you feel a little better (but believe me sometimes in the midst of a problem very little can help put it into perspective). My mom’s acupuncturist told her that acne is mostly a problem of too much heat, so sugar raises heat, meat raises heat, dairy products raise heat, pretty much any and all food that might be good raises heat, also excessive emotion, like being part Italian. But obviously hormones play a huge role in this process, and another piece of information my mom received from her chiropractor (and this is why cruciferous veggies are important) that moving excess,i.e. bad, estrogens through our systems are so important. So again a little more info about the wondrous world of acne.

    Cheers

  10. Krystal! First of all, you’re gorgeous. No matter what. Take what I have to say with a grain of salt since I run my own skincare brand, but the glaringly obvious thing that I think your skin is also missing is oil. A lot of what you’re using tends to strip the skin. This is a really common practice with women struggling with acne. I’d suggest one quick thing: oil cleanser. I’d skip both the ones you’re currently using for a week and I think you’ll see major changes. HUGE changes. I know hormonal is hard to tackle but sometimes fighting oils with oil is genuinely the best thing. Give it a go! It worked for me!

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