the joys of hormonal acne
Acne. Breakouts. Hormones. Let’s be honest, when you’re past your teenage puberty years, it’s a real bitch. This story is a bit long, but as anyone else who deals with hormonal acne knows, it is a lifelong journey.
As part of starting my cycle at such a young age, I also started getting puberty breakouts pretty regularly in 7th grade. I could usually keep them at bay with a good skincare regimen and regular facials. Eventually that wasn’t really doing the trick though, so like many young people, I turned to the dermatologist and was prescribed Minocycline.
Unfortunately, that only worked for so long and then I started the road of various types of topicals and different prescriptions, different types of birth control, you name it. All of which would work for a while and then stop again. I played this game of acne medication roulette until my sophomore year of college. Nothing was working anymore and the breakouts were getting worse and were becoming more cystic in nature. Once again, I made a trip to the dermatologist and waited with bated breath for some miracle that they would tell me would help. I was prescribed Accutane, and I thought surely they wouldn’t prescribe me such an intense drug if they thought there were any other options, so I went forward with it.
If you don’t know, Accutane has many side effects from extremely dry skin and chapped lips, sun sensitivity to depression and suicidal ideation. It is also known to cause severe birth defects so you must be on birth control while you take it and have to have blood work done every month before your next dose is prescribed. A course of treatment is typically 4-6 months and like most treatments, your acne may get worse before it gets better.
I was on it for the full 6 months and it was grueling. I definitely went through days where I felt depressed and kept questioning what I was doing to myself. But every month, when I went to the doctor she assured me things were on track. And at the end of 6 months, she was right, my skin was clear and I was headed to New York City for an internship feeling better and more confident in my skin than ever. That lasted about 9 months and then the breakouts started coming back. Not as intensely at first, just a few here or there. I could manage it, or so I thought. By the time I was half way through my senior year of college, the cystic breakouts were back again and I was desperate to do something because soon I’d be graduating and didn’t want to keep dealing with this. So back I went to the same dermatologist who said, “some people just need a second course of Accutane to really get rid of it.”
So that’s what I stupidly did. I went back on Accutane for another 6 months. And again it kept me clear for a bit, but then the breakouts came back. I couldn’t believe it. I thought I was an anomoly. Why wasn’t it working for me? So I turned to supplements and kept getting regular facials – anything I could to try and deal with it while I was working my first post-college job.
And then I got engaged. Well, I knew I didn’t want to have breakouts and terrible skin for my wedding, so I decided to head back to the dermatologist. But this time, I wasn’t in college and had new insurance, so I picked a new, highly-rated doctor and made my appointment. When I met with him and he reviewed my history, he immediately looked at me and said my acne was the classic sign of hormone related breakouts and that that is the reason I likely wasn’t having luck with the other things and that I should try Sprionolactone instead. I was dumbfounded. Had I just wasted years dealing with medications and the side effects when clearly they were never going to help? How did my previous dermatologist not think about this?
So he prescribed Spironolactone. It’s not officially an acne medication — it’s a diuretic and blood pressure medication — but it works for acne because it blocks androgens (like testosterone). These hormones can cause excess oil production, which leads to breakouts, especially around the jawline, chin, and lower face. It works by helping calm the hormonal fluctuations that lead to cystic acne and reduce oil production. It is a pretty common treatment for hormonal acne, especially in adult women.
And you know what? It worked. I had limited side effects (unlike Accutane), though you still must use some form of birth control due to the risks of birth defects. I was clear for my wedding, honeymoon, months after – until I started my fertility journey, but that’s a story for another day.
I’ve spent the last decade on and off Spironolactone, but now, at almost 36, I’ve been back on it for almost 9 months. And the truth is, while many people will talk about how it’s not a cure or it’s just a bandaid, what I’ve learned during this is that everyone’s journey with acne is different. In a future post I’ll get more into the details of my hormonal imbalance, but for me, Spironolactone works. No, it’s not a cure and I still get monthly facials and use the incredible Face Reality skincare line (no not an ad ;)) but my body needs that extra help to balance things out. No supplement, diet change or anything else I’ve tried has helped, so if this does, that’s OK. I have done countless hours of research and make informed decisions about anything I put in or on my body – something I’d always recommend to anyone considering acne treatments or other treatments.
As women, we are constantly being inundated with how to look and feel better because of society. But what about what we want? You want to get botox? Hell yes, girl, do your thing. Boob job? I say, “tits up.” Dye your hair? Go for the rainbow. Completely au natural? Wear it proudly. My point is, I found something that works for me and makes me feel better. We shouldn’t apologize for that just because others don’t agree or understand. And personally, I might wear my laugh lines, but I don’t plan to stop covering my grays anytime soon!
Honestly,
Theresa