I have always had acne. As a teenager, I watched Clearsil commercials with rapt attention. Maybe that face wash would work? Or those acne fighting pads? I suffered through it, my natural introversion only increased by worrying about the pimple I could feel sprouting on my chin.
And then, I got older and found products that helped keep breakouts mostly at bay. Sure, there was a bump or two around the time I got my period, but overall, my skin was at its best in my twenties and thirties.
Until I hit thirty-five.
The smallish pimples and whiteheads of my youth were nothing compared to the new state of my skin. This acne was double the size of those previous pimples, deep, and painful. The bumps took forever to go away and when they did the scar would stay just as long. The skin care routine I’d had for the last decade wasn’t making any difference. So, what was going on?
If you’ve made it through your thirties and forties without feeling like your skin has a starring role in Night of the Living Acne, congratulations!
Pimples happen when the pores in your skin get clogged, often by dead skin. If bacteria gets in there, your skin might get red and swollen. But, the acne becomes cystic when that infection goes deep into your skin, “creating a red, tender bump that’s full of pus. It may hurt or itch. If a cyst bursts, the infection can spread, causing more breakouts.”
I tried to battle this acne on my own but after a year of frustration, I gave up and went to the professionals. My dermatologist took one look at the large, red bumps I had ringing my chin and told me it looked like a textbook case of cystic acne. That it’s hormonal and increasingly common for women my age.
Confirmation! Now, how could I get rid of it?
She prescribed a topical antibiotic, Aczone, and Retin-A (a longtime skincare love of mine). She also told me about a solution a lot of her patients relied on: spironolactone.
Originally used as a heart drug, spironolactone has been found to treat hormonal acne at a lower dosage. And for many it can be successful, even friends had recommended it.
I started to take it, but felt uneasy about its side effects (possible liver damage and a need to make sure it’s fully out of your system before you get pregnant). Eventually, I gave up on that as the answer.
Even though that wasn’t the answer, two years after that dermatologist appointment, I’ve found the routine that keeps my skin as problem-free as those golden years in my twenties.
If you’re struggling with cystic acne, here’s what worked for me.
I’ve found that I need a couple of cleansers to put my best looking face forward. I use Aveeno’s Clear Complexion Foaming Face Cleanser at night. It cleanses well, smells nice, and doesn’t set off my sensitive skin. It also has salicylic acid which helps to unclog pores. But, I’ve also become a convert to micellar cleansing water. Some people sub it for their cleanser, I supplement with it or double cleanse. Then, in the morning because older skin needs more exfoliation, I go back to Aveeno, but this time to the Positively Radiant Skin Brightening Daily Scrub. It’s just enough scrub to turn over those skin cells, but still gentle.
I used to think given my acne that less moisture was better. So very wrong. Without enough moisture, the skin makes more sebum to lubricate the skin and that can lead to more acne. So, the right moisture balance is key. Kiehl’s Ultra Facial Oil-Free Gel Cream is perfect for me. It’s deeply moisturizing, but light enough to keep wearing even in summer.
Mostly that routine helps keep my acne in check, but when a small spot starts to appear (or to ensure one doesn’t), I also use products to treat the acne specifically. A bump here or there gets a dot of the Mario Badescu Buffering Lotion. It dries any pimple up quickly without drying out the surrounding skin. I still keep Aczone in my acne arsenal, but there’s less need for an antibiotic with the double cleansing. Retin-A Micro is good for acne and for wrinkles, well worth the price if you have insurance. If you don’t, no worries, ROC Retinol Correxion Deep Wrinkle Night Cream is a good lower priced substitute.
When I let up on my routine, run out of my moisturizer and forget to buy a new one, or skip the micellar water some days in a row because I’m being lazy, my skin lets me know. But at least I know just how to get it back on track.
A friend swears by Evening Primrose for her cystic acne and every few weeks to keep my skin at its best, I use Peter Thomas Roth Therapeutic Sulfur Mask. Charcoal masks have also become popular for treating cystic acne and one friend told me for a cheaper treatment, she just made a paste of a bunch charcoal tablets. Options, ladies, lots of options!
Hope you’re figuring out how to love your skin!