Hormonal Acne
This is long, but I’ll try to be concise.
Until my mid-20s, I had clear skin. My dad and older sister both struggled with acne, but aside from the occasional pimple, I never worried about mine. Even after hormonal changes from birth control, my skin didn’t change until I was 25. And it felt like it happened overnight.
The acne started along my jawline and chin, with occasional clusters on my cheeks. It was brutal. As someone who already struggled with body image, this became another major insecurity. I went off birth control, had bloodwork done, and looked into PCOS and other hormonal conditions, but everything came back normal. I upgraded my skincare, tried s*pplements, and saw no improvement. Eventually, I saw a dermatologist, was diagnosed with hormonal acne, and prescribed spironolactone.
And wow, spironolactone worked. Within months, my skin was glowing and my acne was basically nonexistent. Then the side effects started. I gained stubborn weight, had frequent heart palpitations and headaches, and developed ovarian cysts. I know spiro isn’t officially linked to some of those things, but it was the only major change at the time.
Ultimately, I decided the side effects weren’t worth it, so I stopped taking it. Slowly, the acne came back.
Then the pandemic hit. My acne was still there, but less persistent. I still got cysts and had some scarring, but it felt manageable. I accepted it. I lost the weight and started feeling more like myself again. My skin was far from perfect, but I was okay with it.
A few months ago, my acne returned in full force. It honestly feels worse than ever. I’ve become obsessive about taking daily photos in different lighting to track whether it’s improving (spoiler: it’s not). I’ve done the research and simplified my skincare routine (I understand that hormonal acne needs to be treated internally).
What I don’t understand is why it suddenly became so severe again. I’m 32. I hate looking in the mirror. I’m obsessing over my skin constantly.
I saw another dermatologist just last week and was recommended spironolactone and birth control. I shared my history with those medications. They didn’t suggest Accutane. They mentioned Winlevi, but didn’t sound very optimistic about it. I’ve also seen recommendations for spearmint tea and other s*pplements, but I’ve read enough mixed experiences to feel hesitant. Other people tell me to fix my gut health, take pre/pr*biotics, reduce stress, drink more water, etc. At this point, I don’t know what to do besides possibly going back on spironolactone despite the side effects.
For now, I’m dairy-free and hoping that helps. My skincare routine is simple:
AM
Vanicream Cleanser
Vanicream Moisturizer
Azelaic acid (Anua 10)
SPF (Youth to the People)
PM
Vanicream Cleanser
Vanicream Moisturizer
Tretinoin
I am just looking for support and to not feel so alone. Recommendations are welcomed, too.