17 Things I’ve Learned About Dealing with Hormonal Cystic Acne

Sorry I’ve been gone so long! I recently started writing freelance articles about beauty, which you can find here. I’ll somehow try to balance writing for fan-b and writing for not-fan-b. These days I’m pretty easy to find on Twitter if you need to track me down.

I recently shared the skincare routine that has finally helped me bust through the hormonal cystic acne deadlock that persisted for years, but I want to share some of the things I’ve learned along the way as an addendum to the routine.

17 Things I've Learned About Dealing with Hormonal Cystic Acne + Giveaway
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This is a highly specific-to-me, unscientific account of what has worked for my skin and what I’ve learned. Plus there’s a giveaway of a bunch of my favorite products for dealing with acne at the end of the post.^^

17 Things I’ve Learned About Dealing with Hormonal Cystic Acne

1. One change isn’t enough for acne like mine.

It took the skincare equivalent of full court press to get the ball rolling at last. Only when I combined prescription topical medication (I use Curology), AHA, BHA, kbeauty skincare, and spearmint capsules did my skin finally have a breakthrough.

I had many people tell me over the years things like “just drink more water!” or “X pill can clear you up!” but the path to better skin was much more complex than people made it out to be. The main problem is that if you have troubled skin, stopping new blemishes from forming is just the first step: there are likely clogs below the surface that need to come up. A patient, well-rounded approach is key to dealing with your skin’s present and past.

2. pH matters a whole damn lot

My skin got more resilient and less prone to violent, open eruptions once I switched to low-pH cleansers. Cleansing is the step where pH really matters most since that’s when so much is being taken out of one’s skin due to things like surfactants–high pH cleansers hit skin hard in this step. For acne-prone skin, high pH cleansers actually raise the pH level of skin minutely, but enough to allow acne-causing bacteria to flourish. Cleansers like Glossier’s Milky Jelly Cleanser and CosRx Good Morning Low-pH Gel Cleanser that have a pH level of 5.5 or lower have made a huge difference for the health of my skin. For more information on why the pH of your cleanser matters so much, check out the essential reading posts by Skin & Tonics and Snow White and the Asian Pear.

3. Cleansing is the most important non-active thing you can do for acne.

I’ve learned to cleanse lavishly, thoroughly. Cleansing is the step where I think one needs to do full rotations and nail the landing–it’s truly the foundation for great skin, and so many issues can be cleared up or avoided by doing great cleansing.

Great cleansing can cut down on the work one has to do in the other steps. For example, if your moisture barrier is strong and keeping your skin’s own moisture in, that means you may be able to use fewer moisturizing products. Double cleansing (cleansing with an oil-soluble cleanser and then a water-soluble cleanser) can remove more dead skin, oil, and nasty random other stuff, cutting down on unnecessary blemishes.

4. The cleansing you do at night doesn’t need to match the cleansing you do in the morning.

In fact, if you wear makeup or sunscreen, it shouldn’t. I go for a very gentle morning cleanse with Glossier’s Milky Jelly Cleanser while at night I pull out the big guns and use LJH Dr’s Care Cleansing Oil and CosRx Good Morning Low-pH Gel Cleanser to remove makeup and cleanse my skin.

5. The things you do to help your acne will make your skin beautiful in the long run.

Acids (especially BHAs) help make pores smaller, retinols/retinoids help reverse signs of aging, and sunscreen protects against aging. I literally just do my anti-acne routine and don’t worry about other anti-aging steps. Some mystical water and unspecified doses of peptides aren’t going to do shit compared to the heavy-hitters already in my routine.

6. For my serious acne, Asian Beauty alone wasn’t enough to turn things around.

I look to Asian Beauty for amazing cleansing routines and glorious hydration, but in the years I’ve been using it, my skin wasn’t responding to the gentle approach alone. Some skin can turn around with only kbeauty, but don’t feel hopeless if your skin needs more.

7. I need strong Western acids, but not the strongest ones.

Daily acids turned out to be better for me than weekly peels. Drugstore hero Stridex tended to become too concentrated at the end of the jar, leaving my skin in tatters. Finding the right acid that’s in your skin’s acid sweet spot is expensive, time-consuming, and frustrating, but the search is worthwhile and it can really pay off.

8. I may have acne and oily skin now, but my skin is fundamentally normal.

Largely left alone and treated right, my skin glows–it always has. I just don’t need that much beyond good actives to make my skin happy. Realizing that and not fighting it has allowed me to simplify my routine a lot.

9. The key to acne sanity is knowing the difference between a purge and a breakout.

This is tricky. A purge is when you introduce a new active such as AHA, BHA, or tretinoin to your routine and crap in your skin surfaces and forms blemishes. It’s in there, it needs to come out, this is positive, if annoying. It will make your skin clearer overall.

A breakout is when your hormones or a product or sweat or the fucking magnetic pull of Pluto who knows cause your skin to form zits. If your breakout is possibly caused by a product, you probably want to bench it.

How do you know the difference? ahh, it’s tough. If you’re a woman, track your monthly cycle and note when your skin breaks out. Limit your testing of new products to one at a time. Study your skin in different lights and at different angles to see where you have tiny bumps below the surface that could indicate clogs that need to come up.

10. There is no time limit on purging.

It will depend on the state of your skin/pores at the start of your journey and the strength of your actives. My skin was riddled with clogs, so my purging has taken forever.

11. Introducing non-actives does not cause purges.

If you add a new essence or foundation and your skin responds with zits, that’s a breakout and you should pull the product ASAP. Non-actives such as foundations, primers, powders, and essences do not need a “breaking in period” and they can’t cause your skin to purge–but they can certainly cause breakouts. You can always try the product again in the future after patch testing it.

12. It’s going to get worse before it gets better.

Before you can have truly clear skin, you’ve got to bring up the bodies, if you will. If you have what appear to be blackheads somewhere outside of your nose, flesh-colored bumps without a head, or blemishes with a white (pus-filled) head, your skin is holding clogs. Bringing them to the surface quickly won’t make your skin prettier in the short term.

13. If you suspect something is breaking you out, put it aside ASAP and get back to your core routine.

Don’t pause to ask Reddit if it’s breaking you out while continuing to wipe it on, just put it on the bench for a bit and then reintroduce it in one part of your face only (patch test it) to see if your suspicions are correct. If something is really going wrong with your skin, see a dermatologist if at all possible.

14. Spot treating with a strong AHA should be a Thing.

It’s the best way to open closed comedones and get clogs loose. It also helps to lessen the leftover hyperpigmentation from the blemish. I always use a 10% AHA rather than an alcohol-laden spot treatment.

15. Acne patches are EVERYTHING.

Cosrx makes the best ones imo.

16. Someone else’s acne routine will likely not be perfect for you. But some of it might work.

I tried following the routine that works for Kerry from Skin & Tonics and my skin wasn’t happy. But once I scaled back the acids to once per day and found formulas that work for me, ding dong, I was on the escalator to freedom.

17. Pay attention to everything that comes in contact with your face.

Real talk: I gave up wearing sweaters with any kind of collar that rubs on my jaw because they seemed to increase irritation and I could never be sure that they were totally clean (you’re not suppose to wash angora and whatnot each time you wear it). Pillows are often eyed as potential bacteria nurseries, but think also about shirts, scarves, and coats that come in contact with your skin.