How I Finally Learned to Deal With Acne (13 Years Later)

How one woman learned to treat—and accept—adult acne. 

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Photo by Garry Wade/Getty Images
This article originally appeared on MIMI.
As far back as I can remember, my skin has always been one of my biggest insecurities. I grew up all limbs and freakishly tall, so despite being lanky, bespectacled, and having a fairly unfortunate set of bangs throughout my early adolescence, I was lucky enough to skip the relentless weight and body insecurities that plague many young women. However, immediately after puberty hit and I began to wake up daily with a dusting of red zits across my pale skin, I became zealously consumed with finding a solution for this perceived flaw.

Too often, we write off acne concerns as part of the much-bemoaned "teenage experience," right alongside embarrassing crushes, hormonal surges, hating your parents, and learning to drive. And, in many cases, it is a temporary teenage affliction — many people are "blessed" with acne that only manifests itself during their adolescence and fades away as they age. However, despite this temporality, acne basically just really sucks. It's on your face, and even if you become extremely skilled with makeup (which, let's face it, not a lot of 15-year-old girls are), it's still impossible to fully disguise the fact that your skin isn't perfect.

To make matters worse, acne is one of those things that still (consciously or unconsciously) carries a specific social stigma — if you have visible acne, you must not be doing enough to fix it. Even though I knew instinctively it was not my fault that my skin was rebelling against all of my attempts to control it, I was embarrassed and felt that people were automatically judging me as dirty, ugly, and less-than-perfect because of the state of my skin.

Thus, when I was an adolescent acne sufferer slathering my face with off-color creamy concealer and perpetually keeping my hair in my face, eradicating acne was something I thought about daily, but I felt instinctively inclined to keep my skin-related anxiety under wraps. I was initially way too embarrassed to ask my mother if I could see a dermatologist (I was a very awkward teenager, okay?), so I hoarded over-the-counter products and fried my sensitive skin by piling on drying Salicylic Acid and Benzoyl Peroxide Creams two or three times a day. Unfortunately, my efforts had precisely the opposite effect I had intended, leaving my skin somewhere between flaky, tight, and oily. (To this day, the feeling of tight, dry, flaky skin on my face is a special type of hell for me.)

Finally enlisting the help of a dermatologist in my late teens led to a litany of other attempted remedies, some of which made minor dents, but none of which were the magic bullet to help my acne woes. Over the last 10 years, I have tried–in various concentrations and iterations–retinol gels and creams, Benzoyl peroxide, tea tree oil, toothpaste, calamine lotion, Visine, clindamycin gel, light therapy acne treatment, chemical peels, vitamins, various different types of birth control methods, and antibiotics. My antibiotics, although very effective at ridding my face of acne, led me to suddenly become nauseated at pretty much any random time during the day — memorably I once had to pull over while driving my mom's minivan and puke out of the doorway onto the streets on my suburb (Yep, just as classy as it sounds).

My personal experience, though daunting, is not uncommon. I spoke to Dr. Monica Halem, Dermatologist and Assistant Clinical Professor of Dermatology at Columbia University, and she informed me that many acne-sufferers have to try multiple remedies in different combinations until they find what works for their specific skin. All acne is definitely not created equal.

This is my skin. Deal with it.

Luckily, my years of experimentation have finally led me to the combination of a non-hormonal IUD, frequent facials, the strict avoidance of any retinol, and Spironolactone to treat my acne. Spironolactone was a drug originally developed to treat hypertension and congestive heart failure, but according to Dr. Halem, when used on female patients with hormonal acne, the drug acts to limit androgens and thus counteracts hormones leading to acne. For me personally, it's a total godsend.

I've also discovered the amazing world of cortisone injections to treat my cystic acne, and though it's infrequent, when I can feel a large and painful cyst about to appear on my face I immediately visit my dermatologist for a quick cortisone injection. The injection contains anti-inflammatory steroid medication that quickly reduces the size and redness of the zit, basically stopping it in its tracks.

Even more importantly, however, is the fact that I've finally gotten over it. Yep, I have acne. Yes, sometimes it sucks, but that doesn't make me a dirty or fundamentally deficit person. Just like anyone who struggle with any aspect of their appearance, there is a part of my being that I don't love. But at the end of the day, so what? I may not have poreless and Photoshop-perfect skin, but just as accurate body image advocates champion, I'm over chasing an unrealistic standard of beauty.

Though I'm still self-conscious about the moderate scarring on my face from my years of skin issues, I'm happy to report that although I still get the occasional zit, I have adopted a far less obsessive attitude towards my skin. I am far more than just my acne, and although I don't know if my skin will ever be completely lesion free, I am happy to keep it as healthy as I can.

Acne Products and Treatments I Swear By:

Peter Thomas Roth AHA/BHA Clearing Gel ($54, sephora.com)
Exfoliating products are usually too rough for my sensitive skin, but this gel provides a combo of exfoliating AHA acid with the blemish-preventing BHA acid for an effective, yet gentle, treatment gel.

Boscia Detoxifying Black Cleanser ($28, sephora.com)
This warming gel cleanser utilizes charcoal and glycolic acid to remove impurities and increase cell turnover. The warming feeling is pretty awesome on it's own as well.

Dermaplus Signature Custom Facial (Starting at $150, dermaplussf.com)
This is hands down, the best custom facial I've ever received. You'll have to travel to SF to get it, but the products are all made in-house, and are paraben free, fragrance free, color free, cruelty free, synthetic free, eco friendly and gluten free (I know, right?). The esthetician will also work with you meticulously to identify your personal skin concerns and how to best treat them for your lifestyle, age, and past skin experience. It's the true full package.

Dermaplus Custom Blended Mineral Clay Mask (Starting at $28, dermaplussf.com)
I always make sure to take home my favorite non-drying clay mask when I'm at Dermaplus. The product smells like a thin mint, but it packs a wallop in terms of soothing irritable skin and healing blemishes.

Clinique Dramatically Different Moisturizing Lotion ($26, sephora.com)
This is a classic for a reason. It's the perfect non-greasy but also great for combination skin lotion. I've never found anything that works better on my skin.