I was a very privileged teenager. Not because my family was loaded, but because I had gorgeous goddamned skin. My God, did it sparkle.
Nary a zit, blackhead, nor oily patch graced my sprightly mug. I almost never washed my face. In fact, I spent many sleepovers heaping harmful, heavily-scented chemical masks onto it (it was the ‘90s!). Still, my face withstood and even triumphed through the harshness of adolescence. I barely knew what a dermatologist was. By the time I hit 18, I figured I was out of the acne woods for life.
Then I hit 30. And the acne finally came.
Whiteheads, painful honkers, weird blackheads (which I found out later were sebaceous filaments and I shouldn’t squeeze them, oops, still do), those pressurized proto-zits, mysterious bumps — they took over my chin and sprinkled themselves across my forehead. It was completely out of the blue and it was angry, as if making up for lost time.
For a while, I brushed off this sinister skin festival as temporary — even novel. Hey, I had a whole playground of stuff to pick and pop, and it would go away, right? I mean, how can someone who never had acne before suddenly have chronic crapola face?
It has been five years. It hasn’t gone away.
My acne was completely out of the blue and it was angry, as if making up for lost time.
Luckily — or perhaps unluckily — I’m not alone in my struggle. People with adult acne might feel alone, but it’s a very common result of hormone fluctuations, according to Dr. Deanne Robinson, a Connecticut-based dermatologist.
“It’s quite common to be dealing with both wrinkles and pimples at the same time. The hormonal changes don’t end with puberty,” Robinson told me, as I cried inside. “...The primary culprit here is our levels of estrogen, which is already starting to taper down on a gradual path to menopause.”
I had a brief break from the warpath when I was pregnant, but my hands were turning into water balloons so I didn’t notice. After I gave birth, it got worse. In short, hormones are assholes.
“I treat many women battling acne post pregnancy, while their hormones are still in flux,” Robinson said. “Also, adjusting to a new birth control, fluctuations in weight and even diet can also trigger hormonal shifts; even without these easily identifiable triggers, hormonal acne is very common.”
Like many, I made my skin worse by popping and picking. Instead of murdering your face, Robinson suggested seeing a dermatologist for steroid injections for your new pimples, which will help avoid infection or scarring.
But sometimes you really can’t help yourself.
“Very tempting, I get it,” Robinson said. “..If you can’t resist, then treat it like an at-home surgery — scrub in, clean your hands and the area you’re going after well. Next, apply gentle pressure around the pimple, don’t dig into its angry center. And know when to stop, it can be easy to get carried away, which is what leads to spreading the bacteria and creating a larger wound and or scarring.”
Meanwhile, I’ve done everything wrong when it comes to treating my new condition. I’ve used extremely harsh facewash and stuff that was borderline napalm like Onexton and Differin, which dried out my skin like a motherfucker but didn’t get rid of my zits. I also ditched some perfectly adequate treatments prematurely. The epidermal adage “sometimes your skin gets worse before it gets better” is sadly true: Certain treatments work by bringing “acne lesions” living under your skin to the surface.
Fortunately, Robinson provided me with this simple guide to making your skin better.
In the morning, wash with a gentle cleanser. Next, apply any prescription products you’re using. Follow that with an antioxidant serum, then layer on a hyaluronic acid-based moisturizer. Finish with sunscreen, which should be the last thing you apply to your face.
I had a brief break from the warpath when I was pregnant, but my hands were turning into water balloons so I didn’t notice.
Then at night, wash off the day. “I like CLn’s Acne cleanser, which uses unique combination of low dose salicylic acid and sodium hypochlorite, which kills bacteria,” Robinson said.
Apply your retinol, then your antioxidant serum. Finish with a hyaluronic acid based oil-free moisturizer. Sleep on a clean pillow case — clean it once a week.
In general, avoid anything that doesn’t say oil free and non-comedogenic on it. Use headphones during phone calls. Your phone will give you acne. Don’t drink too much, don’t smoke, and eat wll — high-glycemic food like dairy is bad. Being sweaty and/or dirty can exacerbate acne-prone skin, so always carry a towel and soap around, I guess?
Simple right?! I was wondering when on earth I was going to use my advanced chemistry degree and all the free time I have.
For all the treatments — the retinoids, the antibiotics, the birth controls, even the lasers - there is no precise cure for acne. Why? The Atlantic wrote a deep-dive last year: “Most of these treatments target just one potential cause of acne: For bacterial acne, there’s antibiotics. For hormonal acne, there’s birth control. Few address both, along with the myriad other factors, from pore-clogging makeup to time spent wearing a helmet, that contribute to acne.”
According to the article, isotretinoin (formerly known as Accutane) has shown promising results, but it’s administered sparingly due to intense side effects. A vaccine is also in the works that may combat the body’s acne-causing reactions to bacteria, but it’s still not approved, and frankly I’m not getting my hopes up.
In the meantime, my only hope is makeup. If you want to put makeup on your acne, which I know I’ve spent hours attempting to do and failing miserably, professional makeup artist Daylin Laine said that good skincare is an important baseline. Use a color corrector, followed by a concealer. Blend them both. No slabbing. (Ah, so that’s why I’ve always looked like a beige birthday cake!) You might be able to smooth out some crater-y textures with silicone-based primers, but always do a spot test first, said Laine.
Oh, and don’t put makeup on an open wound (what kind of an idiot would do that? Ha. Ha.)
“If it’s that bad, I wouldn’t want to put something on it because it could make it much worse,” said Laine.
As you can see, I’m very upset about adult acne. I’m upset that I have no self control. I’m upset that I’m obsessed with it, and that it utterly trounces my confidence. I’m upset that I have to work around it during video conferences by altering the lighting, or by matting down my hair just so. I’m upset that my toddler points at my zits when she gets close to me. (It’s not her fault, she just likes shiny things.) But mostly I’m upset that, in a world in which tiny robots can perform surgeries and one person’s face can be transplanted on another’s, acne has not been solved.
I will end this piece with a call to arms. My middle aged pimple pals, my fellow elder crater-cheeks, my magma chin family, come out from under your bridges. Take off your strategically placed scarves. Bring on the confusing, the pus-ridden, the festering. I’m not about to tell you to own your acne, because that’s not realistic. I just want us to admit that we have it, and that it makes us upset — so that we can kick its ass.
Are you upset about something and want to write about it? Email leah@theoutline.com.
