I’m taking the care of writing this as if it’s a delicate manuscript… I’ve never taken the time to evaluate my time with cystic hormonal acne. The idea of delving in gives me a pit in my stomach, I start feeling anxious—as I’m writing this I’m becoming aware of how I completely ignored the emotional hold it had over me.
I’ve been putting this off, waiting for the perfect day to dedicate to writing, and now realize I was putting off processing. Fear and anxiety are such jerks???? Gtfo, right?!
It’s the same old story everyone seems to tell: before acne, I would have breakouts here and there, overall my skin was historically clear with an occasional breakout. Most likely taken for granted.
I found myself looking through my camera roll, dissecting my skin for cysts covered by makeup and looking at dates attempting to pinpoint when it all began. It wouldn’t be hard to see them in photos, I was never a makeup guru, and my cysts would range from a dime to nickel in size. But I didn’t take many selfies, as one would expect.
If I were to choose a start date for my hormonal acne story, it would be October 2012, making this month my 5 year anniversary.
I’m letting that sink in. 5. Years.
Here I was thinking I was only pushing 3 years, 4 max.
I would have been on the cusp of my 27th birthday. Maybe it was the 7 year-body-chemistry-changing mark? Or is that a health myth? When exactly does the 7-year mark begin anyway?
Around the same time, I was approaching the end of my second year in Dallas. Beforehand, I lived in a small town in South Carolina, sustaining on processed foods, grits, mayo, and whiskey (I still sustain off mayo, btw). I didn’t have access to Whole Foods, I hardly knew how to cook. Funny how when I was my least healthy, my skin was clear.
After moving to Dallas my diet cleaned up. I ate far healthier than ever before and worked through poor digestion issues. So, maybe my acne was my body screaming at me to heal internally. I wouldn’t see it that way for a long while, though.
Compared to others it may not have been that bad, there are definitely people with acne far worse than mine, but it wasn’t MY normal. Something I’ve learned in the treatment room over the years: you may think a small pimple is petty to have anxiety over but it isn’t YOUR experience. It’s the experience of the person dealing with it. It’s unfair to undercut another person’s experience, whether it’s acne or another emotional trigger. When it’s not your normal, a small pimple can be just as emotionally tormenting as dealing with a massive cystic mess. It’s about personal experience, not comparison.
No one seemed to believe me when I would say my acne was bad. Large, painful cysts that seemed so obvious. My fellow estheticians at the spa were aware, I mean it’s our job after all.
For the most part, I was able to keep cysts minimized, I knew how to treat them and ensure they weren’t as bad as their potential. So I can understand how someone might think they weren’t that bad, I’m an esthetician with the knowledge to treat acne. I obsessively treated my skin, I kept things manageable. I still do.
When my acne first came about I was only a couple years into my career with little experience treating clients with troublesome skin. I would say I specialize in prevention and correction of aging, treating and minimizing inflammatory issues related to sensitive skin and rosacea, and by the end of my acne journey I’ll have a stronger basis for correcting others with acne-prone skin.
See that? I said by the end because I will figure it out. Staying positive and whatnot.
It’s not that I didn’t know how to treat acne skin, I’ve successfully helped many clients control their breakouts and work towards a clear complexion. Every locale varies in what I’ll call “skin culture”. In Dallas, I mostly see dry and dehydrated skin conditions, rosacea and sensitive skin, and by comparison very little acne. Here our culture wants a quick fix, and it doesn’t have to be a natural approach. Most of us run to the dermatologist or med spa, we don’t really go the old school European route of monthly facials. We want fast acting treatments or prescriptions. However, in Austin, the culture is different. The company I work for has a location there, I’ve discussed the difference in clientele at length with another esthetician. She easily sees double the number of acne clients compared to myself.
Anyway, my point is: I had what I now consider a basic understanding of acne. I thought I knew how to treat acne inside and out like I know how to reverse wrinkles and sun damage. Little did I know I had only scratched the surface. I treated my own skin the best way I knew how.
For about a year or so I tackled my breakouts with topical products. To a degree, it helped. Once the spa added Hydropeptide and Skinceuticals to our professional arsenal it improved even more so. Hydropeptide’s acne line is designed to control adult hormonal acne, for a while it was my holy grail until it made my skin too sensitive. I used my Nuface for lymphatic drainage, occasionally successful in reducing the size of a painful lump that felt like a golf ball under my skin.
I’m the type who avoids prescription pills until they’re necessary. I remember being at my wit’s end, nearly in tears as I mulled over the decision with the BF. You might say I was dramatic, I was being a snowflake, but I couldn’t get a handle on my cysts.
They would come and go every few months. Not only was I a normal human dealing with acne, an emotionally stressful experience, but looking back I’m sure there was a layer of feeling like a failure as an esthetician.
This was when I met my breaking point. October always seemed to be the time of year it would be at its worst.
My skin doesn’t look too bad, right? Dehydrated from the California air, a couple of bumps on my chin, a lump on my forehead that hurt but not visible, it blended in. What you can’t see is the massive cyst under my right eye, so swollen I could see it without needing a mirror. It was impossible to cover without being obvious. I lived in my sunglasses the entire week, I was so embarrassed.
Before setting foot in the doctor’s office I knew the options my dermatologist would suggest for treatment: antibiotics, spironolactone, or Accutane. Oh, and retinol. I had been using an over the counter with little success.
In my mind, only one of the three was even on the table. I went into my appointment with my mind made as she listed them off. Antibiotics didn’t make sense to me, I didn’t have an infection—this was textbook hormonal acne. As stressed as I was, Accutane is incredibly harsh and while it’s considered a miracle drug by many, I firmly believe it should be a last resort. I was left with spironolactone, designed to control androgens caused by high testosterone. No blood work was done to evaluate my hormone levels, only to check potassium levels. I believed it to be a no-brainer and trusted my derm’s knowledge.
I never took more than 25mg per day, even when my dermatologist wanted to bump me up to 50mg. For a short while, I did, but I tend to be sensitive to drugs and couldn’t handle how dehydrated my body felt. Even with such a small dose, I saw major improvement. I still had cysts but it seemed to be contained.
When I stumbled upon a topical Vitamin D serum and saw improvement, I decided to evaluate if I might be deficient. After much research, I ended up adding a supplement to my routine. The results blew my mind, it seemed to solve my acne woes so quickly! I was breaking out even less often than when first introducing spironolactone.
Side note: I’ve seen those who are deficient add Vitamin D to their daily routine and see amazing changes. Large pores reduced, sensitivities gone, breakouts reduced. It’s seriously worth reading up on to decide if you may be deficient.
I was satisfied, comfortable with a bi-monthly cyst. They were no longer massive, it felt manageable. But this wasn’t the end… on to part 2!