While many enjoy experimenting with a whole host of colourful, shimmering products as their first foray into the world of beauty, for me makeup meant lashings of thick concealer to mask the cystic spots, rash of whiteheads and angry red scars that peppered my teenage skin.
"Pizza face", "crater face" – I was called them all before finally plucking up the courage to visit my doctor at 13 – and it was far from helpful. First came Epiduo, an over-the-counter topical treatment that uses adapalene and benzoyl peroxide to dry out spots (and every other inch of skin). Then Acnecide, a gel-cream which basically made my face fall off.
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Like a lot of teens, I gave up, and from 18 onwards, the acne got a little better as my raging hormones seemed to mellow. Until I hit 25, that is, and it came back with a vengeance.
As a beauty journalist, things seemed even worse than before. I'm supposed to be able to advise on how to look and feel great, but I felt like a fraud – I couldn't keep my own skin under control. I'd cancel dates, plans with friends and even work meetings all because I was embarrassed to show my face.
Desperate times called for desperate measures and I did the only thing I'd ever known – made an appointment with my GP – only to be given the option of a contraceptive pill that could potentially make my acne worse (not to mention mess with my mental health) and Duac, yet another antibiotic-benzoyl peroxide cream.
I couldn't quite believe that doctors were still treating acne with this stuff. It turns your skin to sandpaper, burns like hell and even bleaches your clothes if you aren't careful. But the worst thing is that it doesn't tackle the problem. It doesn't even touch the surface.
Utterly exasperated with being palmed off, I took a trip to Skin 55 on Harley Street to see consultant dermatologist Dr. Anjali Mahto in a last-ditch attempt to clear up my skin for good – and it's the best thing I've ever done.
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Polycystic Ovaries and Hormonal Acne
As I reeled off my medical history to Dr. Mahto, who inspected my face under a microscope, she concluded that it was most likely my polycystic ovaries – a hormonal condition that affects 1 in 5 women in the UK – were the culprit behind the spots along my cheeks, chin, chest and back.
Other traits of PCOS are excessive facial hair, oily skin, irregular periods and weight gain to name a few, but it was the angry red zits that got me down the most.
Amazingly, that visit was the first time I ever felt like there was hope and I didn't have to cut out dairy or ruin my clothes with OTC treatments to get there. In fact, it was simple.
The 'Secret' Pill
Firstly, I was introduced to Spironolactone. Some refer to the female-only oral tablet as a 'secret' drug, mainly because treating acne is an off-label use for the medication, which is usually used to reduce high blood pressure. It's helpful for hormonal acne sufferers because it boasts anti-androgen effects to counter male hormone testosterone and excessive oil production, which can be responsible for acne. It's much less harsh than Accutane and so much more effective than a course of antibiotics, which does nothing for hormonal zits.
I started on a six-week dose of 25mg daily and was blown away by the clarity, smooth texture and matte feel of my skin after just seven days. On the second week I went up to 50mg, then 100mg, and I haven't had a massive eruption since.
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My New Skincare Regime
It's basically my job to test every new beauty launch that lands on my desk. But if I've learnt anything about problem skin, it's that less really is more, and that you have to choose your ingredients very carefully.
So, teamed with Spironolactone, Dr. Mahto gave my routine a complete overhaul.
Morning Routine
First up, the La Roche-Posay Effaclar Purifying Cleansing Gel, £22. Once this clear gel cleanser transforms into a whip, it dissolves any trace of oil to make skin feel fresh, matte and squeaky clean without any uncomfortable tightness or irritation. Massage it into wet skin for a minute and rinse.
Secondly, I ditched the luxurious moisturisers and glow-boosting 'wonder' serums for a slathering of La Roche-Posay Effaclar Duo [+], £20. Star ingredient niacinamide normalises pores, regulates oil production and blurs red blemishes into oblivion over time, while leaving skin feeling matte to the touch. It doesn't scrimp on hydration and makes for a good makeup primer.
Evening Routine
Acne-prone skin needs a combination of AHAs and BHAs to keep it under control, which is where Medik8 Clarifying Foam, £22, comes in. L-mandelic acid keeps oil on lockdown and salicylic acid cuts through the gloopy mixture of excess sebum and skin cells to prevent blockages. It disappears on contact with wet skin, but keep on massaging it in. It works.
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I then alternate between two products. Up first, the Pixi Glow Tonic, £10. The 5% glycolic acid sloughs off dulling skin cells that get caught in excess sebum and lead to spots. Soak a cotton pad and go for it. After six weeks, you can incorporate a stronger glycolic into your routine.
Every other night, you need to bring out the big guns, The Ordinary Advanced Retinoid 2%, £10.40. A few drops of this smoothed over a clean face at night encourages cells to regenerate at a lightning speed, meaning fewer blocked pores, fewer breakouts, fewer marks and all-round softer, more radiant skin.
I'm not saying this regime will work for everyone. In fact, I still get the odd spot now and again, especially if it's my time of the month (or if I've forgotten to wash my makeup brushes). But my skin finally feels "normal". I no longer keep my head down on the Tube, break down in front of the mirror or cancel on my friends.
My advice? Discuss your options with a dermatologist. Mention Spironolactone to your GP. And stop wasting precious time and money on an astringent, 10-step skincare routine that does more harm than good. Why not try this instead.
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