While many enjoy experimenting with a whole host of colorful, shimmering products as their first foray into the world of beauty, for me, makeup meant layer after layer of thick concealer to mask the cystic spots, clusters of whiteheads, and angry red scars that peppered my teenage skin.
"Pizza face," "crater face" — I was called them all before finally getting 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.
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 out. That is, until I hit 25 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 doctor — 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. It is the best thing I have ever done.
Polycystic Ovaries & 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 — that 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, the solution was simple.
The 'Secret' Pill
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 clear, 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.
My New Skin-Care Routine
It's basically my job to test every new beauty launch that lands on my desk. But if I've learned 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.
I cleanse with La Roche-Posay's Effaclar Purifying Foaming Gel Cleanser. Once this clear gel transforms into a whip, it dissolves any trace of oil and makes skin feel fresh, matte, and squeaky clean without any uncomfortable tightness or irritation. I massage it onto wet skin fora minute, then rinse with water.
I ditched the luxurious moisturizers and glow-boosting 'wonder' serums for a generous helping of La Roche-Posay's Effaclar Duo Plus. Star ingredient niacinamide normalizes pores, regulates oil production, and blurs red blemishes into oblivion over time, while leaving my skin feeling matte to the touch. It doesn't scrimp on hydration and makes for a good makeup primer, too.
Acne-prone skin needs a combination of AHAs and BHAs to keep it under control, which is where Medik8's Anti-Bacteiral Exfoliating Foaming Cleanser 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.
I tone with Pixi's Glow Tonic Exfoliating Toner. The 5% glycolic acid mixture sloughs off dull skin cells that get caught in excess sebum and can lead to zits. Soak a cotton pad in the liquid and wipe it all over your face. After six weeks, you can incorporate a stronger glycolic into your routine.
Every other night, I bring out the big guns. A few drops of The Ordinary's Granactive Retinoid smoothed over a clean face at night encourages cells to regenerate at a lightning speed, meaning fewer blocked pores, fewer breakouts, fewer scars, and softer, more radiant skin.
I'm not saying this routine 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 public transit, break down in front of the mirror, or cancel on my friends.
My advice? Discuss your options with a dermatologist and mention Spironolactone to your doctor. Finally, stop wasting precious time and money on an astringent, 10-step skin-care routine that does more harm than good.