I said "manage," not eradicate completely. That being said, I do see the light at the end of the tunnel as my usually massive cystic monsters have petered out to a shell of what they once were. It’s not a simple fix, but here’s the multi-pronged approach I take to calm my adult hormonal acne.
Ah, aging. In your 20s and even sometimes in your 30s, aging is that theoretical creature that you know is lurking out there, waiting to pounce, but never really think about until it’s too late. Take off my makeup? I’m too tired. Sit out in the sun? But it feels so good. Late night ramen fix? The K-drama made me do it.
All good until one day, you look in the mirror, and you see it. That finest of fine lines. Was that there yesterday? You frown — and then immediately stop frowning because the creases on your forehead freak you out.
At a certain point, though, you accept aging as an inevitable part of life. You almost embrace those laugh lines, symbols of all the good times you’ve had. Yup, I’ve gotten to that point. I no longer agonize over every line, the slow downward droop, the enlarged pores. I’ve made a truce with that aging monster stomping across my face.
But then why do I still have to deal with adult hormonal acne?!?
Seriously, is that fair? Wrinkles and acne? The rest of my face has gone dry, as most aging skin does, but my T-zone still thinks it’s a teenager.
It seems I’m not alone. According to the American Academy of Dermatology, 50% of women age 20 to 29 suffer from adult acne, as do 25% of women from 40 to 49. (Great.) For me, it’s a battle I’ve waged for the better part of a decade now, and while most of that time was spent in utter and total defeat, this last year has seen some interesting changes in my breakout pattern, thanks to some interesting changes I’ve been making in my skincare and lifestyle routine.
Now, I’m not saying this will work for everyone, but I am saying that the changes I made make sense, given what we know about adult hormonal acne.
How hormonal acne works
Doctors still don’t know the exact cause of acne, but they do know the contributing factors (and no, one of them is not dirt). You need the P.acnes bacteria, you need excess oil and dead skin cell cells clogging pores, and you need an inflammatory response. For hormonal acne, you also have bad genes a surge of testosterone, which women will often get right before their period, which contributes to excess oil and clogging.
Now, I’ve grown up with Western beauty telling me I need to wash my face till it’s stripped clean, soak my T-zone in an alcohol-laden toner, and slather my breakouts with super drying benzoyl peroxide. All terrible advice, by the way. Not only are you breaking down your skin barrier — the barrier that, when healthy, does a pretty darn good job of warding off the bad bacteria — but you’re causing an overproduction of oil because you’re dehydrating your skin. Also, benzoyl peroxide generally doesn’t work on hormonal acne, so there’s that.
What I’ve learned in the past year or so is that not only does the K-beauty philosophy of hydrating and babying your skin give you better looking skin, it actually gives you skin that is healthier and better able to fight hormonal acne. Your skin also looks better in general even if you do have a breakout — no peeling or redness from a scorched earth routine. That means it’s easier to cover up when you need to. (Proof: I actually mentioned my monthly battle with hormonal acne to a relative I see frequently, and she expressed genuine surprise — thank you, cushion compacts!)
So what works?
There are a number of factors that contribute to hormonal acne, each different for each person. (Diet and lifestyle are also big factors, but that’s beyond the scope of this article.) For me, I find that when I really focus on hydrating my skin — and thereby strengthening the skin barrier — with a multi-step skincare routine, calming inflammation with anti-inflammatory ingredients, and minimizing excess oil and bacteria with BHA, the battle is more than half won.
1. Boost the skin barrier
The stratum corneum, what we call the skin barrier, makes up the outermost part of your epidermis. It’s there to keep the good stuff in (water) and the bad stuff out (bacteria, pollution, toxins). A healthy skin barrier is your best protection against external aggressors. A compromised skin barrier — whether due to overexfoliation, a high-pH cleanser, or environmental factors — is leaky and weak, allowing water to evaporate and bacteria to invade.
The best and simplest way to strengthen the skin barrier is by keeping it hydrated. I never fail to incorporate a serum with hyaluronic acid in my routine. Hyaluronic acid is a humectant, so it draws water into the skin, plumping it up and smoothing its appearance. Ever since I started using a dedicated hyaluronic acid serum, that midday tightness around my eyes and cheeks has completely disappeared, even in the dead of winter. My skin also looks a bit more plumped up and bouncy, resulting in smaller looking pores.
Korean brands love hyaluronic acid and its salt version, sodium hyaluronate, so there is no shortage of serums out there at a wide range of price points. I’m using Graymelin Hyaluronic Acid 100% right now, and not only is it just as good as the popular Western versions I’ve used, like Hylamide, Niod Multi-Molecular Hyaluronic Complex, and Paula’s Choice Resist Hyaluronic Acid Booster, it’s more affordable. (When compared to Paula’s Choice, you get 2.5 times more product for two-thirds the price.) The Graymelin serum has only one ingredient: sodium hyaluronate — no silicone to make it feel slick, no preservatives. I’m a sucker for anything in a dropper bottle, but this serum is more than just looks. It’s a clear, thick, viscous gel that nonetheless sinks in super quickly and just leaves my skin feeling soft, plumped, and not at all sticky.
But it’s not just about a hydrating serum. You also have to use moisturizer — yes, even if you have acne, even if you have oily skin, and perhaps even more so if you suffer from one or both. Remember, drying out your skin causes your skin to produce more oil. Just make sure to use the right kind of moisturizer.
I’ve been really impressed with Eclado A.C Pimpeel Cream — it’s super lightweight, it sinks in fast, it’s not sticky, and it’s formulated with two of my favorite acne-fighting ingredients: the antibacterial powerhouse propolis and tea tree. The cream has a light gel-cream texture that smells of tea tree, which I like (maybe because I associate that with killing pimples, I don't know) and sinks in fast. I also like Mizon Snail Recovery Gel Cream, which many find not be hydrating enough for my cheeks, but for my teenage T-zone, it’s the perfect amount of ahhh. Lately, I've added Swanicoco Bitamin E Extra Matte Emulsion, which has a base of acai extract instead of water (hello, antioxidants!), and it's really agreed with my oily T-zone.
2. Unclog pores
Like I said, my T-zone thinks it’s still 1988, so I need to regularly ply it with BHA, or salicylic acid, to keep it in check. BHA is oil-soluble, which means it can penetrate the sebum in your pores to clear it out. Regularly purging my pores of all that excess oil helps prevent clogs, which can lead to a breakout. It also increases the skin cell turnover rate, so you’re constantly shedding the dead skin cells that can build up and clog pores. BHA also has antibacterial properties, so it’s pretty much my do-it-all bae.
Interestingly, most Korean companies use betaine salicylate, a gentler form of BHA, due to government regulations. I used to be concerned that betaine salicylate wouldn’t be strong enough for my skin issues (again, that scorched earth mentality of my youth), but I’ve been using COSRX BHA Blackhead Power Liquid for some months now, and I have to say, it not only works just as well as a true salicylic acid treatment, I’ve noticed that the blackheads on my nose are smaller and fewer — a side benefit I never found with another salicylic acid treatment. I also never suffer from dryness or peeling with the Power Liquid — a good sign for my skin barrier.
One ingredient I recently added and am now a forever fan of (uh, because it basically stopped a brewing cystic pimple right in its tracks) is charcoal, and more specifically the charcoal found in Goodal's Black Charcoal Masks . Oh, I can go on and on about these masks (and I do, er, here in this review). Suffice it to say, I now have a super weapon for those days when I feel a breakout coming on.
3. Fight bacteria
To fight the P.acnes bacteria, I try to incorporate as many antibacterial ingredients into my skincare as possible. That means you’ll find lots of propolis and tea tree leaf extract on the ingredient lists of my products. (I’m eager to try Swanicoco A. C Control Tea Tree Essence, which is 90% tea tree leaf water.)
And whenever I have a breakout, that’s when I go into my 1-day-1-pack mode, where I sheet mask every morning for a week in an effort to quell and calm the angry cyst. For me, Moksha Dear Tea Tree Mask Sheet and Dear Honey Mask Sheet are my go-to’s. All of Moksha Dear masks contain 91.5% natural ingredients (many of which are rated low hazard by EWG) and are formulated without parabens, synthetic dyes, and silicone. (Because who needs to risk any more irritations when your skin is screaming at you?)
The Tea Tree sheet mask also boasts Centella asiatica extract to calm inflammation (more on that below), as well as witch hazel extract to sop up excess sebum. It’s literally dripping with a lightweight essence — by the time the 20 minutes is up, my face is still thoroughly wet. But after 30 seconds of patting the essence in, my hormonal acne looks and feels calmer, and after two or three days of sheet masking, the blemish pretty much dies, almost never coming to a head. The sheet mask essence is also light enough that it plays well with my other serums (though after three days of sheet masking, my skin feels so saturated, I practically don’t need the rest of my routine on day 3). It’s replaced my previously go-to LJH Tea Tree Mask, which is great because the Moksha mask is half the price.
4. Gently remove dead skin cell buildup
And the key here is gently. In fact, while Western thinking says exfoliate twice a week, Koreans exfoliate as little as twice a month. That’s because Koreans are super focused on the integrity of the skin barrier. After all, over-exfoliation can lead to more breakouts. (Remember? Weak skin barrier = the better to invade you with, says P.acnes.)
Since I already use BHA on a daily basis, I limit my physical exfoliation to a cleansing brush on my T-zone at night (it can handle it), and a konjac sponge in the morning (again, only on the T-zone). I also incorporate an AHA (glycolic acid) mask once or twice a month as a part of my multi-masking routine. But as any skincare aficionado knows, you’re never done learning and improving, so I’m eager to try the new “It” AHA, polyhydroxy acid, considered the gentler, more hydrating alpha hydroxy acid. Even better, PHA gives you an antioxidant boost and actually enhances skin barrier function.
Korean beauty brands are big on PHA, and there is no shortage of products to try. Next on my list: Eclado PHA Soft Peel 15 (just swipe and go) and COSRX PHA Moisture Renewal Power Cream (PHA was found to be compatible with retinoic acid in treating adult acne — yay!). If you prefer more immediate gratification, check out A’Pieu Naked Peeling Gel PHA Soft and Moist, a gommage-type exfoliator that’ll leave you with bits of ddae (or rolls of dead skin cells — gross yet satisfying).
5. Calm inflammation
Calming inflammation was something I added late into my anti-acne game (though ingredients like vitamin C, green tea, and tea tree also fight inflammation). But the more I read and learned, the more I realized that inflammation was the cause of all sorts of skin (and health) maladies, including acne and hyperpigmentation. And it just so happens that a hot new ingredient in the beauty market (though it’s been used for thousands of years in Asia) specifically fights inflammation: Centella asiatica extract.
Commonly known as tiger grass because it was believed that tigers in South Asia would roll around in the plant when wounded, Centella asiatica (or gotu kola) calms inflammation and boosts wound healing by increasing the rate of collagen synthesis. COSRX’s Centella Blemish Ampule features centella prominently, Purito has an amazing centella line that I'm obsessed with, and Dr.Jart+ just got into the centella game with its Cicapair line. But my current favorite centella product is hands-down the Swanicoco Centella Asiatica Salve.
Don’t be fooled by the name: The Centella Salve is neither thick, sticky, or greasy. It does look like Vaseline, so I was admittedly hesitant about trying it. But it’s actually got a wholly unique, gel-like soufflé texture (seriously, that’s the only way I can describe it), and when you apply it, it feels cool on the skin — yes, cool. It simply glides on, melts in, and disappears with little stickiness. It immediately calms any redness or irritation, and it works just as well on my dry cheeks as it does on my oily T-zone (a true rarity). I love this cream so much, I wish I can bathe in it, but as it is, I use it sparingly because I’m afraid to run out.
6. Finally, don’t stress
Yes, that is a real factor in fighting adult hormonal acne. I find that whenever I’m stressed out — whether due to a deadline, a business trip, a personal dilemma — I break out more and worse. Stress is real. And no, I’m not patient enough to sit through a daily mediation of even 15 minutes, so what’s stress-case like me to do?
Strangely enough, my 10-step skincare routine is my daily mediation. It really is. Sure, I may be rushing through it some mornings, but the ritual, the gentle patting, the smoothing on of different textures, the subtle scents — they all contribute to a moment when I’m focused on myself, when the next step in my routine is more important than the next email I have to send out. In my final serum step, I take time to do a two-minute facial massage that forces me to breathe, to slow down, to count to 10. For me, that’s my mediation.
Because stress is bad enough. I don’t need to stress about my adult hormonal acne.
What do you do to help quell your adult hormonal acne? What products or ingredients do you find really help you? As a constant sufferer of adult hormonal acne, I REALLY want to know, so please share your tips with me!
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