Hormonal Acne Routine Part 1: Philosophies

My hormonal acne is a beast and a half. It occupies the lower territory of my face and often encroaches on my cheekbones and cheeks. It needs to be dealt with decisively and efficiently, but my skin responds better to a more multi-faceted and sneaky approach rather than the nuclear option of blasting my face with strong actives constantly. I think of my acne routine as a multi-headed guerrilla force, neutralizing and putting the enemy down before it knows what hit 'em.

I have discovered the following about my own skin from years of trial and error and plenty of research. If you do not have the basics of skincare covered yet, then I'll respectfully say you have no business moving on to targeted acne solutions, especially not exfoliating actives. This is not to say that good skincare is esoteric and off-limits to beginners- rather that you need to be patient and careful to create a good routine, and those qualities do not just magically appear if you rush into things. Please use caution when introducing a new acne-fighting product. My routine is the result of years of experimentation, and I tweak based on my skin and other factors depending on the moment. The general philosophies and principles remain the same!

My Types of Acne

The first type of acne I commonly get is large inflamed cysts. Cysts are inflammatory acne that are deep inside the skin and do not have a visible head. You cannot squeeze them to empty them and they will often bruise or worsen if you pick at them. I mostly get these cysts on my chin and jawline. I also get them on the inner portion of my cheeks, near my "smile lines."

Pictured here: cysts

The second type of acne I suffer is general clogging on my cheeks and jawline. These clogs, or closed comedones, manifest as fleshy-looking small bumps with no redness and no head. They are rarely  as painful or unsightly as their cystic sisters (band name?) but they are persistent and annoying. I have a bad tendency of letting my hands wander to pick and pop these, since their relatively small size makes them seem easier to conquer. In reality, picking a closed comedone can leave behind a bloody scab that is much worse than what you had in the first place.

Scattered clogs

While not a "type" of acne, scabs and open acne are a reality of my life. Although I try to reduce the frequency and severity of my picking habit, I have also had to learn to cope with the results of my failure to do so. Scabs can be very difficult to deal with, as open skin carries a risk of infection, and they are impossible to hide with makeup. They are best avoided, but if you cannot, then you can treat them gently while they heal.

Scab from picked acne

My Philosophies

• No "spot treating:" This might sound a bit wacky- it's not that there's no such thing as an effective concentrated treatment to apply to one area...just that the underlying philosophy underpinning a spot treatment is one I can't get to work for my acne. The philosophy here is that acne treatment is reactionary, it comes after acne forms, and it's meant to "solve" a problem that has manifested visibly. For me, those assumptions aren't true and are counterproductive to an effective routine.

• Multiple ingredients: I don't think there's one magic active ingredient that works for everyone. To continue, I don't think anyone has to feel driven to find their "perfect acne-fighting ingredient." For my skin, there are 4 or 5 ingredients I rely on depending on the timing and the nature of my acne.

• Better safe than sorry: Many acne treatments can be drying and irritating. They should be kept in balance, and too much of a good thing can be very bad. Overly drying your skin is always going to be worse than keeping it hydrated, even if it means you deal with more acne in the short term. Juggling dehydrated skin with acne is harder than just treating acne.

• Manage the entire life cycle: Each acne spot goes through a "life cycle," where it's emerging, flourishing (or festering?), and then fading away. I think that a robust acne routine will address acne that's in each stage of its life, because people like me tend to have something of each category on their face at all times. It doesn't do any good for me to have acne treatments for only emerging acne. 

• Don't expect all your products to treat acne: When I see people with really ineffective routines bemoaning how terrible their skin feels, I usually notice they have a so-called "acne-fighting" cleanser, moisturizer, and treatment. It's too much. Don't judge a fish on its ability to climb a tree. A moisturizer should moisturize, a cleanser should cleanse. Some ingredients and types of products work synergistically, but if you lock into a 100% acne mindset, you're going to fail.

Continued in Part 2...