Patients must be carefully screened before using any hormonal therapy for acne because there are numerous contraindications (or factors that increase the risks of a particular medication). Contraindications for use of oral conceptive pills include, but are not limited to:
If you have a lot of acne, cysts, or nodules, a medicine that you can buy without a prescription may not work. If you want to see clearer skin, you should see a dermatologist. Dermatologists offer the following types of treatment:
Egg whites contain enzymes that reduce excess sebum production and control breakouts. They also unclog pores by drawing out impurities and dirt from the skin. The pimples dry out and heal quickly with this face mask (42, 43).
Washing your face with regular soap is not enough to make acne better. The best face wash for acne is effective at removing oil and dirt, but still gentle enough to use regularly without overdrying your skin. Look for topical acne medication ingredients salicylic acid and/or benzoyl peroxide in your face wash and use gentle, nonabrasive cleansing techniques.
Acne is caused by inflammation of the hair follicles. It most commonly affects the face, back and chest Features include blackheads, whiteheads, pimples (zits) and cysts. In severe cases, acne may lead to permanent scarring.
Treatment: “Menopausal acne is very different from what you may have experienced as a teen,” Dr. Fusco says. Back then, your zits were probably accompanied by excess oil and shine, whereas mature skin tends to be dry with or without pimples.
Considerations: Despite the frequent referencing of an initial flare of acne when starting is tretinoin, there is no science evidence to back this up. You should not expect an initial worsening of acne.3-4Exposure to sunlight should be minimized as you may be more sensitive to its rays. Ask your doctor before using other medication on the skin, especially anything containing sulfur, resorcinol, or salicylic acid, as the combination may be too irritating. Abrasive soaps and cleansers should be used with caution for the same reason. Side effects can include skin irritation, swelling, lightening or darkening of the skin, an increase in acne sores, excessive redness, and crusted or blistered skin.
Acne that’s more inflammatory is denoted as moderate acne. This happens when there are occasional nodules and possibly mild scarring. Severe acne occurs when there are a lot of inflammatory lesions, nodules and possibly scarring. It’s also considered severe if the acne is still present after six months of treatment or if it causes serious psychological issues.
“A woman’s hormones are kind of like a beautifully orchestrated symphony,” Richichi says. “In the right balance, a woman’s skin will glow.” She recommends nipping acne in the bud with a low-glycemic diet and cutting out refined carbohydrates, gluten and dairy — all of which spike up your insulin levels and, in turn, your androgen levels (see why here). “To me, acne is a symptom and birth control is just a Band-Aid, because birth control pills don’t address the underlying cause,” she says.
When your acid mantle is damaged, you’re actually more susceptible to breakouts, enlarged pores, and inflammation. To make matters worse, evaporating all the oil on your face can actually set your sebaceous glands into overdrive, leaving your skin oilier than ever. If any product included a simple alcohol high up in its ingredients list, we nixed its whole kit.
That’s right. Any acne treatment is a weeks-long experiment that you’re conducting with your skin. Acne is slow to heal, and in some cases, it can get worse before it gets better (nearly every benzoyl peroxide product we looked at emphasized the likeliness of irritating acne further, and starting off with a lighter application). April W. Armstrong, a doctor at the University of California Davis Health System, recommends waiting at least one month before you deem a product ineffective, and Townsend agrees.
Eat healthily. Foods that are highly processed and contain a lot of oils greatly increase the amount of acne on your body. Getting the proper amount of nutrients from whole grains, fruits, vegetables, and protein help your skin to regenerate faster and limit unnecessary oil production. When at all possible, avoid foods that are processed or contain a lot of sugar (think junk foods).
Blackheads are, essentially, open comedones. “Comedone refers to plugging of the follicular opening,” explains NYC dermatologist Elizabeth Hale, M.D., referring to hair follicles that technically cover your entire face and body (hi, peach fuzz). “Every hair follicle appears in a sebaceous gland.” So a blackhead is the mixture of dead cells, bacteria, and grime that builds up and hardens in the follicular opening—but it’s open to the world, which is why blackheads are so easy (read: tempting) to push out.
Pimples (pustules). These are inflamed hair follicles. The bacteria in the follicle multiply, attracting infection-fighting cells. These release substances that cause irritation and redness. The follicle then ruptures and spills the contents into the surrounding skin. This causes more inflammation.
“Benzoyl peroxide destroys the acne-causing bacteria that’s trapped within the follicle, causing inflammation,” says Zeichner. To prevent irritation, make sure you prime the skin with a light moisturizer first, then spot-treat the cyst with a super thin — seriously, less is more here — layer of the lowest percentage of benzoyl peroxide. “If any burning or stinging occurs when you apply it, you’ll know it’s too strong and you should wash it off immediately.” Try the Clearasil Ultra Rapid Action Vanishing Treatment Cream.
Decreased levels of retinoic acid in the skin may contribute to comedo formation. To address this deficiency, methods to increase the skin’s production of retinoid acid are being explored. A vaccine against inflammatory acne has shown promising results in mice and humans. Some have voiced concerns about creating a vaccine designed to neutralize a stable community of normal skin bacteria that is known to protect the skin from colonization by more harmful microorganisms.
Do a Google search for “how to get rid of acne fast” and you’ll see plenty of websites telling you to eat better for clear skin. But are there really foods that cause acne, or is that an old wives’ tale? Dermatologist Hilary Baldwin, MD, of the Acne Treatment and Research Centre in Morristown, New Jersey, says the answer isn’t really simple at all. “The simple answer is, we don’t know. So far studies have suggested that high-glycemic index diets (those with lots of white foods like potatoes, pasta, bread, rice and sweets), as well as diets high in skim-milk dairy products and whey protein supplements might be associated with worsening of existing acne but are less likely to cause acne,” Baldwin says.
Antiandrogens such as cyproterone acetate and spironolactone have been used successfully to treat acne, especially in women with signs of excessive androgen production such as increased hairiness or skin production of sebum, or baldness. Spironolactone is an effective treatment for acne in adult women, but unlike combination oral contraceptives, is not approved by the United States Food and Drug Administration for this purpose. The drug is primarily used as an aldosterone antagonist and is thought to be a useful acne treatment due to its ability to block the androgen receptor at higher doses. It may be used with or without an oral contraceptive. Hormonal therapies should not be used to treat acne during pregnancy or lactation as they have been associated with birth disorders such as hypospadias, and feminization of the male fetus or infant. Finasteride is likely an effective treatment for acne.
Talk to your doctor about any medications you’re using, including topical benzoyl peroxide (BPO). Use of BPO with ACZONE ® Gel may cause your skin and facial hair to temporarily turn yellow or orange at the site of application.
The birth control pill is another option for women suffering hormonal acne. Four types of birth control pills have been approved by the FDA for use as acne treatment, and all four are combination pills that contain both estrogen and progesterone. Talk to your doctor about how to get rid of acne using birth control and keep in mind that Ortho Tri-cyclen, Estrostep YAZ and Beyaz are the only four brands specifically FDA approved as acne remedies.
Oral antibiotics have been used to treat acne for many years. Like topical antibiotics, oral antibiotics work by reducing Propionibacteria acnes (the bacteria responsible for acne breakouts). They also help decrease inflammation of the skin.
Considerations: Side effects are generally mild and short lived. Most common, in 1-5% of people are itching, burning, stinging, and tingling. Other side effects were reported in less than 1% of people. There have been a few reports from darker skinned people of lightening of the skin. Azelaic acid has not been well studied in people with dark complexions.1
“What then happens is that they start trying different products, abandoning them very quickly if they do not see results in a day or two. They also one product to another. Sometimes the products can cause irritation of the skin and add further insult to the owner,” she says.