Hormonal Acne Skincare Regimen
First thing’s first: we have to treat the underlying condition; take all medications as prescribed and keep your appointments.
Taking care of your skin does not have to be expensive or burdensome. This is an easy and cost-effective way to go about it (most of these items are available at low cost from Target, Amazon, Wal-Mart, etc.):
- Wash twice daily with a mild cleanser. There are lots of options, but our pick is Cerave.
- Use a moisturizer after washing. Many brands offer a daytime lotion with SPF and an evening lotion without SPF. Our pick: Cerave and SPF40 with Hyaluronic Acid or ISDIN Eryfotona Actinica.
- Use a toner with alpha-hydroxy acids (glycolic, salicylic, hyaluronic, etc.) once or twice daily to encourage new skin turnover and control acne. You can order Glysal pads with 10% glycolic acid and 2% salicylic acid on Amazon.
- Use a retinoic acid (not the same as a retinol) at night to encourage new skin turnover, which reduces acne and prevents wrinkles. These are available by prescription and can be compounded with emollients to ease irritation. Start at the lowest dose (0.025%) and work slowly over a few months to the maximum dose (0.1%), which you can continue to use for life.
- Once a week, use a bath glove (cheap at Target) with hair conditioner (e.g., Suave or Clear conditioner) to do a body scrub, including the face. This removes the extra skin cells from enhanced skin turnover and helps deeply moisturize the skin. After finishing the scrub, apply a lotion or moisturizing cream, depending on how dry your skin is. Our pick: Cerave lotion, Cerave cream, Gold Bond for dry hands.
- Nodular acne deserves to be treated gently because it can scar permanently. Avoid trying to pop the nodules. When they are painful or bothersome, they can be reduced with a quick injection of steroids.
Retinoic Acids (Retin-A)
What are they?
They are a variant of Vitamin A, which is sensitive to UV light, and this is why we only use them at bedtime.
How do they work?
- They stimulate the layer of stem cells under your skin to make new cells faster.
- When cells are moving quickly through the dermal layers, acne does not form as much, and it is less severe.
- More new cells also mean fewer wrinkles!
Why does sunscreen matter?
Use of retinoic acids does cause some sun sensitivity, and it’s important to protect your face every morning, including reapplying sunscreen every 2 hours!
How do I know if the retinoic acid is working?
- It takes a few months for the cream to really do its job, because it takes about 4 weeks for new layers of skin to start coming up to the surface.
- There is a period after 2-3 weeks where patients will notice more acne, and this signifies that the new skin is starting to transform more quickly. It will improve during weeks 4-6.
What if the retinoic acid still doesn’t control my acne?
There are many other options we have, including:
- Pills like spironolactone and doxycycline. Some studies suggest the diabetes drug metformin can help with acne.
- Prescription antibiotics that can be used on the skin in addition to the retinoic acid, including dapsone, clindamycin, and others.
What can be done about acne scars?
There are a number of treatments available using laser technologies or microneedling procedures to address these problems. Microneedling is available in-office, and laser options would be accessible through a cosmetic dermatologist.