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How Sara Saved Her Skin & (Finally) Cured Her Adult Acne

We’re usually pretty into design over here at EHD, but one of our favorite non-design topics in the office? Skincare. Skin—we all have it, we all need it, and most of us have a very complicated relationship with our own flesh wrapping (ew). If there’s one thing I love talking about, it’s skiiiiiin. Almost as much as the rest of the EHD team loves talking about color trends. Skin is the largest organ of our body! IT’S AN ORGAN ON THE OUTSIDE, GUYS! How is that not fascinating? So since today is Saturday, we’re taking a quick departure from the design world to talk skincare (but if skin is not something you’re interested in, stay tuned because come Monday we’re going to have some pretty beautiful design content here on the blog).

Since the age of 13, I’ve been at war with my skin…

Emily Henderson Sara Beauty Skincare Graphic Highschool Sara

Here is a list of the things I did not have from ages 13 – 21:

  • popularity
  • good taste
  • clear skin

But I had great friends to endure it all with, and to be honest high school is awkward for pretty much everyone, right? I figured college would be a new, fresh start. College would be where I blossomed from awkward teenagehood to full-blown adult. I was wrong. College had just as much acne in store for me as high school. But whatever, I didn’t let it hold me back. I knew clear skin was just around the corner, because adults don’t have acne. Acne is a puberty thing. And it was!

I graduated, turned 21, and my skin calmed down. And I thought “THIS. This is where it starts…my new life as a clear-skinned adult…” Which made sense, college isn’t adulthood. POST COLLEGE IS REAL ADULTHOOD. That’s why my skin hadn’t been cooperating. But the wait was over, and I spent the next four years blissfully thinking my skin would be clear forever. Thinking I had finally acquired “adult skin.”

And then I turned 25 and my acne came back, bigger and badder than ever. WORSE THAN WHEN I HAD BEEN 13. I didn’t think it was possible, but the evidence was right there on my face.

Emily Henderson Sara Beauty Skincare Graphic 25 Year Old Sara

Wow, that last picture is way too close and gross for anyone to see. So happy I’ve put it in large format on the very public internet.

Now, listen, I know I’m not the first person in the world to find themselves battling acne. But at least when you’re a teenager most of your friends are right there, going through it with you. On the other hand, when you’re an adult? When you’re in meetings with your coworkers, and you’re just sitting there feeling like a 7th grader going through puberty. You feel like you’re the only adult in the world with acne (this is not true). And beyond the face forward appearances, there’s the fact that this acne HURT. And honestly, that was the worst part. If you have acne, it can make you self conscious because society is so hell-bent on having clear skin. But acne happens to most of us, and I know from experience that we always think our acne stands out way more than it really does. I rarely notice acne on anyone. But painful cystic acne is no joke, and when you’re face feels like a minefield ready to explode, you’re willing to try a lot.

And over the past two years, I have. Which is what I’m about to share with all of you. In fact, it blew my mind a few weeks ago when Em told me she had just recently started a skin routine for the first time in her life. I’ve had one since I was 14! (Who else had the classic Clinique department store visit with their mom when they were around that age?) But Em said acne just wasn’t one of her issues growing up. *Teen angst eye roll*

But let’s get a few things clear (skin not included): I’m not a dermatologist, I’m not a doctor, I’m not even an esthetician. I’m just an enthusiast who’s spent serious time dedicated to researching skincare in the quest for pain-free, well cared for skin (which just happens to involve a lot of selfie taking, and weekly skin updates between my best friend Nafeesa and myself). There is a lot of information out there, and a lot of it contradictory. What works really well for one person’s skin might wreak havoc on another’s. So what I’ve read/experienced might be different from what you’ve read/experienced. I’ve put together my skin regime based on recommendations from skincare experts that I trust, experimenting, and giving the products I’m trying the patience and time to work.

There’s a joke in the skincare forums that companies will make an all-in-one shampoo/conditioner/body wash/mouthwash/hair gel for men, while they’ll create a lotion specifically for a woman’s left elbow. And it’s all because of a vicious cycle where “the media” tells women that clear skin is a key to confidence, so we’ll pay anything for a product that will give us that result. Men just don’t seem to care as much. That’s not to say that there aren’t men who experience acne and who do care. But in my experience, men as a whole don’t worry so much about the other aspects of skincare that women obsess over: sun spots, wrinkles, smoothness, dewiness, etc. And that’s probably because society hasn’t told them that their worth is dependent on how young and beautiful they look. WOW IT’S SO FRUSTRATING, RIGHT?! At the same time, I do want to take care of this tiny swath of organ wrapped around my skull. I don’t want to feed into unhealthy cycles perpetuated by corporations and advertising, but I also want to look in the mirror and feel happy and comfortable with what I see. And is it so bad that I want to look like a young 67 when I’m actually 70? IS IT?!

It turns out I have a lot of complicated emotions about this topic.

Which is all to say: You don’t need to spend a lot of money on your skincare if you don’t want to. I really do think the beauty and skincare industries have oversold women on how many products they NEED in their routines. I just happen to be really interested in skincare (almost as a hobby of sorts), which is why I spend my disposable income on it. Just like someone else might on clothing or expanding their collection of *archaic* DVDs (I’m looking straight at my boyfriend when I type this; we watch everything on Netflix these days and do you really need the collectors’ edition AND the Criterion edition?).

In fact, let’s start with a few things I did in my general life that really helped my skin without even spending a dime:

  • Change your pillowcases regularly: Turns out that pillowcase you’re rubbing your face on all night gets COVERED with dirt, grime, sweat, oils, and dead skin pretty fast. An acne-causing bacteria buffet. This sounds like a no brainer, but when someone suggested this to me a few years ago it actually hadn’t occurred to me. So simple, SO EFFECTIVE. I try and switch my pillowcase at least once a week, if not every 4-5 days. It sounds excessive, but I’ve found it makes a huge difference.
  • Drink more water. Wow, water is so good for us. Have you heard the joke “I used to think alcohol was the adult drink, then I thought it was coffee, and now I realize water is the most adult drink”? Well, it’s true. I could down eight mimosas no problem, but trying to get myself to drink 8 glasses of water a day is a feat of willpower so impressive I rarely accomplish it. But I do notice my best skin when I’ve been in office consistently for a period of time because that’s when I drink the most water on a daily basis.
  • Try avoiding dairy. I’ve cut out a lot of dairy from my diet, and it’s done wonders for my hormonal acne. I’ve read this is because dairy products contain proteins that are supposed to stimulate growth hormones in baby calves. When we digest those proteins, they release an insulin-like hormone that disrupts our own hormone production. This can cause our skin to produce more oil, which traps more dead skin and sebum in our pores, which acne-causing bacteria feed on. Acne is the result.
  • Make sure you’re not using too many products. Maybe you’re a skincare devotee, like me. And maybe you’ve been trying all the products, all out once, and your skin is freaking the f*&k out (also like me). I was at a point where I was doing some sort of crazy 25 step skin routine overnight with four different kinds of acid, multiple toners, etc. And wondering why my skin was still breaking out. I was using all the good, expensive things! The first time I went to my favorite esthetician for a facial she casually asked me what I was using and it then took me about 10 minutes to summarize it all. She took a beat to process what I’d told her and then said something along the lines of “you might want to cut that back, your skin can’t possibly be benefitting from all of those different combinations, and you’re likely doing more harm than good (therefore wasting your money).” So now I’ve simplified and my skin is happier for it.

I’ve tried a lot of different things in the past—Proactive, diaper cream, toothpaste, straight rubbing alcohol…ouch. But now I’m in a pretty happy place with my skin, and am using some products I really feel are helping me keep my skin clear, hydrated, and happy.

There is one big change I’ve made for my skin that required a doctors visit. I’m currently taking a low dose of a medication called spironolactone. This article from Into The Gloss has a lot of great information about using spironolactone to treat acne. It’s an androgen blocker that has been wildly beneficial in reducing my hormonal cystic acne. I’ve been taking it daily for about a year and half now (it took about 3 months to kick in), and it’s made a huge difference. If you’re a female and are suffering from hormonal acne, it’s totally worth a trip to the doctor to see if spironolactone could be an option for you.

But as far as everyday skincare goes, I really do believe that everyone could benefit from at least least washing their faces, applying moisturizer, and slathering on SPF. If you’re like “ugh skincare, no thank you” then I think a three step process (only two steps at night!) is all you need. ESPECIALLY THE SPF. It’s 2019, let’s move past our egos and just accept the fact that we’re not tougher than the sun. Not only will SPF help keep your skin looking younger longer as it avoids sun damage, it’s also just a good thing to do in order to help minimize your exposure to melanoma causing UV rays. I’ve read multiple times that SPF is the single most important skincare step. I even have Mac wearing daily SPF on his gorgeous face.

But let’s say you’re into skincare, you want to kick things up a notch. Or five. Well then, step into my office (bathroom). Evenings are when I do the heavy lifting of my skincare routine. That way I can allow products to soak into my skin overnight, without the hindrance of make-up.

Emily Henderson Sara Beauty Skincare Graphic Evening Routine 2

Cleanse: Green Clean Makeup Removing Cleansing Balm (I’ve used and love this) | The Balance pH Balancing Gel Cleanser (great for sensitive skin) | Versed Day Dissolve Cleansing Balm (I’m currently using this) | BPO 5 Percent Cleanser (also currently using this) | Tone: Pixi by Petra Glow Tonic (this has a cult following) | Nip + Fab Glycolic Fix Night Pads Extreme (currently using these) | Serum: ExLinea Peptide Smoothing Serum (currently using this) | Total Strength Serum (and this) | Treat: Salicylic Acid 2% Solution (great budget option) | Curology Custom Skin Kit (what I’m currently trying out) | Moisturize: Coco Rose Coconut Oil Lip Conditioner | Ultra Repair® Cream Intense Hydration (currently in use)

Sara’s Nightime Skincare Routine

Step 1: Cleanse

Right when I get home, the first thing I do is wash my face using a “double cleanse” method, which means I basically wash my face twice. Think of it like a dishwasher. The first rinse gets rid of all the big chunks and makes sure food doesn’t dry impossibly onto your dish, and the second wash makes sure your dish is truly clean. For the record, I don’t have a dish washer and do all my dishes by hand. As for my face, first I use an oil cleanser (right now I’m using Versed’s Cleansing Balm) to break down all the makeup and SPF that’s been on my face all day. Then I use a second cleanser to make sure I haven’t left any make-up or SPF on my face (currently I’m using PCA’s BPO cleanser – the benzoyl peroxide helps remove sebum and dead skin cells from my face, which acne causing bacteria would otherwise feast on). I like this combination because it leaves my face feeling clean and fresh, but not stripped or “tight” (your face’s natural oils are GOOD, you don’t want to completely remove them).

Step 2: Tone

Next, I tone with Nip & Fab’s Night Pads. These are pre-wet pads, which have a 5% glycolic acid solution. Glycolic acid is an alpha hydraulic acid, and acts as a chemical exfoliant. That means it helps exfoliate your skin (gets rid of dead skin cells) without the use of physical abrasives, like tiny grains or beads. I prefer to use a chemical exfoliant because physical exfoliants tend to be too rough on my skin, causing microscopic tears that just allow more surface area for bacteria to settle in.

Step 3: “Correct” (Serums)

I then mix together one pump of PCA’s ExLinea Serum and one pump of PCA’s Total Strength Serum in the palm of my hand and apply all over my face in a thin layer. PCA is a skincare line that Emily started using a while back because it was recommended by an esthetician, and I actually noticed a difference in her skin appearance.

The ExLinea is my attempt to be preventative about wrinkles, with ingredients like acetyl hexapeptide-8 (argireline) which “minimizes the appearance of fine lines and wrinkles” and sodium hyaluronate, which “has the ability to hold 1,000 times its weight in water and plays an important role in skin hydration.” The Total Strength Serum has ingredients like almitoyl tripeptide-38, which “stimulates collagen, and helps reduce the appearance of fine lines and wrinkles.” I let this soak in for at least 10 minutes before moving onto my next step.

Both of these serums are pricey, and definitely a luxury item for me. But these bottles last me a long time, and I really enjoy using them, but there are good products out there with similar ingredients for much more affordable prices. Serums are one of those steps that are interesting and exciting to me, and I feel like they have made a difference in my overall skin health, but they aren’t MANDATORY. If you’re interested in skincare, they are fun accessory products to experiment with.

Step 4: Treat (Medication)

Once I feel like my serums have settled in for the night I’ll apply a thin layer of topical acne-fighting ingredients. Right now I’m on month 4 of trying out Curology’s custom topical acne medication. I used to see this all the time on my Instagram feed, and finally caved to the hype (my skincare curiosity got the best of me). But surprisingly I’ve been pretty happy with it. It’s one of those “take a quiz and we’ll create a custom blend for you” companies that I think will be a period marker for this era. And yet… I’ve found success with the product. My medication contains a low dose blend of clindamyacin (“antibiotic and anti-inflammatory with powerful effects against acne-causing bacteria”), zinc pyrithione (“fights acne via its antibacterial and antifungal effects), and niacinamide (“a form of vitamin B3 that acts as an antioxidant, reducing inflammation, hyperpigmentation and fine lines”—I think this has been helping fade my acne scars!). Again, there are other topical options out there that can help, but this is the product I’m using right now and feel pretty happy with for the time being. I let this soak in, and usually go make dinner/watch TV/hang out.

Step 5: Moisturize

About 20 minutes before bed, I’ll apply my moisturizer. I use First Aid Beauty’s Ultra Repair Cream because it’s super basic, gentle, unscented, uncomplicated, and works great. It also comes in a huge tub that will last me at least another 2 years. My eye area and eyelids are sensitive to just about everything (I don’t apply any of the above products anywhere near them), but they don’t mind this moisturizer. I also apply some lip balm with a heavy hand (whatever I have on hand) to keep my mouth breathing lips hydrated overnight.

And that’s it! I do all of these steps with enough time before bed that the serums and medication actually have a chance to be absorbed by my skin, rather than soak right into my pillowcase. And then I wake up.

Emily Henderson Sara Beauty Skincare Graphic Morning Routine 2

Cleanse: Versed Wash It Out Gel Cleanser (great budget option) | BPO 5 Percent Cleanser (currently sitting on my counter) | Tone: Pixi by Petra Vitamin-C Tonic (budget-friendly) | PCA Skin Nutrient pHaze 5 Toner (smells so good) | Serum: The Ordinary “Buffet” (good budget option) | Vitamin C Suspension 30% in Silicone (another budget option) | C-Quench Antioxidant Serum (what I’m using right now) | Total Strength Serum (currently using) | Moisturize: Hyaluronic Acid 2% + B5 (budget option) | Ultra Repair® Cream Intense Hydration (currently wearing) | Hyaluronic Acid Boosting Serum (on my face right now) | Protect: Emerald CBD + Adaptogens Deep Moisture Glow Oil (helps with my redness) | CC+ Cream with SPF 50+ (the only make-up I wear) | Throughout The Day: Pixi by Petra Glow Mist (in my bag all the time)

Sara’s Morning Skincare Routine

Step 1: Cleanse

Not everyone washes their face in the morning. Some people just rinse with some cool water, and I think that’s totally fine. Personally, I like to wash my face (just once this time), to get rid of any residual nighttime products as well as any sweat from the night. I just use one of the same face cleansers from my nighttime routine, based on my mood. Science.

Step 2: Tone

Next up, I tone with PCA’s Nutrient Toner. It’s my favorite smelling thing in my line up, but it also has some great benefits. The pumpkin wine base (produced by fermenting whole pumpkins) “offers the nutritional benefits, including vitamin A and vitamin C” as well as lactic acid, another AHA, which helps with skin moisturizing. It also just makes my skin feel happy, bright, and glowy for whatever that’s worth (which to me is a lot).

Step 3: “Correct” (Serums)

For daytime, I’ll mix one pump of my Total Strength serum with one pump of PCA’s C-Quench Antioxidant serum – one of Em’s recommendations. Topical vitamin C has been recommended as a great skincare step to include by several skincare aficionados, including Velinda’s facialist. Here’s a little snippet from an Allure article all about topical vitamin C: “As far as your skin is concerned, vitamin C is ‘a potent antioxidant that can neutralize free radicals,’ explains board-certified dermatologist Patricia Wexler. ‘Because of its antioxidant properties, vitamin C aids in your skin’s natural regeneration process, which helps your body repair damaged skin cells.'”

Step 5: Moisturize

Before I apply any sort of make-up (which I really don’t wear much of), I gotta make my face as moisturized as possible so it stays flexible and doesn’t flake (I have dry skin). I start with two pumps of PCA’s Hyaluronic Acid Boosting Serum. Hyaluronic acid is a buzz ingredient in the beauty industry, but for good reason. Hyaluronic acid is a humectant—”a substance used to reduce the loss of moisture.” Its molecules are able to retain 1,000 times their weight in water content, and the added ceramides in this serum “supports the renewal of the skin’s natural protective layer and forms an effective barrier against moisture loss.”

But then you need to apply a moisturizer…from what I understand, hyaluronic acid itself is not a moisturizer. It will just help your moisturizer work better, and aid your skin in retaining the moisture you’re applying. So next I apply a thin layer of my First Aid Beauty moisturizer. Then, as an added moisturizer, I’ll mix in two drops of Herbivore’s CBD + Adaptogens Glow Oil to my It Cosmetics CC cream (which has SPF). CBD is another trendy ingredient in beauty products, but I’ve found this oil to really help combat the redness in my skin. It also helps loosen up my CC cream so it doesn’t go on so thick as I like a more sheer coverage, and keeps the cream from getting cake-y. If I’m not headed to work (like on the weekends), I generally avoid makeup to give my skin a breather, and just apply the CBD oil and some Supergoop! Unseen SPF.

That’s it. That’s the whole thing, morning and night. My skin has come a long way since I turned 25 and cystic hormonal acne took up residence on my jawline. After about 6 months of this skincare routine, here’s how we’re looking (I knew all my selfies would come in handy one day):

Emily Henderson Sara Beauty Skincare Graphic Now Sara 1

I still get the occasional pimple, but they’re often surface level and not the deep rooted, painful cystic acne I used to get. My redness still stops me from wearing certain shades of pink-toned lipsticks (lest the area surrounding my lips just look like a continuation of my lipstick), but between being moisturized/non-irritated skin and my light coverage CC cream I no longer look like I’ve just run a marathon all the time. Plus, the scars left over from my cystic acne are beginning to fade away. And most importantly my face skin doesn’t HURT anymore.

I stopped plucking my eyebrows years ago, I let my mustache fuzz be, and I don’t mind the occasional zit. I’m even growing kind of attached to the very light crow’s feet that I see developing. But I also have fun caring for my skin, and going on this journey with it. Seeing what makes it glow or learning what dries it out. I’m just doing my best to care for it, because it’s the only face skin I have.

Thank you for reading my novel. I surprised myself with how much I had to say, seeing as how I have no official credentials with which to preach. But maybe your skin is similar to mine, and you’ve been able to glean a new tip to try. Or maybe you are an expert and have some valuable knowledge to share in the comments! Maybe you’re just as interested in other peoples personal habits – same. Whatever the reason you found yourself reading all the way through, I thank you for sticking with me. I have a lot of feelings about skin. And I’m excited to read what your feelings (and skin types, and solutions) are below.


Emily Henderson Sara Beauty Skincare Product Roundup

1. Versed Day Dissolve Cleansing Balm | 2. Nip + Fab Glycolic Fix Night Pads Extreme | 3. Pixi by Petra Glow Mist | 4. Vitamin C Suspension 30% in Silicone | 5.  Pixi by Petra Vitamin-C Tonic | 6. BPO 5 Percent Cleanser | 7. C-Quench Antioxidant Serum | 8. Salicylic Acid 2% Solution | 9. Green Clean Makeup Removing Cleansing Balm | 10. Pixi by Petra Glow Tonic | 11. The Balance pH Balancing Gel Cleanser | 12. Total Strength Serum 13. The Ordinary “Buffet” | 14. Ultra Repair® Cream Intense Hydration | 15. Coco Rose Coconut Oil Lip Conditioner | 16. PCA Skin Nutrient pHaze 5 Toner | 17. CC+ Cream with SPF 50+ | 18. Emerald CBD + Adaptogens Deep Moisture Glow Oil | 19. ExLinea Peptide Smoothing Serum | 20. Versed Wash It Out Gel Cleanser | 21. Curology Custom Skin Kit | 22. Hyaluronic Acid Boosting Serum | 23. Hyaluronic Acid 2% + B5

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4 years ago

Skincare can be so fun! I’m pregnant, and decided to strip down to essentials only— cleanser, moisturizer, sunscreen. Very boring, but turns out that my skin looks exactly the same and maybe better. Ha! My skin is sensitive, so maybe it thrives on being ignored. But I am definitely a believer in the double cleanse, too!

4 years ago

Yes, so glad you are writing about this!! When I turned 25, the same exact thing happened. My dermatologist said most don’t know it, but women are technically in puberty until age 23-25 and it’s actually very normal for hormonal acne to show up at the very end like that. I was also put on Spiro and it was a LIFE CHANGER. I’ve been on it for 5 years and my skin has never been clearer. I’ve found not many women know about to though, so I am so happy to see it here.

4 years ago

Spironolactone changed my life A few years ago!!!! I am also on a low-dose of minocycline and the only time I ever break out now is when I slack on taking those. However, I might try the dairy suggestion because I’ve already been thinking about trying to cut out some dairy. I know drugs are controversial but I really haven’t had any side effects and I’ve checked with my doctor a few times on the long-term effects and there doesn’t seem to be too much of a downside. However- weird Discovery is that I had some bloodwork done and popped for a positive ANA (auto immune) gene marker. It was a false positive and those two drugs are high on the list for causing those false positives. Just something to be aware of!

4 years ago

I’ve been doing Clarins, Dr Weil….so many over the years, comparing and contrasting with what friends are using and why.
Recently, I threw the lot and tried Sukin!
No bad stuff added.
Smells so good you might wanna eat it.
It’s done wonders for my skin compared to all the expensive ones!
It’s often 40% off and it’s reasonably inexpensive anyway.
Aaaaaaahhhhhhh….nice, calm, better looking skin that other people have noticed and commented on. 🙂

Sara…I’m so glad you explained the hormonal aspect of things, because most people overlook the MASSIVE impact our hormones and hormonal fluctuations have on ALL asoects and parts of our bodies.
May you have comfortable, calm, lovely skin! You already appreciate the amazing job it does for you, so good on you! 🙂

P.S. Emily, have you checked out the hormonal check to help your lovely locks?

4 years ago

Ugh I’m in the same boat with the adult acne, on my face and back (no tank tops for me). I was on a low dose (25mg/day) spironolactone for over 2 years and LOVED it. I was acne free on my whole body since childhood! I wanted to walk around naked and show off my pimple free body to the world! (I did not).

Starting about 1.5 years in I started to experience sever anxiety and mild depression for the first time in my life. This is NOT listed as a side effect and the doctors won’t tell you about it, but give it a google and there’s tons of women reporting experiencing this. There was even an FDA report that identified this as an emerging issue. I stopped cold turkey and my anxiety and depression went away. This is my experience, and so of course take it as just one data point, and listen to the advice of your doctors obviously.

I’m trying to manage the acne topically again, and I’ll give your tips a try! Thank you!

4 years ago

spironolactone + cutting out sugar is what does it for me! The other things all help, but when it’s your hormones that are the main culprit, the spiro is life changing.
Also I think the high school pictures are so cute – you had great hair!

4 years ago
Reply to  Sara Tramp

“Glycolic acid is an alpha hydraulic acid”

should be “hydroxy” DYAC?

Paige Cassandra Flamm
4 years ago

I also struggled with adult acne and it is seriously SO HARD! I also used a curology subscription and it was life changing for me! I highly recommend it to anyone who struggles!


4 years ago

As soon as I add any animal products to my diet my skin breaks out – dairy, meat, or eggs. It seems the hormones in animal products don’t mix well with mine. I notice an increase in breakouts if I have too much nut butter because of all the oils in nuts. Also, too many products on my skin results in flair ups. I’m a ginger with sensitive skin so I’m best with light everything – soap, moisturizer, and make-up (with spf).

4 years ago
Reply to  Kel

This is so me! I went vegan 5 years ago ( at age 26) as a test to see if I could, and one month in my skin was the clearest it had been since I was 12. Yep, that’s when my cystic acne started and I tried everything under the sun. I get zits occasionally, but it’s usually when I drink too much alcohol and they are manageable, not the crazy cysts I used to get. I think dairy was the biggest culprit.

4 years ago

Spironolactone is great (definitely helped my hormonal acne) but it can cause crazy birth effects. NOT an option for pregnant or breastfeeding women!

4 years ago

Do you think it was a part of your routine that actually helped the acne scars fade, or is that a matter of time? I have had a couple small red spots on my face from pimples that popped (accidentally!) as an adult and while I was lucky enough to not have much lingering effects from teenage acne, these ones left red spots that do bother me a little. Not enough to consistently bother with covering them up, but I’d be happier with my usual bare (moisturized and spfed, don’t worry) face if I could get the red spots to fade or go away. Any advice?

Sarah D.
4 years ago

Agree with everyone else that Spironolactone is life changing for hormonal acne. Thanks for sharing all these tips.

4 years ago

I also found out the hard way that using more products isn’t necessarily better. I have very sensitive skin and have had the best results when I stick to a very simple routine using products from Cetaphil and DHC. I don’t think it’s a coincidence that they both have very simple packaging and don’t do a lot of aggressive advertising (at least where I live). People keep buying their products because they really work and aren’t harsh on your skin.

Another tip I’d add to the list of free things anyone can to do help their skin: avoid touching your face throughout the day. Resist the urge to pick at your skin. Nourish your skin from the inside out (drink more water/cut back on dairy and sugar/try other lifestyle changes) rather than attacking it only from the surface.

Carol McKay
4 years ago
Reply to  Sara Tramp

I suffered from painful, irritating, embarrassing cystic acne from 20 until my 30s. Finally, someone recommended
Merle Norman cosmetics, specifically powder base. It worked like a charm to clear my skin! Later I found that it contains zinc, as do many sunscreen products. This may be helpful to those who cannot take Spironolactone around childbearing/nursing times

4 years ago

WHERE IS EMILY??? Just whining because I miss her on the blog, and her thoughts about design and styling!

4 years ago
Reply to  Brittany


4 years ago

Glad you are having great results. It’s so important to have a skincare routine that works for your skin. I use R+F and it’s been my miracle worker.

4 years ago

Just writing to be helpful and say: It’s also really important to cut out ALL comedogenic ingredients in other products like makeup, sunscreen, shampoo, etc. Even toothpaste could be irritating around the chin area. A couple of years ago I switched to using clean/green beauty and skincare thinking it would be good for my acne prone skin. BIG MISTAKE! It turns out those products were loaded with comedogenic ingredients that aren’t safe IF you have acne prone skin. It can take 6 months for acne to form and come up to the surface as a white head, pustule, etc. and it will take just as many months to get completely clear of acne if you have been able to pin point the triggers in your diet and products. I would recommend checking out Roccoco Botanicals’ skincare line. They are more of a luxury brand however they have a wealth of info on their Instagram and website. They have a very lengthy list of ingredients that aren’t acne safe, the most comprehensive one I have found ever!! I wasn’t able to afford their products for a while but I did implement their acne advice and it really made a difference… Read more »

4 years ago
Reply to  Brie

Oh and one more thing, Red LED light therapy can be very beneficial for acne skins (or any skin type), not just for reducing wrinkles. It will help with calming and reducing inflammation not just on the surface of the skin but deeper within. I know this seems insane but I use this grow light from Amazon. It’s at the right wavelength and it is much higher powered than a lot of the expensive hand held devices out there. It’s this one: ABI 25W Deep Red 660nm LED Light Bulb Bloom Booster for Flowering, Fruting, and Grow Spectrum Enhancement –

I’d stay away from Blue LED light as even though it is being marketed to people with acne and blue light kills acne bacteria it has also been found to stimulate melanin or something like that, not good for hyperpigmentation prone people!!

4 years ago

I never had acne per se, but I have rosacea and it’s such a nuisance too! The Ordinary products I like a lot, some of Paula’s Choice too and I listened to some advertising about a creme on Amazon called “calm”… It has about 2000 positive reviews, so I bought it and I like it a lot – will be 2001 good reviews. As you stated in the beginning, every skin type is different and what works for one wonders might be irritating to others. You’ve got such a pretty face and I am glad you found what works for you. Thank you for all the suggestions, I might try one or the other.

4 years ago
Reply to  Betty

Could you be more specific on what products from the Ordinary that you use for rosacea? It is so overwhelming! Thanks

4 years ago
Reply to  Betty

I have rosacea, super sensitive skin, autoimmune issues, and dealt with cystic acne in my mid thirties. I took spironolactone but it didn’t do enough, so I did a six month course of Accutane and it was AMAZING. However, the crazy dry skin and hair was tough to deal with. My clear skin lasted just two years, and due to the autoimmune stuff, I’m not able to take either of those medications again. BOO. However, my dermatologist recommended Tretinoin cream and Aczone gel and it’s made a huge difference. Almost as much as the Accutane, but without the dry skin and hair.

I’ve also been using Aveeno Ultra Calming foaming cleanser and just discovered Clinique Redness Solutions Daily Relief Cream a few weeks ago. I highly recommend the redness solution cream for rosacea, it made a significant difference the first time I used it!

4 years ago

Sounds like you should have been on a course of accurate years ago
You’re probably still a good candidate
Life changing and will prevent future scarring

4 years ago

hey Sara, i too have struggled with blemishes in teen and adult years, but the person who really helped me achieve clear skin is paula begoun. i do not work for or know this woman, but her skin advice is top notch. I started using a cleanser instead of bar soap – cetaphil – and use a BHA product at night (disclosure – I use Beautypedia to see what ingredients products contain and if they are effective). For day time I use a variety of serums and boosters. Most importantly, I use sunscreen every day to protect my face from the harmful effects of the rays. My trouble skin has turned into amazingly perfect skin and I haven’t had acne in years. Again, Begon’s books and website really saved my skin.

4 years ago
Reply to  isabel

This. Paula’s recommendations have worked better than prescription meds for me! I use three products on my face right now and my skin has never looked better. Cetaphil, Paula’s 2% BHA liquid, and the IT CC cream you linked up there! For reference, I’ve used retin-A, differin, oral antibiotics, clindamycin, and ortho try-cyclen. I said no to Spiro (after having a bad side effects with anything hormonal) and was never offered accutane. The three products I used worked better than any of the prescriptions I’ve used!

4 years ago

All of this is great but it most likely the spironolactone that cleared up your acne. I used it throughout my 20’s and 30’s (I don’t have kids, you can’t take it while pregnant). Not to sound like a mom, but you are missing sunscreen from your daytime routine, your CC cream does not provide enough coverage. Try going over to Dr. Dray over on YouTube. She reviews all kinds of sunscreens so you don’t have to. xoxo

Yael @ Nosherium
4 years ago

I’m so glad you’ve found what works for you! I was on Spironolactone for a few years and had to stop after it caused some severe digestive issues. None of the doctors I saw about my stomach issues made the connection, so I recommend keeping an eye on the list of side effects if anything changes. I found Accutane much more helpful for my skin, and the doctors were much more on top of blood tests and follow-up. Getting on birth control helped a lot, especially with my ovulation-related breakouts.

I like the love following Dr. Anjali Mahto on Instagram for dermatology info and education.

4 years ago

Please wear more SPF on weekdays! To achieve the full benefit/protection of what your SPF promises you need to apply minimum half a teaspoon just for your face — I don’t think you use that much CC cream. Also guessing you wouldn’t apply CC cream to your ears…

4 years ago
Reply to  Anna

From personal experience I truly believe my CC cream provides enough sun protection. I’ve used it almost exclusively for over a decade and my skin looks very youthful. My acne scars from years past have faded over time. I never burn with it (and I’m extremely fair skinned!) I had one beach excursion where I used my CC cream on my face…..and Honest sunscreen everywhere else. Guess what was the one place that didn’t burn? My face. I see a dermatologist regularly to inspect moles/sunspots and my face has no such issues. I’m 43 years old.

4 years ago

I’m HORRIFIED that you are taking spironolactone and that you’re suggesting others do the same!!!! It’s a drug! Instead, how about going to a homeopath and/or a naturopath to figure out your hormones without creating future long term health issues. There are ALWAYS natural SAFE solutions. I didn’t read the rest of your article once you mentioned drugs……..

4 years ago
Reply to  Andrea

Andrea, calm your tits.

Sincerely, Everyone Else

4 years ago
Reply to  Sheila

Love it! xD

4 years ago

Sara, you are absolutely gorgeous. With or without acne!! I forwarded your post to my sisters who both suffer from cystic acne. I’m lucky I never got it (I had thin hair instead :/).

4 years ago

Oh, I too share the memories of being dragged to the Clinique counter by my mother. Who could not understand why that didn’t do the trick! After a lot of trial and error I finally have a routine that works pretty well. If only I had I found it before my late 40s! Two suggestions that worked wonders for me: peppermint tea and the Dr. Dennis Gross LED mask. Peppermint tea is an androgen blocker as well, and obviously not a prescription. I drink one cup a day. I have not had a single cystic pimple since I started using it about 2 years ago. The mask is a newer tool and was definitely pricey, but I got it from Dermstore during a sale. It works for acne and wrinkles so that’s a bonus. When I don’t use it daily I can tell, more breakouts and irritation.

4 years ago

This is such a great, thorough post. A few warnings for the peanut gallery: Be careful using The Ordinary’s Buffet with retinol or vitamin C products. My skin can usually withstand a lot–I went from using no retinol to being able to slap it on my face every night with no repercussions, but when I mix Buffet with retinol or vitamin C, that sh!t burns! Also, hyaluronic acid is magic in that it attracts moisture to the shallow layers of your skin’s surface, but the reason have to put moisturizer over it is that if you don’t, it’ll actually pull moisture from deep in your skin to the dryer surface, because osmosis, and then you wind up losing that moisture. Moisturizer over HA ensures that the HA is pulling from the moisturizer into your skin. 🙂

4 years ago

I’m 33 and had about 10 years of glorious skin between highschool and now (also had terrible skin in hs).. so excited to try some of these techniques and products 🙂 Thank you for writing about it!

4 years ago

As someone who struggled with bad acne since I was a teen, I consider myself kind of an expert. After trying spironolactone, antibiotics, and Retin-A, eventually I did two courses of Accutane, which helped. But then my acne flared up again as an adult, so I tried the regimen on, and that is what I’ve been using for the past 10+ years to keep my skin clear. I use the cleanser and moisturizer, but the key is slathering your skin with the 2.5% benzoyl peroxide morning and evening. I can only have white sheets and towels, but I rarely get a pimple, so it’s worth it. It’s very affordable (I spend less than $100/year on it), simple, and it works.

4 years ago

I LOVE The Ordinary products. I’ve been on a similar skin journey, and I swear, that brand has saved my life. Painful acne and sensitive skin are no joke—awful and distracting to the max. Thanks for sharing! Your skin looks awesome!

Elizabeth Kirby
4 years ago

Thanks for sharing! There are definitely some products I want to try now 🙂

Just curious if you have ever tried a dermaroller or apple cider vinegar mixed with water? I also have awful hormonal acne, and I started using ACV recently. I didn’t see any results until I also started using a dermaroller, which helps my skin absorb it more. So far, it’s been helping a lot! In fact, I almost have clear skin now. I also moisturize with pure coconut oil and pure shea butter… the only moisturizers that don’t break me out.

4 years ago

Thankfully my skin doesn’t break out much anymore, but I struggled with acne in my early 20s. PCA Skin products changed my life. I used that same BPO cleanser, the Clearskin, and Weightless Protection SPF 45. They completely cleared up my skin and I will forever share how amazing those products are. I still use the Weightless Protection SPF 45 under a light moisturizer during the day and I highly recommend adding that to your routine.

4 years ago

Probably the best thing I ever did for my skin was read the book, “Beyond Soap”, by Toronto dermatologist Sandy Skotnicki. This book has forever changed my approach to skin care. The basic premise is that we are doing way too much to our skin by washing too frequently, and using too many products with too many ingredients. Natural ingredients aren’t necessarily better for your skin either. Oftentimes, we can be allergic to natural botanicals and fragrances which cause irritation. As a result of reading her book, I have switched my regime to a fragrance free regime (NOT unscented – because sometimes fragrance is used to make something unscented) that uses simpler ingredients. In doing so, I have saved a LOT of money and my skin has never looked better. I would definitely recommend having a look at this book.

4 years ago

Hi, where is the vase from in the top photo? Thanks!

4 years ago

THANK YOU!!!!! I am like Emily-never needed a skincare routine. I use SPF when I know I’m going to be outside. But my daughter has been battling cystic acne for YEARS!! It took almost 2 years for me to even realize how bad it was and how much it was effecting my beautiful daughter. I am loath to put her on any low dose birth control until her body is fully developed at 19. We have tried EVERYTHING. And none of it consistently works. I sent her this article. So thank you!!!

Leigh H
4 years ago

LOVE this post… and the “skincare as a hobby” comment! I can totally relate. Thanks for all the suggestions and honesty.

4 years ago

I really enjoyed this article, thank you! I’m looking forward to trying some new products. The quest for great skin is a tumultuous journey. Vitamin C serums and Biologique Recherce toners have been miracle workers for me. But I’m 44 and still get the occasional hormonal pimple!