There’s exactly one good thing about still struggling with hormonal acne as a nearly 30-year-old woman: I’ve spent half my life figuring out how to calm, heal, and prevent hormonal breakouts like a pro, through trial and error.
My relationship with acne started in high school. At 15, my dermatologist prescribed a couple different antibiotics (doxycycline and minocyline, specifically) to keep it under control. Both completely dried my skin out — but, as I discovered, flakiness is even harder to cover with makeup than pimples. At the suggestion of my derm, I later went on The Pill in order to regulate my hormones and eliminate the hormonal breakouts and dryness... or so I hoped.
Being on birth control helped; as did Accutane, a powerful prescription acne treatment often described as a “last resort,” which I took for a year. But I found that my under-the-surface cysts would reappear without fail whenever I was stressed; kind of like a bizarre BFF, always there for me in the hard times. College finals? Job interview? First date, engagement party, wedding? All of the above prompted breakouts.
Once, when my cystic acne was at its worst, some random guy walked up to me in a restaurant, totally out of nowhere, and said, "You should really try Proactiv" — as if I hadn't already tried everything; as if I hadn't spent years of my life obsessing over how I looked. His comment convinced me that the acne was all people saw when they looked at me. I didn't want to be seen.
In college, this meant skipping classes and parties; as I got older, this meant calling out of work "sick" when my skin wasn't cooperating. I stayed home a lot, crying and filling up my Amazon cart with products that promised to help.
But the vicious cycle of stress-related acne is real, and the anxiety I felt about being seen only served to make me break out more.
I’m not alone here: many women deal with stress-related acne, which can be traced back to the hormone, cortisol. “Higher cortisol levels that are released during times of stress can decrease the skin's potential to heal,” Dr. Jennifer Vickers of Sanova Dermatology tells The Zoe Report. “This can then lead to flaring of many inflammatory skin conditions, such as acne, rosacea, psoriasis, and eczema."
Like all of the skin issues that Dr. Vickers mentions, acne has no known cure; the most you can do is manage it. So even though breakouts are inevitable, over the years, I’ve developed a system that helps me manage my hormonal acne on every level.
Ahead, a step-by-step look at what works for me.
In addition to being acne-prone, I’m also the proud owner of extremely sensitive skin, so spot treatments with even mid-range levels of salicylic acid or benzoyl peroxide (two popular blemish-fighting ingredients) can cause irritation. Since I have to be so careful about what I put on my face, I rely on all-natural skincare products and ingredients to treat my blemishes.
I use pure Manuka honey, a type of honey that’s native to New Zealand, to wash my face every morning and night. It contains methylglyoxal, an antibacterial compound said to prevent acne-causing bacteria from regenerating, and has anti-inflammatory properties that reduce the size of my pimple within the day. Bonus: Manuka honey is a humectant — meaning it absorbs moisture from the air and draws it into the skin — so I find it gives me the perfect natural and dewy glow. To use, I just wet my face with warm water, massage the honey into my skin for a minute or so, and rinse off. (When mixed with warm water, Manuka is surprisingly not sticky at all.)
Next, I tone with a homemade mixture of tea tree oil and water. Tea tree oil is an essential oil with antibacterial properties, and is often cited for its ability to clear out clogged pores. This stuff is powerful, though, so it needs to be diluted in water before use. I typically add seven to 10 drops of tea tree oil to a 2 ounce spray bottle of filtered water and spritz generously.
Finally, I reach for organic jojoba oil in place of moisturizer. Jojoba oil actually mimics the skin’s natural sebum — something I learned from Dr. Aanand Geria of Geria Dermatology in New Jersey — and, as a result, helps regulate oil production. It doesn’t clog pores either, which is a major plus for the acne-prone.
Of course, I experiment with other skincare products; but these three always work. When I'm too tired for a 10-step routine at the end of the night, I can count on these to be an easy and effective treatment trio.
Because hormonal acne is a result of, well, hormones, it can be treated internally, not just topically. This was a major lightbulb moment for me, and focusing my diet around foods and supplements that support a healthy digestive system and level-out my hormones has improved my skin more than any single topical product. The book Woman Code by Alisa Vitti is my go-to resource for regulating hormones naturally; it outlines exactly how to care for your body during every phase of your menstrual cycle in order to keep things like cramps and breakouts at bay.
I also find that my skin is clearer the more I exercise (much to my lazy weekend-loving disappointment). There are a couple reasons for this: One, sweating opens up your pores and essentially cleans out the toxins sitting just underneath the skin’s surface (which is why it’s important to wash your face after working out). Two, exercise gets the lymphatic system moving — and the lymphatic system is basically your body’s natural detox mechanism, responsible for moving toxins out of the body. When the lymph is stagnant (due to things like lack of exercise, stress, or eating too much salt), toxins don’t effectively leave the body and may show up on the skin, instead.
Since I can trace so many of my skin issues back to stress, I’ve actually found that taking care of my mind has had an undeniable impact on my skin. Twenty minutes of meditation a day keeps me calm throughout the day — and calm equals lower cortisol levels and fewer stress-related breakouts. Every morning, I find an ambient music track or a guided meditation video on YouTube and zone out for a while.
Sometimes, I’ll even meditate on a skincare-related mantra, like “I am beautiful on the inside and it shines through the outside” — which, I admit, sounds a little esoteric at first. But anyone who’s struggled with acne for over 15 years will understand that there are moments when you feel desperate enough to try anything to heal your skin. And for me — someone who, traditionally, would've laughed off meditation as too out-there to touch — "anything" meant adding mantra-based meditation to my daily skincare routine.
Now, I'm thankful that my moment of desperation led me to a life-changing practice that helps calm my skin and my mind.