Combatting Acne as an Adult

Adult acne

I’ve written here and there about my struggles with adult acne, but I realized that I’ve never dedicated an entire post to the topic. My own acne is mostly under control, mild compared to what many people deal with, and considerably better than it used to be. But some of that is because I have had to change my behaviors on many fronts to ensure a relatively breakout-free existence.

Pillowcases and towels

In order to keep exposure to my own old sebum to a minimum, I change my pillowcase every other night. I sleep on one side, flip to the other side on the second day, then throw the pillowcase into my laundry basket. I use a new washcloth every night, and dry my face with clean, unused towels only. I use hand towels to dry, and have found that I can make them last for four uses by using half of each towel side per use. I own my home and do laundry once per week in my own basement. At least one person has mentioned that the amount of dirty linens that I generate through this system seems prohibitive, and I hear that. But when I travel for long periods and am unable to keep this up, I can see a difference within about a week.

Oral medications

For many years I took hormonal birth control for my acne because without it I suffered from incredibly painful cystic acne on and under my chin. It did seem to mess with my moods quite a bit, but I’d tried many creams and pills and consulted with many dermatologists over the years and it was the most reliable solution. More recently I have been taking spironolactone – originally formulated for high blood pressure, but now known to help with cystic acne in women – and it is equally effective without the mood swings. (I am terrified of Accutane and don’t think my case is severe enough for it anyway.)


My cysts stay away so long as I keep to the spironolactone, but whiteheads and blackheads seem to be triggered by dietary choices. I make absolutely no claims that my own choices have any bearing on science, other people’s acne, or anything in the world except my own complexion, but sugar makes me break out. I try to eat candy, baked goods, ice cream, and just about anything sugary in extreme moderation to keep the pimples at bay. (And I dream of diving into pools of chocolate mousse. Really, I do.)

Occasional facials

I got my first facial at age 37, and by the time I was approaching 40 I realized that getting one quarterly kept my skin in amazing shape, acne-wise. Yes, they are a huge, HUGE indulgence and not something everyone can afford. But if you can set aside the money for three dinners out and put it toward a facial every three or four months, it can really work wonders. (Or, anyway, it has for me.)


I began using this tool in 2012, and haven’t stopped since. I use mine every other night for deeper cleansing and a bit of exfoliation. A reader gave me a great tip ages ago that has made my use of this tool even more effective against acne: The Clarisonic is supposed to get rid of dirt and makeup. But if you use it to remove those things, you may end up just grinding them deeper into your skin. So now I wash my face first, swipe on more cleanser, and THEN use the Clarisonic.

Very little makeup

For a while, I wore BB cream every day. Now, I just do bare skin. Even BB creams and foundations meant for fussy skin and formulas that are “guaranteed” not to clog pores upset my skin eventually. I do undereye concealer and blush, a bit of powder when absolutely necessary. No foundation, no BB cream, just slightly splotchy, natural skin tone.

Hands off

I’ve saved this one for last because I know it’s relatively controversial. I do my utmost to keep my hands off my face. I keep my hands clean, but know that they’re still collecting dirt and bacteria all day long. And I’ve noticed that if I rest my chin in my palm for long periods, I get pimples. Right there. So I just don’t touch my face. I’ll scratch itches and rub my eyes and such, but just avoid prolonged contact with my hands.

And that, friends, represents a significant investment of time, money, and energy to keep my acne only somewhat at bay. I still break out regularly, still typically have three or four zits on my chin and neck. I don’t like them. They’re a part of my natural biology, but I have failed entirely to embrace them. I’ve read a few articles and posts that ask why acne never gets folded in with the other issues associated with body acceptance, and lamenting that fact. It’s a valid point, ya know? Some people have acne and can do very little about it. Why should they be shamed? It seems like skin conditions – eczema, rosacea, and others – are near-universal triggers for judgment/embarrassment. In my case, my acne can be agonizingly painful and I feel that’s a good reason to work hard to keep it in check. But I’ll admit that even the non-painful, everyday zits irk me. And I am yet to feel body-love-related holistic acceptance of them.

If you’re an adult dealing with acne, I hope some of my tricks might be helpful to you, too!

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67 Responses to “Combatting Acne as an Adult”

  1. paulien

    I have been reading for a while but never commented. But this post really made me want to comment. I have acne too, and I am almost 30 so nothing to do with puberty any more. I used to use birth control (diana 35) which helped a ton, but my doctor wanted me to switch because there were too many side effects. I made the switch a year and a half ago, and my skin has not yet recovered.
    I tried all manner of products, from salycilic acid to tea trea and everything in between. The two products that helped me finally were both dr brandt: pores no more pore effect as night cream, and blemishes no more intenssolution as a toner after my facewash morning and night. I know this may sound as a commerical, but I am not affiliated with the company. I just wanted to mention these products for everyone else that might want to try them.

  2. Jill

    For my face I use Neutrogena’s On the Spot acne treatment. It is a low dose benzoyl peroxide. For my body acne I use liquid Clindamycin, an antibiotic from my dr. I’ve never had any luck using the same thing on my face and body so they must be different issues, but I use these two products as soon as my skin is red and have had great results.

  3. Viktoria

    Great post. I had terrible acne from 13 and on, particularly on my face and back. It was just considered “normal” (though no one else seemed to have it as bad) when I grew up in Sweden in the early 80´s, but during my exchange student year in Iowa, I got some proper help with it. I have no idea what they gave me, but no Swedish doctor seemed to know what it was, so I was back to square one when I got home. Then, finally, at 20, a doctor I was seeing about something completely unrelated diagnosed an over-production of testoterone and prescribed a small dose of cortison to be taken at night, to stop my glands producing so much macho hormone. It did the trick – I cleared right up, and stopped taking it after a year. Acne vulgaris did not return.

    I still have sensitive skin, a mild case of rosacea, and the occassional zit, but using olive soap, Vanicream, and an unscented face powder has improved it a lot. I have lots of allergies, and creams and potions that help others often doesn´t work for me. Everyone´s skin seems to be like a planet of it´s own. And I think having acne in one´s youth is likely to be the beginning of a life long skin obsession. Rosy soft skin is the one thing of beauty that I admire most in others.

  4. Jessamyn

    Long time reader, first time poster because this post simply could not have come at a better time! It’s depressing to be in my 30s and be mistaken for a high school kid, not because I *look* young, but because my skin is so awful! Thanks to this blog I started using Burt’s Bees acne products which have helped minimize the cysts and larger whiteheads. In the last month though I’ve been fighting with constant breakouts in weird (to me) places like my cheekbones and chin (neither are typical breakout areas for me). I’m pretty sure it’s tied to how much Halloween candy I’ve been sneaking from my kids. I need more will power! Sorry, I didn’t mean to write a book–just wanting to let you know you are not alone and I’m looking forward to hearing more tips for adult acne 🙂

  5. Wendy

    Do you drink milk? I have to avoid milk or I get those painful cystic acne flair-ups under my chin.

    Also, I did the Accutane routine. I had perfect skin for about 2 months after I was done with the torture that is the Accutane dry out. But I’m right back where I was. *sigh* Wasted money. Even my roscaesa is back.

    • Megan Mae

      Same, Wendy. I have to avoid soy and dairy as much as possible.

      I pretty much stick to the most basic of basic skin routine. Olive oil or Simple brand moisturizer, gentle moisturizer or plain water for the worst days. Witch hazel to help the worst places heal.

  6. Nan

    I have had cystic acne since age 12 and I am now nearly 60. It gets better, really. But it doesn’t go away. But the care for acne prone skin is almost exactly what is now recommended for aging skin – so I look significantly younger than one would expect! Many people have told me that I have flawless skin. Well – I have good skin care and excellent makeup skills after decades of practice. I know this may be surprising, but I use ProActiv and have since it first came on the market. Every day. No exceptions or there are flare-ups. And I use an Olay Pro spin brush with the ProActive every morning in the shower.

    Now I have scalp acne – ouch! The pillow case remedy – absolutely helps. So does daily hair washing with sulfate free products plus topical treatment with clindamycin from the dermatologist. People are surprised to see my scalp acne. I have uncovered it to only a few close friends and they almost cry when they see the hot red swollen sores. At least it’s under my hair so it’s not like the old days of walking around with a face/chest/shoulders covered with inflammed painful cysts.

    And those cysts? They turn into brown spots as one ages – yup, big freckles. Hey – it’s always something, isn’t it? And in spite of it all, my lovely boyfriend thinks I am beautiful, he loves my crazy wavy hair and my bright eyes and smiling face. And I believe him and smile.

  7. romy

    Hi Sally! I have that 1 zit on those days of the months, so I’m not as worry as you are, but I know how frustrating could be as I suffered it till my late 20’s, I notice it disapear the moment I stop touching my face, you know I always were with my hand resting on my chin or my cheek. as soon as I stop that habit, the acne almost vanished. Also found the olive oil to be very helpfull for my extra greasy hair and face skin, it still amaze me who clean my hair and face feels after an oil cleaning.

  8. Colleen

    I wonder if we react the way we do to acne and simply not except it as the way we are is because there is still the mindset that acne = uncleanliness, which is a bit funny because I know that if you over wash can get worse!

  9. Jill

    I had horrible cystic acne that began in my twenties (so bad that strangers would come up to me and tell me I could take medication for it…the kicker was that I *was* taking meds already). It persisted in one form or another despite everything I tried (except Accutane, like you, it frightened me). It has, thankfully cleared up quite a bit over time but I do still get the hormonal cysts, mostly on my chin, Or I *would* still get them…if not for the NuvaRing. Best form of birth control for me and I get almost zero acne (I’m 45 now), even at that time of the month. Also because the NuvaRing isn’t cyclical like the pill, I’m getting a more steady / constant does of hormones which keeps my moods / fluctuations more even as well. Just one girl’s experience…

  10. Sarah

    I have acne, and I swear by this stuff:{adtype}&Kpid=prod1373760&sst=133074ce-f945-d809-1bca-00007eec5ca1

    Everytime I try another foundation or tinted moisturizer, I break out really badly. I’ve tried BB creams, treatments, special cleansers….this is the only thing that keeps my skin in check. It has SPF and retinal and it really, really is a miracle product. I use it every day (on weekends, I usually skip makeup and just wear a moisturizer with SPF).

    I struggle to accept my skin, acne and all. I remember being about 5 years old and looking at my dad’s skin and praying I didn’t inherit it from him, but I did. I have large pores, oily skin, and pimples – especially during my visit from Aunt Flo. It is what it is. I definitely feel like it’s connected to body love. It’s hard to feel happy with your reflection when you have big pimples all over your face, but I try every day.

  11. Jennifer

    This issue hits home for me. Short of typical puberty zits, I never had an issue with my skin until a year or two ago. All of a sudden my face became a greasy mess, with tons of blocked pores and blackheads on my chin and jaw line, eventually turning to full acne all over my face. At the time I attributed it to excessive sweating while training for a half marathon in dank, sweltering DC summers (no human should be able to produce as much sweat as I did back then). Nothing seemed to help though, until I went to the dermatologist for an unrelated skin condition which made my neck and chest break out into tiny white pustules, which turned out to be either strep or staph. A month on antibiotics (Monodox) did the trick and I was good for a while. I was able to control my skin through the winter with gentle soap free cleansers and Clarisonic. But, as soon as the DC summer rolled in, my skin erupted all over again. Back to the dermatologist, where they gave me a prescription to a benzoyl peroxide concoction which was OK for a little bit, until my face blew up and felt lie it was on fire. Immediately discontinued that and went back to the derm who put me on Ziana (clindamycin/tretinoin) and a glycolic acid face wash. This works, but if I try to cut back I get break outs again. I’m due for a follow- up in a few weeks so we’ll see what they have to say. I do, however, notice that things get worse the more I touch my face, if the weather is exceptionally hot/humid or my pillowcase isn’t changed often enough. Ugh.

  12. Kate

    I deal with this too, at 35 I’m dealing with age spots and wrinkles as well. What fun.
    For the small clogs and blackheads – have you ever tried a BHA lotion or toner? I’ve found this helps a lot, particularly with blackheads. I’m finding that the cystic, hormonal acne is much better now that I have identified some food triggers. I can’t drink green tea, eat soy, flax or take DHA oil. And just recently read that drinking spearmint tea can help. So I am giving that a try, only a week into daily cups, so we shall see.

  13. H

    I struggled with hormonal adult acne, mostly on my chin (not awful objectively, but awful to me!) for years. Then about a year ago, after reading something about it on a fashion blog, I cut dairy out of my diet. The acne almost completely disappeared. Worth a try, at least! Good luck, everyone.

  14. Phira

    I’ve had pretty bad acne since I was 9 (not just a few pimples–I was a third grader with a face covered in high school levels of acne), and tried everything. All sort of percentages of benzoyl peroxide, followed by Differin and Retin-A, as well as minocycline, tetracycline, and doxycycline. At age 12, my doctor finally gave up and put me on Accutane, which left me with clear skin for about 5 years. I started birth control when I was 16, which also helped, but when I was 17, my acne was coming back strong enough to put me back on Accutane.

    Since then, I had minimal acne using hormonal birth control, and washing my face nightly with an exfoliating face wash. However, it came back pretty badly when I went off the pill, and now I use the face wash in the morning and Trader Joe’s cleansing pads (with witch hazel and tea tree oil) at night.

    I don’t recommend Accutane, not because it doesn’t work (holy crap, does it work), but because it really messes with your body, and the decision to go on it is a very individual and personal one. I didn’t experience any lasting side effects after the first round, but during the second round, I had really bad lower back pain, which never completely went away. In fact, I’m currently home from work today because I aggravated my Accu-back pain, so when I saw this topic, and the mention of Accutane, I knew I had to comment!

    Still don’t regret the decision, but I’m glad I made it when I was too young to care about side effects.

  15. Angela

    I need a day to explain my acne story. Terrible cystic acne in my teens treated with antibiotics. Suffered through my twenties, tried all kinds of over the counter remedies. Finally broke down and took Accutane in my thirties, loved it, side effects harsh but it worked for 5 years. I wish I had taken it in my 20’s but as I was having children, it was dangerous,

    Finally, at age 42, I am almost gluten and lactose free and taking a very low dose of antibiotics, approximately 3 a month, with very simple cleansing routine of soap free cleansers.

  16. Dee

    Wow, I am totally confused now. So many different regimens and products! I have had breakouts since I was a teenager, and am now in my mid 50s. Birth control pills were great, never had such great skin before or after, but of course I have been off the pill for many, many years. I see a dermatologist and have tried a number of antibiotics, none that really gave me great skin. I am not using anything really special now – I guess I have pretty much given up and just live with the breakouts! I wear makeup that covers up a lot and don’t worry about the rest. I recently started using Clinique BB cream – can’t say it has done much either way. I may try changing my pillow case more often – I never heard of that. I will say the one, and possibly only, benefit of having oily skin with resulting breakouts is I have almost no wrinkles – I am told fairly often that I don’t look my age. So I revel in that and not the zits!

  17. Aziraphale

    This is something I haven’t given much thought to, which I guess is weird because I do still get zits. Rarely anything cystic, I admit, but still, at any given time I always have at least one or two little zits somewhere on my face (or, sometimes, irritatingly, in my cleavage). They just don’t bug me that much. I put a dab on concealer on them and off I go. I guess, at 40, my bigger skin issues revolve around questions like “how much longer will the collagen hold up?” and “where the hell did these undereye circles come from?”

    I’ve always had skin like this. During pregnancy, my skin was blessedly free of spots and had that rosy glow, but other than that I’ve always had a bit of acne. I think that’s the key, though: a “bit of acne” is a lot easier to accept than recurrent cysts, which are unsightly and hard to forget about because they are painful.

    I think the reason acne is excluded form the self-love movement is that it tends to be treatable, and any given zit is not permanent. I see acne as a medical condition, not an aspect of a person’s face or body, like the shape of the nose or fullness of the thighs. We can grow to love and accept our physical shape, but it’s hard to love an inflamed pus-filled blemish that causes pain! The difficulty is, the treatment for acne seems to vary so much from one person to the next. A miracle product for one has absolutely no effect on another.

    For the record, if I seem to be having more zits than usual, I spread a thin layer of benzoyl peroxide on the general area every evening for about a week. That always clears things up. Or maybe it just clears up on its own. I have no idea what my triggers are, or if I can even do anything about it (since I suspect hormones play the biggest role). And I know full well that benzoyl peroxide does not work for everyone, but since we’re sharing, that’s what I use.

  18. Trystan (the CorpGoth)

    It’s funny, I’ve always thot I have horrible cystic acne (I’m 43, it’s the same now as when I was a teenager no matter what I try, no matter that I’ve been on hormonal birth control for 20+ years). But women regularly tell me I have such beautiful skin! Just a case of ‘we notice things that nobody else does’? Perhaps.

    I don’t get tons of pimples, just a few big, bad ones semi-regularly. I’ve gone thru every possible washing routine, tried every OTC acne med & a couple prescription ones, wondered if there was a connection between what I ate or time of month. But no, the zits just pop up in a few specific places on my face & body over & over. It’s as if certain pores are damaged & prone to infection. *shrug*

    Ditto what one person said — oily skin does mean less wrinkles! My mom has the same issue, & she & I are always mistaken for younger than we are 🙂

  19. Cheslea

    I noticed a few years ago that I tend to breakout where my bike helmet strap rubs on my throat, especially when it’s warm out. Since then, I regularly wipe my helmet strap down with alcohol wipes. It’s seems to have made a huge difference. Thought I’d share in case anyone else has this issue…

  20. marytn

    LOVE your blog—just got your book for my Kindle as well and hope to start ‘the process’ over Thanksgiving break.
    Anyhow…acne….HATE it. I finally got on Accutane when I was about 40; was on it about 6-8 weeks and had no severe side effect other than a bit achy in my legs. It worked wonderfully and my skin has remained clear for many years (I’m one of your older readers!)

    My 2 daughters have problems with acne as well and I swear by ProActive—-they both saw pretty dramatic improvement—although it does take about 6-8 weeks of regular use. Have a great week—and Thanksgiving.

  21. Jess

    I guess at 20 I’ve only recently breached the barrier between teenagerdom and adulthood, but I’ve had bad acne ever since I was 11 and I hate hate hate hate it. I have not accepted it in the least. I’ve tried every topical medication (both prescription and not), I’ve tried oral antibiotics, I’ve tried herbal/natural remedies, and I’m on birth control. Absolutely not a single thing has helped at all. My mom had bad skin into her twenties and then I guess it tapered off for her by 30, so I’m just waiting it out at this point.

    And I can handle what’s on my face. I use a topical medication that doesn’t clear my face, but if I use it for two days on a new pimple it makes it smaller and lighter, at least. And I’ve had nine years to learn the best way to cover up spots with makeup. But I also have terrible, really painful acne on my back, and if I go out with friends to a party or something, I feel really embarrassed showing my back and shoulders. And though I have a pretty fit body that I’m proud of, I feel so awful in a bikini because it looks like a swarm of mosquitos went to town on my shoulderblades. Even getting backrubs from my boyfriend is mortifying and sometimes painful, and though I know he loves me, it makes me wonder in the back of my mind if my skin disgusts him or if he wishes he was with another woman who has baby-smooth skin. I’ve gone to see several dermatologists, but they haven’t been able to give me any answers.


    • Anne-Marie

      Hey Jess — I also had acne on my shoulders and back. Have you tried using a high dose of benzoyl peroxide (like 10%) possibly with sulfur? When I’m consistent with the benzoyl peroxide, I have smooth skin. It can be a pain since benzoyl peroxide bleaches clothes and sheets. I just put it on at night time and shower it off in the morning.

      • Jess

        I have tried a strong BP spot treatment, and it sort of worked, but I wasn’t able to apply it consistently, since I sometimes sleep over at other people’s houses after parties, or stay the night at my boyfriend’s. I live the wild life! Haha, not really. I’m usually just too lazy to drive home. And it started getting through my sleepshirts and bleaching my sheets…

        I may try it again. Last time I used it was over a year ago, maybe this time it’ll clear up faster or something? I dunno. Thanks so much for the suggestion though! 😀

    • Nan

      Many years ago, my dermatologist put me on spironolactone, which is a blood pressure medicine that has the side effect of reducing androgen production (male hormones in women). It’s not an antibiotic, so I could take it while I was on fertility treatments and I had no bade side effects. It worked wonderfully well on my back cystic acne and also had a positive side effect – it caused my body hair to decrease. I never have to shave my pits and have so few hairs on my legs that shaving is more of a habit than a necessity. My current dermatologist says that he prescribes it to a lot of women with cystic acne with good results.

      • Anonymous

        I also use spironolactone with good effect. My doctor has suggested that I stop using it but whenever I try my skin becomes oily again.
        I’m on a very low dosage and it works for me!
        I used accutane 25 years ago with good results and had dermabrasion
        to reduce the effect of acne scarring. I never walk out the door without makeup to hide behind!

      • Jenny

        I also use spironolactone. It reduces the secretion of oil in your skin.
        I took accutane and had dermabrasion to reduce the effects of scarring.
        I have a regular cleansing routine and wear makeup whenever I leave my house. With my makeup on I can face the world and look people in the eye! I’m almost 60 and always have my tretinoin cream with me just if case!

        • KimB.

          Here’s another shout out for Spironolactone! After having a total hysterectomy and going into immediate menopause I was also thrown into cystic acne all along my chin and jawline. Very large painful ugly cysts which would leave scars if I even tried to pop them. Went to derm to ask for Accutane and he said he was sure mine was totally hormonal and wanted to try Spironolactone. It has worked wonders for me! I’m on 150mg daily. I found the acne came back if I tried decreasing to 100mg. I also try to practice good hygiene and never touch my face if possible. I believe my skin has never looked this good before. I get lots of compliments on my complexion now and I’m 48 years old.

          • Marisa

            Another +1 for spironolactone. It’s made a tremendous difference for me, both with the painful chin cysts and with more run-of-the-mill acne (and back acne!).

  22. SamiJ

    I’ve recently seen a change in my skin — I have mild rosacea and break out on my oily T-zone. My skin has gotten clearer, and the rosacea has faded. I’ve had three changes this year that might have contributed: (1) started working out 20 min, 3 days a week — and I wash my face prior to working out (I only rinse after). (2) I started eating better (no more regular eating of pasta, bread or baked goods, no chips or fried anything); and (3) I started using a BB cream. I orginally made the first two changes because my dr. told me I was pre-diabetic and that my cholesterol was too high. I am shocked about the results — rosacea runs in my family, my face/nose has been red for years. Now it’s not so red anymore — what little redness remains is covered by the BB cream.

  23. Anne-Marie

    I’ve been a long-time reader and have never commented, but this is a topic near and dear to my heart.

    I had acne from 13 on into my 20s. I finally found the right esthetician and found a few tricks that worked wonders for me. I have beautiful, clear skin now. It’s an incredible confidence booster.

    1) Avoiding ingredients that make me break out. I didn’t realize that I was putting on foundation and sunscreen that would make me break out 4-6 weeks later. If you Google “Pore Clogging Ingredients in Skin Care” you’ll get a fantastic list; don’t touch these ingredients.

    2) Use a daily exfoliant. I use 8% mandelic acid. It’s very help.

    3) Use a daily acne treatment. I use 5% benzoyl peroxide.

    It took years and years, but I finally feel great about my face. Now, if I could only find a lipstick I could use without breaking out…

  24. Natalie

    I too am an adult acne sufferer. I’ve posted about it on my blog, but I have been through a particularly horrendous 6 months since moving house and country. I’m finally, fingers crossed, beginning to get my skin back under my control.
    To complicate matters even further for me, I have incredibly sensitive skin that reacts very badly to many things (I had an allergic reaction to removing my upper lip hair last night for example), including all the acids and toners they recommend for acne prone skin. My skincare now involves oil cleansing for removing make up, rhassoul mud for second/morning cleanse, green clay masks, rosehip seed oil moisturisers and a wonderful gel I can’t get in Austria but I have my Mum send me from the UK which is designed for sensitive spot prone skin and is rich with zinc.
    I sleep with a towel on my pillow case to protect it from my hair colour, but I too change it regularly to protect my skin. Interestingly travelling this week we weren’t in any place more than 2 nights and my skin cleared up so fast.
    I have also started taking a raft of supplements, but most significantly Agnus Castus (sometimes sold as Vitex in the USA I believe). I don’t think it is suitable for women taking hormonal birth control, but it pretty much does the same thing, only slower and encourages your body to do it. I have a Mirena which can bring on similar side effects to PCOS, but I haven’t found a better birth control method. The Agnus Castus in theory will mitigate the side effects of the Mirena and help my body regulate my hormones better. I’m only a few weeks in but I think it is working!

  25. Jeanette

    Thank you for your post. I am 49 and am suffering from cystic acne on my chin. I’ve tried many things, and am still struggling. I look forward to taking the time to read everyone’s helpful comments.

  26. BelindieG

    Accutane and Retin-A worked for me. Mine was also probably over-supply of testosterone. Once I had a baby, acne went away, never returned.

  27. Stephanie

    I have some acne, but it doesn’t particularly bother me. Then again I shell out the money for Proactiv every few months so I guess I do care at least somewhat. It’s not a miracle worker but it does better than anything else I’ve used. I still usually have a couple of zits at any one time, but it’s so much better than what it used to be so I don’t really care. If you let that sort of thing get to you, you’ll drive yourself crazy. Seriously, I remember seeing a commercial when I was a teen– “Is a blackhead ruining your day? Try product XYZ!”. With that logic, I haven’t had a good day since I was 11 years old. XD One of the reasons why I avoid the media now…so ridiculous.

    I like the pillowcase idea; maybe I’ll try it. Depending on how many pillowcases are actually in my house…hehe.

  28. Sarah

    I have struggled with acne since I was in 2nd grade, including 2 rounds of Accutane. My greatest ah-ha moment has come recently after reading Wheat Belly by William Davis. It seems that wheat (and by extension, refined carbs, as you notice with sugar) is the underlying cause of much of the acne in western society. Wheat (and other refined carbs) triggers insulin which, in turn, triggers sebum production and acne formation.

    Since cutting out wheat, my acne has improved dramatically. When I do flare up, it is because I have indulged.

    • Angela

      I also read that, my dermatologist recommended it, I think no wheat is helping my skin and stomach

  29. Becky

    I had bad cystic acne until I went on Accutane in my early 30s. I tried lots of other stuff; antibiotics, retinoids, oxy-whatevers, dietary changes, gentle cleansing with this and that. I’ve always eaten a really healthy diet, low on grease, high on veggies, plenty of water. I don’t like sweets, so have rarely eaten much sugar. I never saw any dietary effect on my acne.

    I did have one, single “clear skin” day between 13 and 32. I had gone backpacking with my dad, brother, and best friend – three days of absolutely no stress, time with people I love and get along comfortably with, and enjoyable outdoor exercise; my only skin care was to wipe my face with cold water on a bandana twice a day. When I looked into the bathroom mirror at our destination campground and saw *not one zit,* I couldn’t believe it. But by the time we’d driven the 8 hours home, it was back to the usual. Maybe it was a coincidence, but even today, joy, being outdoors, exercising, and getting enough sleep does good things for my skin.

    Accutane was like magic for me; hellaciously dry skin for six months, followed by 14 years and counting of clear skin with only the occasional zit when I get particularly stressed or hormonal. I understand people being uncomfortable with the potential side effects and would never press someone to take it who didn’t want to, but I am glad I took it. Now I can see in my skin when I’m being healthy vs. neglecting my body; before, it just always looked bad.

    I can second Sal’s “no hands on face” rule. It was amazing the way touching a spot on my face would cause a little colony of zits to form there immediately afterwards! I always wondered whether it was from bacteria, or just the warmth and pressure.

    • Jennifer

      I noticed my skin clears right up whenever I go to the beach and swim in the ocean. Now if I could only be a professional beach bum 🙂 I also noticed saltwater does wonders for my hair. I get perfect curls and body after getting my hair wet in the ocean.

  30. sherd

    I completely agree with avoiding touching your face! For me, it seems that anything that encourages bacteria leads to a flare-up. So I mainly focus on managing that, balanced against being really gentle and not drying my skin out too much. Hormonal birth control is probably the major thing that works for me. But other things that have helped are using a gentle facewash (like Neutrogena or Cetaphil), keeping my hair out of my face and not touching my face, changing linen, plenty of (gentle) moisturiser, and using good quality makeup (and taking it off at the end of the day!). Oh and benzoyl peroxide cream on spots. I’m on the fence about diet – for me it’s much more stress-related, although I do tend to eat more sugar when I’m stressed, so it could be a factor. Basically it was trial and error over about 5 years since my late 20s, but now it’s (touch wood) under control.

  31. Th

    I’m kind of glad you made this post. I do think it’s an important part of body acceptance that is often ignored. It is something that’s transient, but I get ance regularly, even if the individual pimples are only there for a small amount of time, relatively.

    I’m 23 and I’m still dealing with my own acne, it’s never been bad but it’s been a source of self-loathing since I first had it. During a hormonal breakout sometimes I just want to take a cheese grater to my face, I just can’t stand looking at it. I have an okay routine (mixing it up now) but if I start to slip than hello giant cystic pimple inbetween my eyes.

    Doesn’t help that my mom always bought be the harshest anti-acne creams/etc as a kid, sometimes it’d be worse afterwards because I also have sensitive skin. She’d also stop me and fuss over my face up until I was 18, and never said anything good about it when my skin /was/ clear.

  32. Stephanie

    I’ve started wondering recently why we don’t talk about acne as part of body acceptance, too. Ever since puberty I have been ashamed of my body just because of my skin. When I had my senior year high school pictures taken, people would say I looked like a model, but I couldn’t believe it. Five years later, my friends have been trying to convince me that I am gorgeous and definitely attractive, and I still won’t let myself see it – because all I see are the flaws from acne. I’ve spent my whole life thinking I can’t be attractive and therefore shying away from dating, just because of acne. It feels like something incredibly shameful, even when in so many other ways I conform to the beauty standard – this one thing holds me back from feeling good about myself. So I would like a revolution. I would like us to talk about having acne and not hiding it, but dealing with it so that it’s not painful, and after that… not being ashamed. I’m so tired of being ashamed of something I can’t seem to control. I’m tired of not wanting anyone to look at me for fear they’d judge me by my skin. I’m tired of thinking how it’s the last thing about myself that I want to “fix” and then I really will be beautiful. It’s so hard, and it’s holding me back from a lot of things.

  33. Anonymous

    I know why I don’t think of acne along body acceptance lines: because I can’t not pick it. I pick my own acne. I squeeze my husband’s clogged pores when he lets me. When I encounter a stranger with a zit crying out to be squeezed, I can’t focus on other aspects of the person. I’d rather look at dozens of scabs and acne scars than one juicy zit. I know I’m more OCD about this than most people, but I think obsessive picking of acne is pretty common and probably contributes to how we view acne as a problem to be solved rather than a natural characteristic to be accepted.

    I deal with my acne by not putting anything other than water on my face. (Exceptions are my eye cream, since I don’t get acne there, and Cetaphil cream in the occasional dry patches.) Not touching my face would also make a big difference, but obviously I’m not doing that. I also had Accutane in my early twenties. It improved my acne for several years. It’s gotten worse since then, but perhaps it would be a lot worse if I hadn’t done the Accutane.

    I have one tip for anyone on Accutane… When your nasal passages get uncomfortably dry, use some Vaseline on a cotton swab to moisturize them.

  34. Christie

    One thing I always, always do is clean the frame holding the lenses of my glasses/sunglasses. I was getting little bumps on my cheeks and around the lower eye area. I use an alcohol pad on them and my cellphone. My age spots are getting more pronounced so I use some Paula Begoun BHA stuff. Works pretty well.

  35. Lena

    Wow, it’s a really good question why we aren’t more accepting of ourselves for having bad skin. It’s not something I’ve ever thought about, but I definitely do not feel my most confident whenever I have a skin issue and I don’t know if I could ever “get over it” let alone celebrate it.

    Thankfully my skin is much better now that I’m older, and it was much better yet when I was on birth control pills. I wash my face every single night and if I miss, I will notice a difference and get breakouts. I do get those painful cystic bumps every so often. Topical creams NEVER work for me, they always flake and make everything more red and dried out, which makes it too difficult to hide with makeup.

    So my most magical tip is to use Neosporin(r) (or similar) cream — there’s an oily ointment and also a cream version. Rub a very small amount into the bump, morning and night. It almost helps moisturize before putting on cover-up in the morning. Sometimes I’ll do a couple of separate applications in the evening if it’s a really bad one. Rub it in, and let it soak in. Seriously, if you do not pick at it, and use the cream, you will have to suffer 1-2 days at most. It dries up the infection without damaging the surface skin. I know we aren’t supposed to over-do the antibiotics, not sure if topical creams count but honestly I would never use anything else. It works for me!

  36. Jane

    Accutane is wonderful! I quickly got over the skeevies about it when I had exhausted all other options. In hindsight, the only regrets I have is not having used Accutane sooner! Been about 6 yrs since I stopped using Accutane & I still have cyst-free skin, nary a pimple & much much less blatantly oily skin. Seriously glad I went the Accutane route!

  37. Yan

    I’ve had acne since I was about 12, but right around the time I turned 30 and moved, the cysts got worse. Hormonal BC wasn’t an option. I’d already had some cysts on my chest that scarred, but for about 6 months, they would cluster, mostly on my chin, and as soon as one started to clear, the next two would rise up. They were painful and embarrassing, and when one of them finally burst *inward* and sent me to the ER because my jaw went numb, I did Accutane.

    I was lucky — Accutane cleared my skin up in about 6 weeks, and I was on it 5 months. That was 5 years ago. I do still get the occasional zit, but I’ve only had 2-3 cysts since, and they’ve been small.

    For the whiteheads, an application of straight up lemon juice at night, before bed, works better than anything else. Oil cleansing has also worked wonders for me, but I’m learning as I go into my first winter that my formula will need to change with the seasons. Even on my worst days, these things make my skin better in my 30s than it was in my 20s.
    The surface whiteheads

  38. Yan

    Oh, and I bought a professional pore squeezer (I have no idea what it’s called) for clogged pores. I love it, and it’s so much better than what I used to do with my fingernails. It’s a metal stick with a little ring that you press over (around) the clogged pore, and if it’s ready to unclog, it just squirts right on out.

  39. Meka

    I hate to post and run but I’ve battled body acne for as long as I can remember. I’ve used everything, to no avail. A couple of months ago, I decided to try Origins Skin Diver Charcoal Body Wash. My skin noticeably improved with one use. My skin stays clear if I use the charcoal body wash every other day. I intend to try the body scrub part of the Origins line.

    That said, I’m beginning to think that there may be a dietary component to my persistent acne problems.

  40. Rebecca

    -Clarisonic – this has made the biggest difference.
    -birth control (which I won’t ever go off anyways – too practical, and helpful with keeping moods *level* for me)
    -salicylic acid
    -avoiding dairy, flour and sugar. Within three days of eating any of those, esp dairy, BOOM goes the acne.

  41. Lisa

    I think skin conditions don’t fall under the “body acceptance” umbrella because they’re not only cosmetic, but often extremely painful and indicative that something is going awry. I had cystic acne as a teenager, and still am very hirsute (abdomen, face, back, etc.), and both are because of too much testosterone. I would itch all the time, and get painful ingrown hairs. Even though my hormone levels are now within a normal range, I exercise and watch my diet, and it helps.

  42. Practical Paralegalism

    I was so surprised to see you have adult acne because you have such a beautiful complexion. I’ve been wondering if I should blog about my own struggles with adult acne – and I’ll be 50 in several months. I change my pillow cases frequently. But what has really made a HUGE difference is switching to disposable facial wipes for cleaning my face. Even my dermatologist is amazed, and says he’s had other patients report the same results.

  43. Veronica

    I’ve had acne since puberty. There was a bit of time from about 18-22 that I had really good skin. Then I went off birth control and got pregnant. BOOM! Acne all over my face, even in the areas I never got it before. That happened each time I got pregnant and took over a year to get over. There was a break between #2 and #3 that my skin looked good, and I attribute that to working out and eating healthier, which I’m not now. There never seems to be enough time and I like sweet I’m still getting acne now and my son is 2.5. Keeping my hands off my face is hard, I’m a picker. I wash my face every morning but not every night, I get lazy. I will try the pillow case idea, but I think I need to buy more pillow cases.:)

  44. Anne

    Did the antibiotics in my teens, which cleared up my skin only as long as I was taking them. Accutane in my early twenties (side effects were unpleasant for me, wouldn’t recommend) which improved things greatly, but never really got rid of the acne.

    In my 30’s, after having a baby, I went on a elimination diet while breastfeeding to try to solve the baby’s digestive issues. Ended up taking all legumes (peanuts, beans, soy) and a lot of flour-based baked goods out of my diet because they were bothering the baby. Bingo, that cleared up my skin. A happy, unintended consequence. Now if I eat a few peanuts or something with soy, I get a pimple or two.

    Also, as a result of years of unhappy skin I don’t wear makeup 90% of the time, I oil cleanse maybe twice a week, and do a baking soda exfoliation maybe once a month. I also no-poo (shampoo & most soaps are too harsh) and I take my fish oil supplements daily (helps overall skin tone).

    As for self acceptance/love – my acne, especially the cysts, hurt. While it’s not a lack of cleanliness that is causing breakouts, acne is an infection/inflammation – something we generally want to minimize in our bodies. It’s tough to embrace the sometime occurrence of something that is transient and painful, I think.

    • Anne

      Oh, I wanted to add –
      I do think that we should practice self-acceptance of skin with scars & discoloration caused by acne. It’s only this last decade, but I’m finally ok with my scars & minor skin discoloration. I don’t hide them with my hair or makeup, and often don’t even remember they are there.

  45. Lady Cardigan

    Wash face twice a day with salicylic acid cleanser. In the morning, follow up with glycolic acid lotion. At night, apply ice after the salicylic acid, then follow with benzoyl peroxide (low dose is better). This works for me after a lifetime of bad cystic acne. I don’t dare use makeup and rarely apply sunscreen. I will always have acne but at this point, no one knows it but me.

  46. Bree Bronson

    I haven’t commented before either, but now I have to because I have always been ashamed of my skin. In Finland (Europe) where I live there was just a challenge going around for all bloggers to post a portrait photo of ourselves without any makeup. Couldn’t do it, and I wonder where I could find the courage. For me my skin has always been the number one reason for low body confidence so it’s definitely an issue! Thanks for a great blog!

  47. Rachel

    This is very interesting! I’ve had (bad) acne since early puberty (I’m 38 now), although it’s migrated over the years – these days it’s heavily on my cheeks and temples, before it was more the forehead and back. I’ve been on birth control pills for years, and they definitely do make a difference – I went off for a year and it was so much worse, it was unbelievable. My skin, while being oily, also tends to be flaky, so I’ve had a hard time finding a skin care treatment that works.

    But I was fascinated to hear people talk about changes after avoiding dairy or wheat! I don’t eat much dairy other than cheese, but I’m going to have to try cutting it out for a while to see if it makes a difference.

  48. Natasha (@onewomansstylee)

    I have finally gotten my acne under control, but I think these are some really great tips that I will add to my own routine. I found that glycol rich cleansers like Peter Thomas Roth and Vitamin C cleanser (like Ole Henriksen) and a monthly facial (helps with the extractions) put me on the road to recovery. I just started using BB cream and it seems to be the miracle cream that they are touting it to be. (-:

  49. Cheryl

    I just zipped through the comments but didn’t see the thing that cleaned my skin better than anything. I stopped the Prilosec hypo acidity in your stomach can cause skin problems. So when I stay away from wheat my rosacia is totally gone

  50. Marie

    I am 58 and my skin breaks out, then turns dark where the problem was. I break out on my upper arms occasionally. I have tried many products have not found one I can use yet. My skin is so sensitive that when I use any kind of lotion or product that has any oil in them I break out worse. So I keep looking for a solution. I never had skin problems when I was a teenager. It has been the last 20 years that I have had problems. I know some of it is hormonal, but I am on progestrin and my doctor has tested to see how the levels of all hormones are, they are all where they should be. So I guess I will keep looking for something that will work for me.

  51. Sophie

    I’ve been taking Agnus Castas for a few years now and it’s been the only thing that’s taken the edge off my hormonal acne. You need to stop dosing every 3 months for 2 weeks though to give your body a chance to let it work again. Also, you might need to take a higher dose than stated on the bottle. I usually need to take 3-4 a day with food to see a dramatic difference. Changed my life. Also, helps with PMS moods which is always a plus.

  52. DEE

    Thank you for these tips. I am 32 and still struggle teribly with adult acne. i have scars all over my face,neck, back and shoulders from acne. I havent excepted that I have it after all this time. I fight with it daily. It is the cause of some huge self esteem issues. I actually did do acutain and it worked for almost a year then back it came.. So frusterating. Aside from never looking in the mirror again i don’t know how I could possibly get over my personal hatred of my acne. I think maybe the cause for having it is deeper. Genetic predisposition and a deep lack of emotional wellbeing steming from traumatic life experiences. Maybe working on the root causes is the solution hard to say..

  53. acne and pimple treatment at home

    I know that sometimes there are people saying that there is no connection between foods and pimples.

    Laser treatments and acne scar surgeries are very expensive.
    These usually contain antibacterial agents such as benzoyl
    peroxide (eg Oxy and Clearasil Max).