Hormonal Acne Treatment Prescribed By My Dermatologist

the prescriptions that finally worked!

Suffering from acne can be a very frustrating experience and this may be my most vulnerable post yet. I’ve been pretty open about my struggle to get clear skin and I hope sharing my acne-fighting journey helps you, or someone you know.

I’ve been battling acne since middle school and it’s a constant struggle for me both physically and emotionally — even today. Your self-esteem can plummet drastically and it can be devastating for a young teen or adult.

MY PERSONAL ACNE JOURNEY

I started having little bumps around 5th grade. It started on my forehead and I quickly remedied that with bangs — problem solved. In middle school, the pimples migrated to my cheeks and that’s when makeup became my best friend.

I would wake up early just to put on my Cover Girl foundation and a few layers of pressed powder for the shine.

Finally, after high school, my acne went into overdrive, completely obliterating my skin. I tried everything and anything that had any sort of claim to getting rid of acne.

I once got duped into buying a $100 jar of clay from the Dead Sea from one of those kiosks in the center aisles at the mall because the sales girl swore it would “dry up my pimples.” It did not.

In my early twenties, after many failed attempts to control my breakouts, I decided to see a dermatologist. She recommended an alternate form of the drug Accutane — or isotretinoin.

The drug reduces the amount of oil released by oil glands. However, there were many scary side effects, including birth defects in fetuses. I had to take monthly pregnancy tests and blood work just to be sure.

I was on the medication for a few months. It did dry up my skin but also left me with chapped, cracked lips. The inside of my nose would also get dry and I experienced frequent nose bleeds.

A few years later, after another major breakout, I was back on the medication in a second attempt to clear up my acne.

DEALING WITH ADULT ACNE

My skin, although not perfect, was tolerable and I was OK with the occasional pimple here and there. However, in the Spring of 2019, my biggest nightmare resurfaced in the form of a pretty gnarly breakout.

These weren’t your typical, minuscule pimples. These, my friend, were painful, large, and hard to get rid of.

My cheeks flared up and some deeply rooted cysts formed along my jawline. It was truly devastating — how could this be? It’s not like I’m some adolescent experiencing hormones for the first time. I was well into my 30s. Why me?

Posting these before pictures are not easy. In the social media world, everyone wants to post the perfect picture, with the perfect life and everything just perfect. Well, it’s not all filters and rainbows my friend — this is real life.

I know I’m not the only person going through this, so this is me showing you how bad it really was and how my afterpicture is still not perfect (and probably will never be) but it’s my major improvement.

HORMONAL ACNE TREATMENT FOR ADULTS

A few months after taking these before pictures and after failed attempts to control the breakouts, I called up my dermatologist and scheduled an appointment.

I was afraid of what she would say — Isotretinoin? again??

I was relieved when she prescribed me 3 medications as a hormonal acne treatment.

DISCLAIMER: These medications were prescribed to me and monitored by a medical professional. I am in no way saying these medications will help you. Please consult a dermatologist before taking any medication or starting treatment.

First up, I had to get the hormones under control. The hormones rev up oil production leading to clogged pores and ultimately a big ‘ol zit.

HORMONAL ACNE TREATMENT

SPIRONOLACTONE

My dermatologist prescribed Spironolactone as an oral medication.

Spironolactone was initially used to treat high blood pressure and water retention, so it is a diuretic. It also treats high levels of the hormone aldosterone which is responsible for sebum production; the excess oil that may lead to clogged pores.

Spironolactone blocks some male hormones, like testosterone, and is not typically prescribed to men.

The medication does take a few months for you to start seeing results. Luckily, I did not experience the “purging” effect like many other acne medications. I saw results in as little as 3 months with my face almost 100% free of acne.

My dermatologist started me with 3-25mg pills of Spironolactone to be taken daily.

I suffered from low blood pressure on and off and noticed that, since starting spironolactone, I’d get lightheaded when I would stand.

It’s not severe, but my dermatologist did mention that the medication may lower blood pressure. 

TRETINOIN

Next in my acne-fighting arsenal is Tretinoin. Tretinoin is a retinoid that combats acne by clearing out pores and preventing new ones from forming.

I have noticed that when applied directly on a pustule, the pimple will scab over and greatly diminish in size in 1 to 2 days.

Tretinoin is also used for anti-aging which is amazing for the skin. Some side effects that I have encountered are dry patches and slight peeling around my mouth.

I treat this with a rich moisturizer or alternate application days to every other day.

My biggest fear while using topicals to treat acne was that the skin usually gets worse before it gets better — a process called purging.

This process makes it easy for someone to abandon treatment early but, lucky for me, I didn’t experience it this time around.

DAPSONE

Finally, my dermatologist prescribed me 5% Dapsone. Dapsone is an antibiotic used to clear skin lesions. My dermatologist advised me to use this medication as a spot treatment.

I do prefer tretinoin to spot treat because it seems to dry out and make pimples flake off faster, but I continue to use Dapsone for its antibacterial and antimicrobial properties.

I have seen significant improvements with minimal side effects as I’ve experienced in the past. You can read about my past experiences with acne treatments here.

HOW TO TREAT DARK SPOTS AND HYPERPIGMENTATION FROM ACNE

Now that my acne flare-ups are under control, I’m battling hyper-pigmentation where pimples once stood.

This is where my trusty vitamin C and brightening creams and serums come in. I’ve been using vitamin C serums for a couple of years and have seen major improvements in texture and tone.

POST-ACNE TREATMENT SKINCARE ROUTINE

Vitamin C is an antioxidant that helps protect the skin from free radicals. Free radicals can come in the form of UV rays, smoke, stress, and pollution — all things that damage the DNA of a cell.

In turn, you experience premature aging and brown spots.

Vitamin C helps protect those cells while boosting collagen. This helps keep skin firm and also helps fade and prevent dark spots and hyperpigmentation.

Here are a few of my Vitamin C skincare favorites:

After a couple of months, I was scheduled to see my dermatologist for a follow-up. Although my skin improved tremendously, it could be better.

My skin continued to be on the oilier side so she recommended a sulfur wash to go along with my current treatment.

Sulfur washes are great for reducing oil on the skin. Sulfur has keratolytic properties that help break down the keratin in the skin. Keratin builds up in the lining of your pores left behind after exfoliating.

Sulfur helps regulate the shedding of the top layer and also works as a drying agent.   You may experience dryness but, in my case, it has worked like a charm.

My sulfur wash came with a prescription of 4% sulfur.

There are also sulfur masks and spot treatments to help combat acne. Here are some products containing sulfur available without a prescription. 

Although I’ve seen major improvements in texture and tone using my vitamin C and ferulic acid serums, I’m still not at a place where I am satisfied. As you can see in the after pictures, although the acne is gone for the most part, I’m left with hyperpigmentation.

I’ve been researching a few products to diminish the brown spots and can’t wait to update you on the results.

I hope that writing about my latest skincare fight to combat stubborn, hormonal, adult acne gives you an alternative to whatever you’ve been using. Maybe it will work, maybe not.

I know I’ve had my share of failed experiments with different acne-fighting products, but I’m happy to report that this has worked for me.

Another treatment that has also helped with diminishing dark spots and scars is microneedling. You can read more about my experience here.

Again, I want to make sure you consult with your dermatologists before trying out these medications or any other skincare routine. And if you do see results, please let me know! I’d love to hear about it.

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