In my 30s and crying over acne that just won't go away
VentI'm in my mid 30s and I still get random surges of acne. They're never small. They're huge, and then I'm left with dark marks that take forever to fade. Sometimes I look at myself in the mirror and just want to cry my eyes out.
I went to a dermatologist and she barely spent any time with me. She quickly put me on a high dose of spironolactone, which was a nightmare. I was on my period for two months straight and felt like I was going crazy. Then she tried the lowest strength tretinoin, but my face couldn't tolerate it no matter how slowly I went.
I stopped seeing her and started playing around with over the counter actives and laser treatments, which was probably a mistake. Now my skin barrier is wrecked, so I'm back to cleanser, moisturizer and sunblock.
I drink tons of water, I try to eat healthy, I try to be physically healthy. I wash my face at night with lukewarm water. I wear sunblock every day. What else should I even be doing?
My skin is oily and acne prone. I have an appointment with a different dermatologist this month, but I don't know how that will go. I'm losing hope and just feel like crying.
Edit, a month later: the new dermatologist put me on an antibiotic for 8 weeks at most, and a prescription gel with three actives in it for nighttime. Will update then.
Edit, April: I forgot to update at 8 weeks, but my skin feels amazing. I came off the antibiotic at 8 weeks, stayed on the gel and added a BHA exfoliant. My skin has gotten so much better. I still break out, but the spots are tiny and go away almost immediately. My dark spots are slowly fading and my texture feels great. There's still some work to do, but I feel really good.
Some really good advice has been shared already, but I didn't want to just pass by. The issues you're having in your 30s are incredibly common. I see this so often, so you are not alone. Big painful breakouts, irritation from past treatments and the emotional exhaustion that comes with it are absolutely fixable. You just need to find out what works for you.
Because you've been through harsh actives, lasers and a bad spironolactone experience, the most important thing right now is a full reset: a gentle cleanser once at night, a non-comedogenic ceramide moisturizer morning and night, and daily sunscreen so the marks don't get darker. Avoid peels, acids, retinoids and lasers until your skin no longer stings or feels tight.
After 2 to 4 weeks of barrier repair, you could bring in something far gentler than tretinoin, like azelaic acid, every other night at first.
At your new appointment, be clear and firm about your history, and tell them how much this affects you emotionally. You are not doing anything wrong. Your skin simply needs a calmer, more tailored approach, and that is entirely achievable.
Thank you for this. This was incredibly helpful.
See your primary care doctor for a referral to an OB-GYN and endocrinology. Dermatology doesn't treat hormones. My acne finally disappeared when an endocrinologist diagnosed me properly and got me on the right meds. For me it was PCOS and perimenopause.
It's incredible. I've never had non-oily skin in my life. I can shop for any makeup I like. I don't sweat in my sleep and wake up like I ran a marathon all night.
I'm so sorry you're dealing with this. I'm in my late 30s and I understand how frustrating it can be. Can you list the exact products you're using? I'm not a dermatologist, but I'm way too familiar with which ingredients cause breakouts in acne prone people, so I can look at the ingredient lists and see if I can help.
My dermatologist tried to put me on a high dose of spironolactone and it made me sick, so I stayed on a low dose, and for the last 2 months I haven't had any breakouts at all.
I also know I have triggers and I avoid them, like dairy, chocolate and processed foods such as sodas and chips. I went for a facial this weekend and the beautician said my skin was glowing and very clean.
Have you tried azelaic acid? I can't tolerate tretinoin either. I've been using a 10% one and it's been helping. A sulphur mask helps too. I have sensitive skin and I'm 36.
I'm in my 30s and I had lots of bad cystic acne. My dermatologist gave me a 10% benzoyl peroxide wash and it cleared it up in about a month.
I'm sorry your acne is giving you such a hard time. Keep working on healing your skin barrier, maybe with moisturizers made for that. Slowly bringing in a gentle retinoid or azelaic acid might help with the acne and the dark marks. Best of luck.
I was in the same boat as you. The pill sorted me out.
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