Another source of hormonal changes: stress. Whether you work full time, are a full-time mom, or juggle both, chances are, your stress levels are high. "When you're stressed, you have an organ called the adrenal gland that makes the stress hormone cortisol, and puts it out into the body to help the body deal with stress," Dr. Schultz explains. Unfortunately, a tiny bit of testosterone leaks out with it. For a woman, this male hormone can drive the oil glands to produce more oil—the root cause of breakouts. (Thanks a lot, hormones!)
Oral contraceptives: Oral contraceptives (birth control pills), which are low in estrogen to promote safety, have little effect on acne one way or the other. Some contraceptive pills have been shown to have modest effectiveness in treating acne. Those that have been U.S. FDA approved for treating acne are Estrostep, Ortho Tri-Cyclen, and Yaz. Most dermatologists work together with primary care physicians or gynecologists when recommending these medications.
There are many treatments for mild acne. Mild acne can consist of whiteheads, blackheads and small pustules. At home, you can wash your face twice per day with warm water and a gentle cleanser or soap. Your doctor may suggest you also try an over-the-counter lotion or cream. These medicines may make your skin dry if you use them too much. Be sure to follow the directions.
There’s no quick fix for acne. Medicines don't work overnight. Many treatments take weeks of daily use before your skin improves. Some acne may take up to 6 months to clear up. Afterward, basic skin care -- bathing daily and washing your face and hands with mild soap -- may not be enough. You may need to keep using your medicine even when your skin clears. Follow your doctor’s directions. Don’t use too much or too little.
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Sometimes, your gynecologist can share insight into your acne, especially when it comes to deciding if birth control could help your breakouts. The FDA approves of Estrostep, Ortho Tri-Cyclen and Yaz to combat acne, but the trick is to be patient, as it can take up to four months to start seeing results. "This plan of attack works best when paired with whatever topical treatments you’re already using to treat your acne, like Proactiv, benzoyl peroxide, salicylic acid, etc," advises dermatologist Dr. Elizabeth Tanzi.
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Make sandalwood paste. Sandalwood is known for its skin healing properties, and is easy to prepare at home. Just mix one tablespoon of sandalwood powder with a few drops of rosewater or milk to form a paste. Apply this paste to the affected area and leave it on for at least 30 minutes before rinsing. Repeat this process daily until your scars have vanished.
Steroids have long been known to cause acne. These drugs are generally taken without a prescription in order to gain muscle, but there are instances in which women are prescribed steroids for rare conditions. Steroids cause hormonal changes, and as the androgen hormones increase, so too does oil production. The more sebum, the greater chance of clogged pores. Steroids might also accelerate the growth of P. acnes, which can make pimples and inflammation worse.
Dermal fillers: "Certain scars can be filled with a substance that elevates the depressed areas, like hyaluronic acid. This can make the surface of the skin more even and get rid of shadows," says Dr. Bowe. Until recently, fillers weren't a lasting solution. But now, if you're over 21 years old, Bellafill is the first FDA-approved dermal filler designed for permanently correcting moderate to severely dented acne scars. Unlike other fillers, it contains two different ingredients to help improve acne scarring. "It's 20% polymethylmethacrylate (PMMA), which helps your body make more protein to allow itself to heal," says Dr. Shah. "PMMA are tiny balls that sort of act as a scaffolding. Most fillers degrade over time, but since PMMA cannot be absorbed into the body, this offers a permanent result," she says. The other 80% is collagen. The procedure takes about 20-30 minutes, and while you may need a touchup a couple months later, some people just need the single treatment, says Dr. Shah.
It starts out as a powder (a blend of raw cacao, bamboo charcoal, soil nutrients, and spices), only releasing its potent healing elements when mixed with water. The resulting mousse heals blemishes, fights inflammation, encourages circulation, and visibly tightens pores pretty much instantly. Use Lindstrom’s facial treatment bowl and brush to mix the paste.
The redness in rosacea, often aggravated by flushing, may cause small blood vessels in the face to enlarge (dilate) permanently and become more visible through the skin, appearing like tiny red lines (called telangiectasias). Continual or repeated episodes of flushing and blushing may promote inflammation, causing small red bumps, or papules, that often resemble teenage acne. Acne rosacea and adult acne are other names for rosacea. One of the most unpleasant aspects of rosacea is the overgrowth of dermal tissues producing a "phymatous" change in the skin. This appears as a thickening and permanent swelling of the facial tissues. A bulbous nose called rhinophyma is an example of this change.
Sun exposure is a well-known flare for many rosacea sufferers. Sun protection using a wide-brimmed hat (at least 6 inches) and physical sunscreens (like zinc or titanium) are generally encouraged. Because rosacea tends to occur in mostly fair-skinned adults, physicians recommend the use of an appropriate daily SPF 50 sunscreen lotion, along with overall sun avoidance.
Treatment of acne scars: For those patients whose acne has gone away but left them with permanent scarring, several options are available. These include surgical procedures to elevate deep, depressed acne scars and laser resurfacing to smooth out shallow acne scars. Newer forms of laser resurfacing ("fractional resurfacing") are less invasive and heal faster than older methods, although results are less complete and the procedures may need to be repeated three or more times. These treatments can help, but they are never completely successful at eliminating acne scars.