I wish my acne story ended there, but it didn’t. I was later diagnosed with a condition called polycystic ovarian syndrome (or PCOS), which itself is a cause of acne and oily skin, and it returned in my twenties. I’m now 40–and a dermatologist–and since then I’ve had intermittent treatments for it when I need it. Now, understand that acne is, for me, a chronic condition which waxes and wanes over time. There isn’t going to ever be a “cure.”
When I started my medical training, I realized I could empathize with patients having problems with their skin. Now, my aim is to catch acne before it creates long-term physical damage in the form of scarring, or psychological damage due to deteriorating mental health. I don’t want my clients to do what I did and waste time and hard-earned money on products which won’t work if acne is deep or inflammatory.
What have I learned? Keep things simple. I know it has become popular to use multiple products in the morning and evening, but I am really fussy about what I put on my skin. Less is more and it’s important to stick to gentle cleansers and moisturizers but to use a prescription acne treatment which is a mixture of vitamin A (retinoid) and benzoyl peroxide every night. There is no doubt that for those with mild acne or congestion, using products containing salicylic acid, as well as the above, can be helpful.
Chemical peels can be excellent at improving skin tone and shifting pigmentation, while laser has been fantastic at removing my own indented or atrophic acne scarring. I still have some on my left cheek, but it no longer bothers me so I’ve stopped treating it further. As I’ve gotten older there are also a number of antiaging treatments I like, which includes the occasional injectable–Botox or fillers–as well as skin tightening of the lower face with high-intensity frequency ultrasound. Often in the press we tend to see the horror stories, but when these treatments are done well, no one should be able to tell you have had them done.
Like so many others, I have also tried the standard stuff like cutting out dairy and reducing my sugar intake. It made no difference for me and my acne, and my diet is now fully inclusive and I don’t restrict myself–I simply eat what I want.
I still suffer with break outs and suspect this will continue to be the case over the coming years. With many chronic conditions, there is a constant threat of things worsening, even when things seem to be going well and are under control. But getting older has been helpful. I simply recognize that my skin is a very small part of who I am and what I can achieve.
My advice to those struggling with acne is to speak directly to your GP, or arrange to see a consultant dermatologist. It can be easy to spend time and money on skincare which may not work and it is better to get professional advice early. No one should have to suffer or despair because of their skin, and it is not up to anyone else to underestimate how you feel or how it affects you.