The only thing worse than a stressed-out bride is a stressed-out, HORMONAL bride

August 17, 2011 12:29 PM

My skin is exploding with hormonal rage... and I'm getting married in 3.5 weeks. Help?

I have very pale, very sensitive skin. Ever since I went off of hormonal birth control, my skin has gotten awful, especially right around my period. As luck would have it, I seem to be expecting my period right on my wedding day.

After trying various things recommended here and elsewhere (benzoyl peroxide, clean pillowcases, Zeno, etc.) I went to the dermatologist, who prescribed clindamycin and Differin, both in lotion form. I did the clindamycin for about a month before even trying to add the Differin, and as soon as I did my skin went bright red and scaly for about a week. I haven't used anything since, aside from washing my face in the shower with Cetaphil.

So I called my OB/GYN, asking if I could go on a pill (even for just a few months...) and they said no because my triglycerides are high. I've had an IUD, which was perfect, but it expelled twice so I don't think that's an option again. So that leaves me with Nuvaring, which I'm hesitant to try, and from what I've heard won't really do much.

My visible acne is mostly big bumps around the jawline and red, slightly rough cheeks that get dry and flaky if you so much as look at them. It could be rosacea or KP; the dermatologist said that I have KP on my arms.

Any other ideas? Can I get a second opinion or some other treatment to make sure I'm okay for the big day? Do I even have time?

posted by Madamina to health & fitness (37 answers total)

IANAD, but I've used Nuva Ring and it has helped my skin as much as the Pill did -- there is a visible difference in the quality of my skin when I am on it.

I am also, for what it's worth, allergic to Cetaphil -- it makes me red and rough. I know it's supposed to be the most gentle thing ever, but my skin really hates it.
posted by Countess Sandwich at 12:33 PM on August 17, 2011

The Differin made my skin terrible and just *hurt* for two weeks and then it became clear almost immediately after. Six months later I was off both topical medications completely and it's still pretty clear (except for the occasional one or two that still pop up right around my period). I no longer use any special medicated facewash, which is nice.

If you've got 3.5 weeks I'd go back on the Differin and clindamycin, wash your face with regular soap instead of the Cetaphil, and moisturize like crazy. You will be red and scaly for a couple of weeks but it does get so so much better!
posted by olinerd at 12:38 PM on August 17, 2011

Rubbing alcohol works well in the immediate short term, if you're still stuck. (It's horrible over the long term, as it sends your pores into overdrive.)
posted by Capt. Renault at 12:38 PM on August 17, 2011

Same thing happened to me once I went off the pill. There are hormones present that calm breakouts, and I've had friends go on the pill just to clear up acne. Going off the pill means everything goes into high gear again, and leads to breakouts. Stress doesn't help either, it leads to a rise in the chemicals that give you pimples and blackheads.

A few things that could help:

1) No makeup. At the very least, no more foundation or cover-up. Eyeliner, mascara, and eyeshadow will be fine, but reduce the amount of stuff you put on your face. It helps keeps your pores clear of blockages.

2) Wash your face every night before bed with a gentle, oil-free cleanser specifically for removing makeup and/or cleaning pores. Neutrogena has a lotion cleanser that is wonderful for this.

3) I've started using Oxy pads once in the evening and once in the morning, and it has drastically reduced breakouts. It works wonders! Follow the directions on it (ie, don't wash your face after giving your face a wipe-down, don't use other anti-acne medicated washes in conjunction), and hopefully that will work.

4) Meditation. Stress could be a big component in this as well, and calming down a little will help. Meditation's not for everybody, but anything you can do that you feel makes you calmer and works stress out of your system would be good.
posted by dustpatterns at 12:39 PM on August 17, 2011 [1 favorite]

My experience was the same as Olinerd. The redness and flakes get better about ten days out. Use cetaphil gentle cleanser (not the facial one - it's more drying) and make sure you're using a gentle moisturizer. (like the cetaphil one, too.)

Also, I thought the flakiness was slightly helped by three fish oil capsules a day, but with two caveats: 1) could totally be placebo affect 2) check about your cardio/triglyeride issues.

Good luck.
posted by mercredi at 12:42 PM on August 17, 2011

On preview - if you go the clidamycin/differin route, do not use any other topical products like oxy pads or benz. peroxide.
posted by mercredi at 12:43 PM on August 17, 2011

I'd find another doctor, call Planned Parenthood, or INSIST that you want a scrip for several months only ... you can also keep taking them (no skipping or sugar pills) to avoid menstruating on your wedding day/honeymoon. For cleansers, I swear by Philosophy's Purity. Good luck.
posted by cyndigo at 12:43 PM on August 17, 2011 [2 favorites]

Myabe you could ask your doctor for minocycline (antiobiotic). I've never had anything that worked as well as this. It's been a miracle for me.
posted by la petite marie at 12:44 PM on August 17, 2011

they said no because my triglycerides are high

You only need to be on it for a month, right? Get a second opinion.
posted by Dasein at 12:48 PM on August 17, 2011

When I was in a wedding a couple of years ago, I asked my dermo. for a month Rx for the antibiotic doxycycline (which I was prescribed to when I was younger for cystic acne). Face cleared up in about a week. I stayed on it for a month or so. i plan to due the same for another wedding coming in October.

i personally never had any problems with long-term antibiotic use but stopped using it once I was on birth control pills.

Also, I've been given direct shots for huge cyst pimples so that they went away quickly. I don't remember what type of drug it was.
posted by KogeLiz at 12:48 PM on August 17, 2011 [3 favorites]

some dermatologists will give you injections of corticosteroids directly into large pimples before big events. might be worth asking...
posted by genmonster at 12:55 PM on August 17, 2011 [1 favorite]

So I called my OB/GYN, asking if I could go on a pill (even for just a few months...) and they said no

If it makes you feel any better, the pill might not help anyway. My skin went nuts when I went off the pill (I stayed off it for about 6 months). I've been back on it now for 6 months (the same amount of time I was off it) and my skin has never recovered. It's still the same as it was when I stopped taking the pill.
posted by amro at 12:57 PM on August 17, 2011

This is a very difficult problem and I think only your dermatologist can help you with it. My sympathies.

One tip I can give you, though, is that you need to introduce the Differin gradually. I started by using it one night a week for a month; then every sixth night, and so on.

Another thing I do is that I apply Cetaphil Daily Advance Ultra Hydrating lotion after washing and leave it for 15 minutes before applying the Differin. This makes a really big difference.

Any treatment you apply to your skin needs to be left for 30 minutes or you risk just wiping it off. No-one will tell you this, but when I got this tip, the difference it made was incredible.

You might also want to try switching to 2.5% benzoyl peroxide (you can find it, though it's difficult) and use it both in the morning and at night. This would mean putting the Differin aside for a bit, but tbh I don't think Differin even works for acne; I only use it for beautification and boy does it work in that capacity. If you use benzoyl peroxide you will definitely want to use the moisturizer for 15 minutes before you apply it, and as soon as your 30 minutes are up after applying it. This will be very, very time-consuming. However, benzoyl peroxide tends to be underrated and once you figure out how to use it well it can be your loyal friend.

Other thoughts: washing with Cetaphil, yes, and I wouldn't be without the stuff. At the end of the day, though, you might want to try washing *twice*, and then refilling the basin a *third* time for just a rinse. Again, this is something that I've learned from personal experience made an enormous difference. The first wash got the makeup off, the second got me clean, and the third removed the last traces. So yeah, maybe try this.

And another thing that made a dramatic difference to me was washing with 2% salicylic acid wash. This comes mostly from two companies: Garnier and Neutrogena. I found that the breakouts stopped with Garnier and came back with Neutrogena, so, YMMV. But, splash on, leave for 2 minutes while you brush your teeth, then rinse off. Morning and evening.

So, in short, here's what I suggest:

1. Morning step 1: Garnier 2% salicylic acid wash, as per instructions.
2. Morning step 2: Cetaphil Ultra Hydrating Lotion, left on for 15 minutes.
3. Morning step 3: PanOxyl 2.5, left on for 30 minutes.
4. Morning step 4: Cetaphil Ultra Hydrating Lotion, left on for 10 minutes.
5. Morning step 5: your sunscreen, and watch out to make sure it's not making you break out. Leave on for at least 10 minutes if it's a chemical sunscreen.

You will have to get up astronomically early. Sorry about that.

6. Evening: wash 2x with Cetaphil, then a final rinse.
7. Repeat morning steps 1-4.

It may be that bcp is fundamental to your treatment, in which case, the cystic acne will only keep getting worse. But see if this helps.
posted by tel3path at 1:07 PM on August 17, 2011 [1 favorite]

I was prone to acne along my chin and jawline, particularly around my period. I found that taking a B-Complex supplement daily cleared this up. (This is without being on hormonal BC.)
posted by unannihilated at 1:15 PM on August 17, 2011 [1 favorite]

The machine that's used for electrolysis can also be used for getting rid of cystic acne and blackheads. It's quite impressive and might work for a short term solution. Just find a good experienced practitioner.
posted by Salamandrous at 1:16 PM on August 17, 2011

Hormonal acne can often be helped by spironolactone. Unfortunately, it may not work in the timeframe you've got...
posted by elsietheeel at 1:17 PM on August 17, 2011 [1 favorite]

My skin went haywire with hormonal acne before my wedding because I had the poor judgment to start a new HBC pill that same month. The acne was along my jawline and around my mouth. And I too have very pale, sensitive skin although it leans more towards "shiny and oily" instead of red and flaking.

I ponied up some money ($80) and went to a highly recommended esthetician who gave me a facial and did a LOT of extractions, getting all the crud out of my pores. This was about five days before the wedding, to give my skin time to calm down (but not enough time so the acne could flare up again). She gave me strict skincare instructions and samples of products to use until my wedding day. She was also my wedding makeup artist, so she said she could do a last minute day-of extraction if I got any more huge blemishes.

Honestly, it was worth it. My skin was flawless for my wedding and honeymoon, which is what I wanted. YMMV.
posted by castlebravo at 1:31 PM on August 17, 2011

Especially because your skin is irritated and flaky right now - I would recommend trying Pond's cold cream. It's been recommended elsewhere in AskMeFi as an easier alternative to the oil cleansing method. Instead of washing with your usual cleanser, you put the cream on and remove gently with a warm cloth. My skin has been crap since I got an UID and I stopped using moisturizer completely because it was so, so oily. But I bought some Ponds for the hell of it on a road trip because I was feeling really dry. I never expected this, never in a million years, but my acne was reduced by about 85%! Give it 5 days to a week. If you're not willing to use it to wash, just try it as a moisturizer. That's how I started out. It it doesn't work, you've only lost a week, and at least you won't be flaky anymore.
posted by kitcat at 2:10 PM on August 17, 2011

NO ALCOHOL!!!! NO HYDROGEN PEROXIDE!!! You are stripping your skin of it's natural oils which makes it go haywire!!! Google the Oil Cleansing Method!!! My skin is sensitive, acne prone and that was and is the BEST thing I ever did!!! A gentle steam clean, jojoba and castor oil. Any change in skin care will cause a temporary flare up but 3 weeks is PLENTY of time to get things under control with the OCM. It has changed my life....and I have my 11 yr old doing it. Congrats on the wedding!! You'll be radiant and beautiful regardless!!
posted by pearlybob at 2:10 PM on August 17, 2011

Seconding elsietheeel: My dermatologist prescribed me generic Spironolactone about 2 months before my wedding last year, and the only place I had really terrible acne was on my back, chest, shoulders and jawline.

They were huge, cystic pimples that wouldn't go away completely even with corticosteroid injections. I used to spend hundreds of dollars on various creams and cleansers, treatments and what-have-you - and since I've been taking this medication, I've stopped all that completely.

My skin on my whole body looks like a baby's, and it cleared up 100% about 3 weeks after I starting taking it.

Maybe you've still got time to try it? Good luck, and congrats!!!!
posted by Unicorn on the cob at 2:24 PM on August 17, 2011

I don't have much experience with hormonal acne, so I have no idea if going on the NuvaRing would help you with that, and likely all the dermatological-type suggestions here will be more effective. But if you think adding hormones back into the mix might help, what are your hesitations about the NuvaRing? I love-love-love-love-loved being on the NuvaRing and I'd be happy to answer any and all questions about it.
posted by ootandaboot at 2:24 PM on August 17, 2011

I don't know if it would work in time, but I can tell you that since I quit eating dairy, my skin is perfect, and this after a lifetime of adult acne. It has been absolutely mind-blowing. I don't use any sort of product anymore and some days don't even wash my face. My acne was noticeably hormonal, so I'm guessing that the hormones in commercial dairy were what caused my problems.
posted by something something at 2:36 PM on August 17, 2011

I swore by cetaphil until I tried Gamila - I mocked the hefty price tag ($34US for a bar OMG) but it's been fab. Worth it.

Also, Nuvaring did better for my skinwise than the pill - I've never had serious breakouts but between the nuva ring & the gamila soap, even my "period pimples" have gone away.
posted by pointystick at 2:47 PM on August 17, 2011

When I stopped taking the pill, the same thing happened to me. Nothing helped except going back on the pill. I did use Nuvaring for a year and didn't notice any skin issues, so that may be worth a try. Or get a second opinion and go back on the pill.
posted by thejanna at 2:51 PM on August 17, 2011

IANYD but have you ever tried taking an anti-inflammatory? I also deal with similar hormonal acne for about a week before my period and my doctor suggested popping Aleve (naproxen sodium) twice a day with meals for a few days leading up to the usual "danger time" could greatly reduce the flareups. Acne is a type of inflammation of the skin, so the logic behind using an anti-inflammatory makes sense. I definitely see an improvement when I remember to take the pills!

There was a discussion of aleve and premenstrual acne (including reference to research) over at the acne.org which explains more.
posted by elkerette at 3:09 PM on August 17, 2011 [1 favorite]

This doesn't really help you hormones, but consider hiring a makeup artist for the wedding day. A professional will be able to minimize any blemishes and will have foundations and concealers that are meant to stay put the whole day. You can also ask for a touch-up kit with a little extra concealer to freshen up before the reception.

No matter what, just remember that your fiancee will not notice or care if you have a little acne. And your photos will be retouched so its really no big deal. I was freaking out about a brand new zit the day of my wedding, but the makeup covered it mostly and it wasn't visible on the final pictures, so no one will ever remember or care.
posted by halseyaa at 3:19 PM on August 17, 2011 [1 favorite]

Everyone's skin is sensitive in its own special way, but I was surprised to learn recently that Cetaphil is nowhere near the super-gentle wonder everyone says it is. Since that's all you're using and your skin is still acting up, I'd start experimenting with other options.

For what it's worth, Paula's Choice Skin Recovery cleanser and moisturizer are my go-to products whenever my skin gets weird and they haven't failed me yet. I also really like the standard fragrance-free liquid Neutrogena for daily use, and I'll second whoever recommended Philosophy's Purity up above (it does a better job than anything else I've used at getting every last bit of makeup off in one go).
posted by ella wren at 3:44 PM on August 17, 2011

Beware the spironolactone - in my opinion that drug is the devil. I've got a medical condition for which spiro is the frontline drug of choice, and I've tried it twice in my lifetime, each time with these disastrous results: nonstop neverending menstruation, horrible breast pain, and, pardoxically, increased acne and much oilier skin. Spiro has an anti-androgenic effect (which helps acne for some) and as a result, it messes with estrogen. Big time. My most recent go-round with this drug lasted three bloody (pun intended) weeks, and even after discontinuing it the bleeding and pain continued for 4 more weeks.

I've also got acne that is best helped by hormonal BC, which I can't take, but the next best thing has been prescription Benzaclin. It irritated my skin a little the first few times I used it, but my skin adjusted really fast and I've been using it for years with no ill effects.
posted by chez shoes at 3:46 PM on August 17, 2011

I don't think even if you could get back on the BC at this point you'd have enough time to dramatically improve your skin.

Aesthetician! You need a great aesthetician! I didn't understand what facials were until I got one, but they've dramatically improved my skin. Basically what they do is dig out all the junk that causes your big red bumps. A great one may also help with products for your red cheeks. (I've never heard of KP on your face, by the way. Did the derm suggest that?) I think that a really good aesthetician (maybe find one attached to a dermatologists' office? That's where mine is) could help you in your timeframe.

You've got no time to experiment with new products/oil-cleansing. In fact, I don't think you have time to establish a routine with the Differin. (I had good results with topical Clindamycin and found it to be nonirritating, but obviously ymmv.) But right now, you need a professional. You do have time to scour Yelp and find an aesthetician and beg them to fit you in (maybe twice) between now and wedding day. You'll drop probably $100 on each facial, but I think that's the best you can do between now and then.

Good luck, and congrats!
posted by purpleclover at 4:06 PM on August 17, 2011

If you can seriously, completely restrict your intake of sugar and milk, it can have a really good effect on acne. Acne = infection, and less sugar in your bloodstream gives the bacteria less food. Really.

Also, are you on any kind of internally-taken antibiotics? Even for hormonal acne, I think they might help (but ask the dermatologist who'd likely have to prescribe them anyway).
posted by amtho at 4:20 PM on August 17, 2011 [1 favorite]

I listened to a super interesting npr segment the other morning on home remedies. The two guests discussed the effectiveness of milk of magnesia (the same as the laxative) in clearing up acne, which I'd never heard before. Could be worth a try... Since using accutane as a teen, my skin has been pretty clear, but I'm curious if it works.
posted by shrimpsmalls at 6:15 PM on August 17, 2011

I had cystic acne and terribly sensitive skin for 20 years. The only thing that finally cleared it was Vitamin D. I took about 10,000 IU per day, and it started being less angry within a week. I kept that up for several months and my skin was amazing. I then went down to 2,000 IU per day. For anybody who wants to say 10,000 IU per day is too much, I can only say to READ, READ, READ. If you can, get a Vitamin D test to check if your levels are low. Vitamin D is cheap and readily available.

A couple other suggestions: ditch the Cetaphil, I love Cerave products. I damaged my skin barrier with Retin A. The Cerave cleanser and lotion did not break me out at all, and really almost any lotion used to break me out. They were incredibly soothing. You should be able to find this line at any drug store.

Paula's Choice has some great options, although I'm not sure you would get the product in time (mail order). I love her 2% bha liquid. Maybe start out with 1% and see how it goes.

I hope you have a fabulous wedding~ best wishes!!!
posted by icanbreathe at 7:25 PM on August 17, 2011

What works for me is drinking a lot of water and staying away from caffiene and (especially) Pantene.
posted by 4ster at 7:31 PM on August 17, 2011

I'm not a celebrity endorser, but me and my three teenage kids have all been using ProActiv for years. We see results within about a week and we all have good skin.
posted by kinetic at 2:07 AM on August 18, 2011

Acne.org's regimen is the only thing that has ever helped my skin. It might be worth a try (and it's not very expensive).
posted by getawaysticks at 6:34 AM on August 18, 2011

Go back to your dermatologist and tell them your skin needs to be clear for your wedding and ask what short term fixes they can give you. Also look into a makeup artist that does the airbrush makeup. Ive seen amazing results.

Also consider getting a little sun. Don't get burned, but it always clears up my skin fast.
posted by whoaali at 6:51 AM on August 18, 2011

Not that you necessarily want to try this, but egg whites usually get fast results...there are pre-made masks out there, or you could make your own.

(I am also of very, very pale and sensitive skin --- I've found using only water to clean my face during breakouts works well to clear up acne, too. If I use anything beyond water and the occasional mild soap, my acne gets worse. If I use just water, it clears up within a week. Take that FWIW.)
posted by zizzle at 7:16 AM on August 18, 2011