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- I’ve been diagnosed with polycystic ovary syndrome – and its cystic acne sidekick – for almost a decade now. As many as 75% of women with PCOS remain undiagnosed, and like me, have to find ways to treat their acne without medication.
- I’ve spent a lot of time testing out all kinds of topical treatments for cystic acne that comes with PCOS because the hormonal disorder can create too much androgen in the body, increasing oil production in the skin and leading to acne.
- Ever since I spotted my first painful and unpoppable zit along my jawline, I’ve been curating my own routine of products designed to target acne-causing bacteria and oil production. These are the six I use nightly.
Even though I’ve had polycystic ovary syndrome and its cystic acne sidekick by my side for 10 years, I wasn’t diagnosed with the hormonal syndrome or able to gain control over my cystic acne until recently.
After nearly a decade of testing out what felt like every product on the market from high-end to drugstore and boutique brands, and even had a brief tryst with DIY skin care, I’ve finally curated a nighttime skin-care routine that kept my PCOS-inflicted acne at bay without additional medication.
To be clear, the fastest fix for any type of hormonal acne is actually medication prescribed by a doctor, and anyone who has questions or concerns about their own skin condition should talk to their doctor first – especially if they think they might have PCOS. But 75% of women, according to the International Journal of Environmental Research and Public Health, have undiagnosed PCOS, so you might not even know the root of your acne. I was personally dealing with cystic acne for years, but wasn’t diagnosed with PCOS until recently.
Unlike normal acne, the cystic kind is much more severe and painful – and in my experience, takes forever to heal. “Adult and teenage acne are both caused by the same elements including increased sebum production, acne-causing bacteria, and slow cell-turnover peppered with underlying inflammation,” says Dr. Shereene Idriss, board-certified dermatologist.
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Instead of choosing products that are specifically marketed as acne-fighting or based on your skin type, I’ve found greater success in products with simple, but powerful ingredients that gently fight acne-causing bacteria and encourage the turnover of new skin cells. “I tell patients to wipe their slate clean and simplify their skin-care routine. Less is more when you’re trying to control an active breakout,” says Dr. Idriss.
Ever since I spotted the first painful and unpoppable zit along my jawline, I’ve been curating my own routine of products designed to target acne-causing bacteria and oil production. Six steps might sound like a lot for a nighttime routine – especially when you just want to go to bed – but each of these has a specific purpose and visibly improved my acne-ridden skin.
Here are the six products in my nighttime skin care routine that kept my hormonal, PCOS-induced acne in check:
A charcoal-based cleansing balm to remove makeup and oil
Boscia Charcoal MakeUp Melter, available at Dermstore for $ 32
Lots of makeup-removing balms have the bad reputation of smudging makeup around the face rather than actually clearing it off. But true to its name, this balm is a legit cleanser and melts off every bit of makeup off your face. Not only does it easily remove layers of waterproof mascara, it does so without drying my skin out.
The titular ingredient – charcoal – is what gives the balm its dark gray color, but I think the sunflower oil is the true star. And though some people with acne run at the word “oil,” this one is primed with acne-killing bacteria, according to Dr. Idriss. “It’s also non-greasy and is easily absorbed by your skin so it won’t clog you up.”
A cleansing gel with acids that exfoliate and help increase cell turnover
Peter Thomas Roth Anti-Aging Cleansing Gel, available at Sephora for $ 38
Yes, it’s marketed as an anti-aging cleanser, but the combination of glycolic and salicylic acids in this gel clear out the oil from pores while gently exfoliating the surface of your skin, and glycolic acid also supports the growth of new skin cells.
I use this in my nightly double-cleansing routine after the Boscia cleanser, as well as in the daytime before I put on other skin-care or makeup products too, because it cleans my skin gently without making it too dry or sensitive. Plus, the acids help exfoliate dead, dry, or flaky skin so the products I put on afterwards can penetrate deeper into my pores and sit smoother on my skin.
Admittedly, $ 38 may sound like a lot for a cleanser, but the 8.5 oz bottle has lasted me quite a while. I’m only just now getting ready to buy my second bottle and I’ve been using it for more than a year and a half.
A cult-favorite rose water toner in a convenient mist to soothe skin
Thayers Natural Remedies Alcohol-Free Rose Petal Witch Hazel Facial Mist Toner, available on Amazon for $ 9.19
This is the same formula as the cult-favorite Thayers Witch Hazel Toner, but in mist form. “Witch hazel is loaded with antioxidants and anti-inflammatories to help soothe inflamed skin,” says Dr. Idriss.
I’m Indian, so rose water was often used in my grandmother’s all-natural remedies and this one brings back a lot of memories.
I’ve definitely seen a difference in my skin after using this, and like the Peter Thomas Roth cleanser, I also use this during the day. If I’m going out for a morning workout, I’ll just spray this on my face before heading out and come back to do my entire morning routine later.
The combination of witch hazel, aloe leaf juice, and rose water are perfect for calming down my inflamed, red acne. I’ve also noticed that it helps decrease puffiness under the eyes. I spray this very generously all over my face, because the smell alone is heavenly.
A powerful retinol to increase cell turnover
Peter Thomas Roth 3% Retinoid Plus, available at Sephora for $ 82
Unlike previous products in my nighttime routine, this one really is strictly for p.m. use due to its high retinol percentage, which makes skin sensitive to sun.
When my acne was at its worst, I remember waking up in fear to a whole new set of pimples scattered across my face. Once I started using this product, the amount that happened went down significantly – almost immediately.
I had heard a lot about the magic of retinoids, but this was the first one I used that didn’t irritate my skin, likely due to the gentle lactic acid. Retinoids help increase skin cell turnover, so not only was my skin feeling more plump in general, but the new skin that was being produced was clear of acne. Plus, the scarring I had from previous breakouts wasn’t nearly as severe as it used to be before I began using this.
After my acne cleared up, I continued using this to clear up the pigmentation on my skin and it worked really well.
A prescription-level acne treatment but without the prescription
Differin Adapalene Gel .1% Acne Treatment, available on Amazon for $ 12.88
This gel used to be available only by prescription because it’s that powerful, but it’s available at beauty aisles now without one. My doctor first prescribed it to me when I was 13 but I promptly stopped using it when my skin became flaky and red almost overnight. I picked it back up at a drugstore a couple of years ago, armed with the knowledge I have now to balance out its drying ingredients.
The Peter Thomas Roth cleanser got rid of a lot of the acne I had on my cheeks and the smaller pimples I had on my chin and jawline, but incorporating this gel afterward is when I saw the biggest decrease in the large, painful, cystic acne that I had on my jawline.
According to Dr. Idriss, the Rx-strength retinol in this, known as adapalene, unclogs pores and prevents breakouts, but it’s really strong, so be careful not to use it if you’re trying to get pregnant.
It was extremely effective with the worst kind of acne, but I personally had to pair it with a very thick, moisturizing night cream – which acts as the perfect segue to my next point.
A thick nourishing night cream
Goop Replenishing Night Cream, available at Net-a-Porter for $ 140
Every product before this was designed to penetrate the deepest layers of my pores, clean them out, and then generate new skin cells. So as not to irritate my skin, I knew I needed something to counterbalance with extra-soothing ingredients.
Most of the items in this nutrient-packed moisturizer from Goop are recognizable to me, like aloe leaf juice, shea butter, olive and avocado oils, and hyaluronic acid. The cream is designed to soothe and nourish skin, and worked its magic on mine.
Anyone with acne knows it isn’t just about the painful pimples – it’s irritated skin and redness too. When I started using this, I woke up to no redness whatsoever, and makeup and concealer were easier to apply and more effective during the day.
The price tag is a lot, but I’ve used this for a year and haven’t come close to running out. I’ve also yet to find another nourishing night cream on the market with such recognizable ingredients and powerful results.