I work in beauty, I have for years, and I don’t have clear skin. This, despite having access to the country’s best derms and the most cutting-edge treatments. And the fact that I’m no longer 16. Like, I’m a grown-up, an adulting-for-real grown-up…with pimples. Which goes to show that acne is like that one frenemy who just keeps popping back into your life: You hate her but can’t seem to lose her, so you have to keep finding new ways to deal. Because here’s the (hard, sorry!) truth: Acne is almost always chronic that’s getting worse for adults—in fact, 99 percent of you deal with acne, according to a Cosmo poll—and, fun fact, it’s not something you cure but something you control.
So buckle up, because I (and, okay, some people with actual pimple-fighting medical degrees) am going to show you how.
First, it helps to know that there are two main kinds—teenage and adult-onset, explains Shari Marchbein, MD, a derm in NYC. The former typically shows up in the T-zone (forehead, nose, chin), while the grown type tends to invade the jawline, mouth area, cheeks, and neck. They both stem from four causes: bacteria in your skin, inflammation caused by said bacteria, enlarged oil glands, and hormones.
Especially hormones. Imbalanced ones force your sebaceous glands (the things that spit out waxy, pore-clogging sebum) into action. And this may be a key to why breakouts have become a Big Problem for 20- and 30somethings lately, says Dr. Marchbein. “One theory we have right now is that you have an increase of hormones in your skin”—from things like hormone-treated foods and hormonal IUDs—“that causes your oil glands to overproduce.”
What makes hormonal acne worse?
STRESS
Being frazzled means the stress hormone cortisol is coursing through your body, triggering the inflammation that leads to flare-ups. This is what your annoyingly “wellthy” friends are talking about when they say deep breathing is how they got glowy skin.
POLLUTION
Gross debris in the air can basically sit on your face, clogging pores and causing zits. Block it by using anti-pollution skin-care ingredients like vitamin C.
PRODUCT OVERUSE
“People want to try every new beauty trend, but few consider what’s right for their skin,” says Dr. Marchbein. Her Rx: Stay strong against IG beauty bombardment and pare back your regimen.
DIET
Eating a high- glycemic diet (sugary junk and simple carbs like french fries [sorry, again!]), as well as certain dairy products, could make you break out. “The latter contain a protein that spikes certain hormone receptors, creating acne,” explains Dr. Marchbein. Also, try to buy hormone-free meats because, yup, those hormones are impacting your own.
How can I make my skin clear and glowing? Behold:
Your New A.M. Anti-Acne Regimen
Your Do-Every-Single-Night-Before-Bed Routine (DO NOT SKIP THESE STEPS!)
What can a dermatologist do for my acne?
If the above at-home, over-the-counter regimen doesn’t work after a month and a half—don’t quit early, PS, because your skin takes 28 days for your cells to turnover, so give it a freaking chance!—book an appointment with a board-certified derm to chat about the below ways they can help clear up your skin.
TOPICAL CREAMS
Prescription antibiotic gels like clindamycin and anti-inflammatories like benzoyl peroxide and Aczone can calm red, inflamed pimples, while retinoids like Retin-A, Tazorac, and Differin promote skin-clearing cell turnover and help with scarring. Note tho: Depending on your insurance, these drugs could be cheap or kinda pricey.
ORAL MEDS
“Birth control pills regulate acne- causing hormones,” says Dr. Marchbein. They regulate estrogen and progesterone, halt ovulation (which can = zit fests), and calm testosterone (it can send oil glands into overdrive). Spironolactone is another drug derms swear by—it’s a high-blood-pressure pill that’s used off-label to keep hormones in check. “If a patient’s acne *still* hasn’t cleared, I suggest isotretinoin (formally Accutane)—an oral retinoid that’s very strong,” she adds.
STEROID INJECTIONS
Got cysts (aka deep, invisible pimples) or a giant red blemish that needs to go rn? Ask your doctor for a spot treatment. She’ll inject a mild steroid right into the area to quickly nix it.
Can I get clear skin overnight, though?
ArtPartner
Is that even a thing? Kind of, but no promises. You can try spot treatments, but the problem with your typical salicylic acid- or benzoyl peroxide-packed formulas are that people often overdo it when them, which poses a whole slew of other issues. “Overusing them can dry out already infected areas around your pimple, creating micro cracks in your skin’s barrier that invite more bacteria in, putting the skin at risk for infection,” explains Joshua Zeichner, MD, a dermatologist in NYC. Your new fix? A zit sticker. Think of these little bbs as nonirritating spot treatments made of a hydrocolloid material designed to heal wounds. Also: They look cute AF and help you resist picking at your zits—outta sight, outta mind, amirite?
Wait, One More Thing:
While everyone’s skin is different, and what works for me might not work for you, here are what the Cosmo’s beauty editors swear by…
“Instead of using wipes, which can spread bacteria to other areas of your face, I use a gentle cleansing oil to dissolve my makeup.”
— Ruby Buddemeyer, beauty editor
“As soon as I see a pimple coming, I run to the freezer and stick an ice cube on it. The cold instantly takes down redness and swelling.”
— Lauren Balsamo, senior beauty editor
“At the first sign of a cystic zit, I use topical cortisone—the ultimate nondrying spot treatment—to kill inflammation before seeing my derm.”
— Chloe Metzger, senior beauty editor
“I never touch my pimples. Seriously. Because (1) squeezing doesn’t erase cysts anyway and (2) popping them leaves scars!”
— Ama Kwarteng, beauty assistant
“I bought a bunch of silk pillowcases on Amazon and change them every third night to keep from sleeping on a dirty pillowcase.”
— Me (Carly Cardellino Vaccaro, beauty director)