How to Deal With Hormonal Breakouts

Hi Amy,

My son was born in October, about a week before Ezra. My skin has never been great, but after college I stopped breaking out all the time and just broke out when I was premenstrual. My skin looked pretty good during pregnancy. Starting a few weeks postpartum, my skin looked great: blemish free, smooth, all around radiant. However, when my son was about four months old, right when my hair started falling out, my forehead got incredibly greasy and pimply. I bought the Clinique gentle face wash, and my skin seems cleaner without getting too dry, but my forehead is still very rough and not totally blemish free. I could probably just deal with it, but I have now seen the beauty of perfect skin and I want it back!

When I saw a dermatologist in high school I had luck with something (a mask? a soap? I don’t remember. It’s been awhile) with alpha-hydroxy acid in it, but I’m not sure where I would look for that now.

If it matters I’m still exclusively breastfeeding and haven’t started cycling yet, so although this is almost certainly hormonal, there is no end in sight. Please help!

Thanks,

Brooke

Why Your Face is Breaking Out

Ack! The postpartum premenstrual stage of misery. I know it well. I also haven’t gotten my period yet (TMI? oh, I don’t think there’s such a thing left for me anymore), but my body seems somewhat stuck in a permanent state of PMS. Actual zits! I never get actual zits! Stop it, face.

The good news is, of course, there IS an end in sight. Your cycle WILL return and things WILL eventually calm the hell down. When will that happen? Well, that might be the bad news. The average time it takes for your period to return (assuming exclusively breastfeeding for six months, continuing to nurse on-demand after the introduction of solids) is about 14 and a half months. It can happen sooner, obviously, if you wean or drastically reduce the number of nursing sessions. (Here’s some excellent information about breastfeeding and fertility/menstruation from kellymom.com.)

So. That’s the time frame we’re dealing with. The hormonal wonkiness could very well last that entire time…or this could be a temporary month-or-two thing, much like the hair loss.

Luckily, unlike the pregnancy-and-acne-cream debate, there’s no controversy over OTC skin care products and breastfeeding. They are pretty much all considered safe for nursing mothers, Alpha-hydroxy acids (AHAs) included. (Although it never hurts to Google specific stuff, just for your own peace of mind.)

Chemistry time! Common AHAs in skin care masks and soaps include glycolic acid, lactic acid and citrus acid. Salicylic acid, the other super-common anti-acne ingredient, is a beta-hydroxy acid. So even though you can’t remember the specifics of what your dermatologist recommended, I’d bet dollars to donuts it was a glycolic acid-based product.

…And What You Can Do About It

There are so many masks and soaps and cleansers and moisturizers out there with glycolic acid that I could never begin to guess what you used (I mean, SERIOUSLY SO MANY) but I can tell you that from an “active ingredient” standpoint, they’re pretty much all the same. Everything else (whether it foams or smells nice or comes in a bar or a jar or a car) is typically just branding/marketing bells and whistles. It’s the glycolic acid that’s gonna clear up your skin.
Since you have a pretty isolated problem area (your forehead) and mention concerns about dryness, I would stay away from all-over face washes or soaps. They can be pretty harsh on sensitive skin and pretty drying for just about everybody. If you’ve got all-over breakout problems, you usually just accept the dryness and balance it out with a really good moisturizer. But if you only have problems in one or two spots — like your forehead or chin or t-zone — go with a mask or other targeted spot treatment.

A few possibilities: Murad Clarifying Mask, Korres Cinnamon & Natural Clay Deep Cleansing Mask, DDF Glycolic 10% Exfoliating Oil Control Gel, and Freeman Feeling Beautiful Facial Enzyme Mask. Again, I haven’t used any of these, but am familiar with the brands — Murad and DDF, in particular, are favorites of many Smackdown readers.

I like masks, even though they are a little higher-maintenance than a daily wash or scrub, because you’re less likely to go overboard on the treatment and cause your skin to dry out, freak out and overcompensate with MORE oil. Plus, for those of you who ARE prone to monthly PMS-related breakouts, they’re a great way to deep treat your skin on the specific days that you need it without having to break out a whole special skin regimen to try to combat the hormonal swings. Start by only treating your problem areas to see how your skin handles it. If it seems okay, you can treat your whole face next time — no more than two or three times a week. If the glycolic acid seems to work but you’re still getting the occasional pimple, add a spot treatment or gel to use as needed.

If you’re completely overwhelmed by the choices or completely strapped for cash, you can totally make your OWN glycolic acid mask. It’s cane sugar. Pure cane sugar is LOADED with the stuff. You’ll want to cut it (about 50/50) with some moisturizing/soothing ingredients though — avocado, aloe vera gel, vitamin C oil, etc. But if you can get your hands on cane sugar, you can easily make your own scrub and mask to see if glycolic acid is the cure for your particular flavor of zit.