According to the Journal of American Academy of Dermatology, 54 percent of women older than age 25 have some facial acne—The Bachelor‘s Ashley Iaconetti Haibon is one of them, and many of us can relate.
Adult acne is on the rise, and for women, our hormones play a huge role. One thing that helps all of us get through the breakouts and frustration is when influential people use social media to get real, rather than depicting filtered, perfect skin that doesn’t exist. That’s why Haibon’s recent Instagram post caught my eye. And, not only does she show us her raw self, but she also educates her followers on the things she’s learned along her skin journey in hopes of helping someone else.
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Below, Haibon’s candid post, which I dissected with the expert insight of New York dermatologist Melissa Kanchanapoomi Levin, MD, to make sure you have all the info you need on the important topic of hormonal acne. Curious about why skin “rages” when you get off the pill? Or the effects of spironolactone on cystic acne? Read on.
“In general, birth control pills can be used to address adult female hormonal acne by decreasing androgens—the male sex hormones such as testosterone—because androgens trigger an increased production of sebum, which results in clogged pores and cystic pimples,” says Dr. Levin. “When women discontinue birth control pills, there can be another hormonal adjustment, which can cause hormonal breakouts for three to six months.”
To help minimize these breakouts, which Haibon refers to in her caption, Dr. Levin recommends starting a topical routine before discontinuing birth control and through the transition. “Depending on whether someone is going off birth control to start planning pregnancy or just discontinuing birth control in general, it will affect what is safe to apply on the skin. Seeing a board-certified dermatologist is key for the right topical treatments, such as topical retinoids, exfoliating ingredients or anti-inflammatory creams. In-office treatments including blue light, fractionated resurfacing lasers, microneedling, and chemical peels can effectively treat acne, too.”
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There are also oral antibiotic and anti-inflammatory medications, as well as spironolactone. “Spironolactone is a diuretic that blocks the male hormone receptors to decrease the body from absorbing a particular type of testosterone,” explains Dr. Levin. “While spironolactone is not FDA-approved for the treatment of acne, it has been used by dermatologists for decades for either hormone imbalance or signs of increased sensitivity to testosterone in the skin or hair follicles for the treatment of conditions such as hormonal acne, female patterned hair thinning, polycystic ovary syndrome, excessive hair growth known as hirsutism, and congenital adrenal hyperplasia.”
For patients with similar concerns to Haibon’s, Dr. Levin also recommends “a low-glycemic diet that includes cutting out refined carbohydrates and sugar, and eating vegetables, fruits, lean meats, nuts, and seeds.” Remember that quote our parents told us growing up: “You are what you eat.” Well, when it comes to our skin, what we ingest does a play a role.
According to the American Academy of Dermatology, some studies have shown that those who consume a high-glycemic diet—think white bread, potato chips and sugary drinks—have higher incidences of acne. In the U.S., one study involved 2,258 patients placed on a low-glycemic diet so that they could lose weight. However, this diet also reduced their acne, with 87 percent of patients saying they had less acne, and 91 percent saying they needed less acne medication.
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