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How to Treat Oily Skin, Hormonal Acne and Post-Acne Marks

My favourite products and tips.

It's reader question time! Today I've got some advice for reader Giselle, who is looking for a skincare regimen that treats oily skin, hormonal acne breakouts AND their pain-in-the-butt aftermath, post-acne marks. She writes:

"I'm having trouble finding a good skin care regimen. I have oily skin and seem to break out a lot at my time of month. A lot of SPF moisturizers cause breakouts. I also have brown spots on my face, from old breakouts and age I suppose."

Now Giselle is in her early 50s, but what I'm going to recommend applies to pretty much everyone over age 25.

Treating Hormonal Acne Naturally

I promise I WILL get to the product regimen part... but first things first: if you tend to break out at certain times of the month (join the club), it's worth a little effort to see if you can re-balance those hormones. Yes, medications like the birth control pill, spironolactone, Accutane and antibiotics can help, but I'm generally against them. They're short-term fixes with some serious side effects (some say even breast cancer, eeks). I'm also on the fence about laser treatments—they can work, but again, not necessarily permanently, and they can get REALLY expensive.

Although it's undoubtedly more challenging, you can do a lot naturally through diet and lifestyle changes to at least lessen the severity of those monthly breakouts. (The payoff is that it's going to make much more of a difference than any product you put on your skin topically, plus you can improve your overall health at the same time.)

What to Eat for Acne

I advocate cutting out processed foods (including soy—a major baddie) and upping your quantities of healthy saturated fats like butter and coconut oil.

Yep, you read that right. Fat is not the enemy—unless it's hydrogenated vegetable or soybean oils. I've eliminated those (along with the vast quantities of nuts and seeds I used to eat) and started using tons of butter and coconut oil. I know it sounds strange, but it's made a difference in my skin.

It's also important to eat enough protein (animal protein is the highest quality), which most of us females don't get enough of.

And you probably already know that sugar and white flour are the absolute worst, so avoid them like the plague.

UPDATE (2013): Some other things I now think are important when "eating for acne" are:

  • Avoiding ALL polyunsaturated oils (PUFAs).
  • Aiming for 80 grams of high-quality protein daily. Gelatin, milk, shellfish and beef are good sources.
  • Avoiding all gluten (it's toxic for everyone; some people are just more sensitive to it than others). You may want to also consider eliminating starches and replacing them with fruits as your carb source.
  • Sugar I no longer feel is problematic. White sugar, honey and fruit sugars should all be fine on their own—it's the junk they come with in processed foods that's a problem.
  • Vitamin A is an extremely nutrient for acne prevention (I have many more details on that here).

Liver Detox and Acne

Many natural health practitioners also say that acne is connected to a sluggish liver—our livers process our hormones. If you're feeling very brave, you could try a liver and gallbladder flush, which can remove blockages (intrahepatic stones) in the area that may be contributing to hormonal breakouts. This site is a good resource on how to do the flush. Warning: it's not for the faint of heart!

There are two schools of thought on whether this works, however. While some people think you need to flush to get rid of the stones, others say they're a side effect of not consuming enough healthy fats, and once you change your diet they will dissolve.

Morning skincare for acne-prone skin

Start with a basic gel cleanser (nothing creamy). The foaming cleansers I really like include the Instant Foaming Cleanser from Caudalie:

The Organic Foaming Face Wash from Consonant:

And the Outer Peace Foaming Cleanser from Aveda:

At the drugstore, try Olay Foaming Face Wash:

Or Neutrogena Fresh Foaming Cleanser:

Unless your skin is very oily, be careful with cleansers labelled for acne-prone or oily skin—many of them can be too drying. Also be cautious with cleansers that have added exfoliating properties, which can be too irritating. I prefer exfoliating with hydroxy acid toners (more on that in a second).

Then apply a serum. I'm a huge fan of serums because they're more powerful than moisturizers; due to their liquidy format, formulators can infuse them with higher proportions of active ingredients. This is where you can treat both the pigmentation issues and the signs of aging.

I use La Roche-Posay Mela-D, which specifically targets dark spots.

Clinique also has a new product out for dark spots called Even Better.

Don't be afraid to use more than one serum though. You can layer on an anti-aging one as well. I've also been using the new Prevage Anti-Aging Serum, which is pricey but super-effective on both pigmentation and fine lines. (It's just a little silicone-y, so see if you can get a sample first to make sure it doesn't break you out.)

The Skincare Edit Recommends

If you've got oily skin, you don't really need to layer on moisturizer and then sunscreen—it will just make you too greasy. Just put on your sunscreen (and maybe some eye cream, if you need it). Sunscreen is really important to protect any areas of pigmentation from getting darker.

Sometimes breakouts can arise from chemical sunscreens, so I'd use a natural sunscreen with zinc oxide or titanium dioxide. One of my favourite facial sunscreens is Lavanila The Healthy Sunscreen.

Remember to apply sunscreen all over your face, neck and chest.

Finally, use a mattifying or oil-control lotion or primer. This step will help absorb oil throughout the day so your skin doesn't look as shiny. I've had good luck with OC8 Mattifying Gel:

And Hourglass Veil Mineral Primer:

NeoStrata also has a new Oil-Free Mattifying Fluid that you may want to check out.

After this, go ahead and apply your makeup. Note that a mineral powder foundation like Jane Iredale PurePressed Base is going to be much better for acneic skin than an oily, potentially clogging liquid foundation.

Evening skincare for acne-prone skin

Cleanse your skin again.

A few times a week, use a gentle exfoliating toner. I prefer hydroxy acid toners instead of actual scrubs with beads. They will not only remove dead skin build-up that can clog pores, but will also help fade the post-acne marks. The very best one I've tried is fromBiologique Recherche(Lotion P50), although it's hard to find.

Mario Badescu makes a Glycolic Acid Toner:

And Kiehl's has a salicylic acid version:

I also like the Clarisonic a few times a week for some extra buffing power.

After exfoliating, apply your serum again.

Then, use a treatment product. Depending on which issue is bothering you most, this could be something for the pigmentation issues or breakouts, or both.

For pigmentation, if you want to call in the big guns, I'd go with Lumixyl, a hydroquinone-free brightening cream that one dermatologist I've spoken to really likes.

I've used it for short time and I think I can already see a slight difference.

For acne, you want a product that won't dry you out too much (flaky, crusty skin is much worse than a pimple). If your breakouts are mild, you can spot-treat them by dabbing on a clay mask. Bentonite clay is the best—it won't ever "burn" your skin but it dries it out amazingly well. Just pour a tiny amount into your hand and mix with water into a paste.

Otherwise, if your acne is all over, you can apply a thin layer of a hydroxy acid treatment over your entire face. A good, non-irritating option is Dr. Dennis Gross Skincare All Over Blemish Solution:

Or Juice Beauty's Blemish Clearing Serum:

I don't think benzoyl peroxide products are a good idea, as they generate free radicals which can lead to accelerated aging. Don't forget eye cream, lip balm, and some night cream on your neck and chest (aging shows there too)! You can also throw in a masque once a week depending on what your skin needs (moisture, oil-control, etc.).

Have your say

Do you suffer from any of these skincare concerns?

What skincare regimen works for you?

Have you checked out any of these products?

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