tiny volcanoes on your face (let’s talk about acne).

I would never ever say I had great skin, but I definitely had good skin for most of my life. With the exception of PMS breakouts and a rough 7th grade, I was mostly in the clear. Literally.

And then one day, a few months shy of my 30th birthday, I woke up looking like a Proactive “before” picture.

I am not exaggerating—acne erupted on the bottom third of my face out of nowhere. And I’m not talking little zits, like the tiny flat harmless kind that can be covered with makeup. I’m talking monster zits, apocalypse zits, the kind of zits that are gigantic and painful and cannot be covered whatsoever even with eight pounds of concealer.

No time to waste, I ran to Target and bought every acne-clearing potion on the shelf. The acne shopping spree was followed by three eighteen hours of online research, which was both ironic and alarming considering that when my kids have a rash, I do one quick search on WebMD before diagnosing them with “nothing too worrisome.” I do not ever research illnesses or symptoms online because—more often than not—it leads to diagnosing myself with a brain tumor, and also anxiety.

But acne? I researched that subject to death. Every night. For HOURS.

What causes acne?
How do I get rid of acne?
How do I cover acne?
Acne cure
Acne soap
Acne cream
Acne before and after
Acne pill
Do I need Accutane?
Does Accutane make you depressed?
Which is worse: acne depression or Accutane depression?
Acne diet
Acne regimen
Acne celebrity regimen
How hormones affect acne
What is hormonal acne?
How do I cure hormonal acne?

And so on. And so forth. Like I said, I did this for hours.

Based on my research (and the fact that I had just gotten my first period after Carson and was in the process of weaning him), I was 90% sure I had hormonal acne, but I also didn’t want to have hormonal acne because everything I read online said over-the-counter treatments would not be able to treat hormonal acne.

Let me set the record straight. I am an over-the-counter type of gal. Doctor appointments and dentist appointments fall somewhere between “scrub the toilets” and “check voicemail” on my to-do list. Ain’t nobody got time for that. (Well, I suppose responsible adults who are successful at life and self-care probably have time for that but I fall into neither of those categories). I have not been to the dentist in a very long time. Because I would need to book a babysitter to go to the dentist and that feels super lame. Doctor: same. Eye doctor: same. Chiropractor: same. Dermatologist: same.

I have fantasies of my children going to elementary school where I can finally catch up on years worth of self care and responsible adulthood. Massage Monday. Teeth Cleaning Tuesday. Workout Wednesday. Thank-you-card-writing Thursday. Facial Friday.

Doesn’t that sound like a dream? I only have three years to go until this is a reality for me (if we don’t add another baby to the mix, oof). Hopefully I don’t gain fifty pounds and lose all my teeth before then.

But I digress.

Normally I’m an over-the-counter girl. If I can order it on Amazon prime, consider it done. And oh I ordered! I ordered so many things. I tried just about every over-the-counter acne potion on the market and they did NOTHING. Actually, that’s a lie. I think they made the acne angry.

(And in case you’re wondering, I also started washing my makeup brushes/drinking more water/cleaning my phone/washing my pillowcases/cutting back on dairy, and 12 other ideas from Google, all of which made not a lick of difference.)

Which is why, when my sweet friend Hilary from MOPS e-mailed me out of the blue one day offering to give me a complimentary facial at her spa, I almost cried.


And my facial was amazing. I walked into that spa on a regular Thursday night half-asleep after a long day with the kids and walked out feeling like a queen. Hilary was fantastic. We talked all about my acne and she reassured me we would figure it out together. I loved her. She was like my acne midwife.

I was still hesitant to see a dermatologist, partly because the optimistic side of me believed the acne would clear up on its own and partly because when could I go to the dermatologist? I can’t even make it to the dentist twice a year.

But the acne didn’t clear up on its own. And I started to feel…..depressed. My face was making me sad. I never wanted to see anyone. I could not leave the house without eight pounds of concealer all over my chin, and even then, I was incredibly self conscious. I didn’t want to be in any pictures. It was all so dramatic and lame and I confessed to my friends how horrible I felt, both about the state of my face and the fact that I could let something as dumb as acne bother me so much.

But man…..when your face is covered in tiny volcanoes, it’s really hard to ignore.

I finally caved and booked a dermatologist appointment at the Laser Skin and Surgery center. If Hilary (my esthetician) was like the acne midwife, the dermatologist was definitely the acne doctor. Acne midwives hug you and listen to you and smile at you and reassure you that it’s going to be okay. Acne doctors are no-nonsense. Acne doctors write prescriptions. She examined my face, asked me ten questions, and made a formal plan in two minutes (antibiotics! topical gel! retin-A! new skincare regimen! new makeup! new birth control!).

It was…..a lot. But I was at the end of the road and willing to try anything, so I took my little prescription sheets and paper bag full of instructions and ran out the door with a smile on my volcano-covered face.

HOPE. At last.

Sure enough, 10 weeks later, I was mostly cured. And today, my face looks like this:


(Pardon my crappy grainy cell phone pic, but you get the gist, yes? I wish I had had the forethought to take a “before” picture, but I didn’t, so just google “hormonal chin acne” and you’ll get a good idea of what I looked like three months ago.)


My skin is not 100% clear or perfect, but I have seen a 1,000x improvement from where it was. Other than a few tiny blemishes here and there, I haven’t seen a single monster zit in over a month.

This was the plan that worked for me:

*Three months of antibiotics (doxycycline)
*Acanya topical gel on breakouts
*Retin-A before bed (note: my face shed like snakeskin for a month adjusting to this)
*Off the mini-pill; start ortho tri cyclen (note: this made me nauseous the first week)
*Skincare routine: cetaphil morning and night; CeraVe AM / PM lotion
*Makeup overhaul: replaced everything in my makeup bag with new “oil-free” options.

Current makeup favorites:

Tarte Amazonian Clay Foundation (this stuff is AMAZING)
Tarte Amazonian Clay Bronzer
Urban Decay Makeup Setting Spray
Phsyician’s Formula Blushing Rose

Obviously, I hope this goes without saying: your skin is not my skin. Your face is not my face. Only your dermatologist can make a plan that’s right for you. If you’re looking for a dermatologist in Sacramento, I cannot recommend the staff at the Laser Skin & Surgery Center enough. Ask for Rebecca (acne doctor) and Hilary at the MediSpa (acne midwife). I OWE THEM MY FACE. And my confidence. If you tell them I sent you, they’ll give you 25% off a deep pore cleansing acne facial. Treat yourself!

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11 Responses to tiny volcanoes on your face (let’s talk about acne).

  1. Heather says:

    Ah, this story sounds eerily familiar! Glad you’ve sorted things out. The Tarte BB Tinted Treatment is also amazing! 🙂

  2. Ashley Smith says:

    Yay!! I’m happy for you and your cleared up bottom third of your face!! 🙂 Acne can be really stressful because it’s right THERE and cannot be ignored. But you are so funny! “Which is worse: acne depression or Accutane depression?” *insert laugh/cry emojis* I’m glad you finally got your answers AND wrote it all down in this super amusing post.

  3. Angeline Evans says:

    Seriously, Cetaphil is the BOMB. That and Aveeno are the only things keeping my skin from exploding in red, oozy rashes all over (adult eczema is no. freaking. joke). The antibacterial cleansing bar is the only thing that keeps my adult-eczema skin from freaking out (all over my body, not just my face) and has also majorly cleared up Kevin’s razor rash – if you have smaller breakouts in the future and don’t want to go the full antibiotic route, it might just do the trick!

  4. Victoria says:

    I’m glad you found a solution that worked for you! I am going through infertility treatments, so my skin keeps changing every time a medication is added or removed. For example, excess estrogen made my skin look fantastic! But excess progesterone made my skin look like a pizza, especially in front of my ears which is a very weird place for it I think. I find that the less I put on my skin the better. I do have sensitive skin though, so everything can be bad. Since my IVF cycle was a fail (sad face), I am back off all my drugs and my skin is definitely calming down. I did add in a prebiotic facial cleanser that I think has made a huge difference in my skin. It’s by Aleavia and I would totally recommend it. All clean and natural ingredients which is a requirement for me. And the Lavender body cleanse smells fantastic! I also just downloaded “Skin Cleanse” by Adina Grigore from my library to read next and I can’t wait to see what it says about clearing up your skin.

  5. J says:

    Girl! I’m right there with ya, well expect I didn’t want to be on birth control :/ and mine lasted A LOT longer than 3 months! What finally worked for me was hydration/nutrition from the inside! Yup, I added a fruit/veggie smoothie every morning (with coconut water). Pretty sure I was lacking the correct serving of fruit and veggies per day and that smoothie help me check those servings off the list every morning. Not only has it help with the acne, but also the wrinkles! (I’m a few years older than you, believe me that will be the next worry, are those dang worry lines!). I feel and look 10 years younger! Cheers to looking and feeling better! Thanks for the post!
    J´s last blog post ..tiny volcanoes on your face (let’s talk about acne).

  6. jasmine says:

    The same thing happen to me right before I had Tatum and went on for 3 months after I had her. Since I was breastfeeding I had to wait it out. I didn’t get a period for 2 and a half years since I was still nursing her but we weaned this past October. That’s when Sh*t hit the fan. Finally made an appt in Feb and I have almost the same plan as you except I was put on Minocycline.

  7. Amanda says:

    I read this when you first posted it a couple of weeks ago, and can’t stop thinking about it, so I had to come back and comment. I have had a similar experience these past months, but it’s not the first time this has happened in my adult life. I had my first really bad break-out when I was about 26, then somehow it subsided. Then a couple of years later, I broke out again – not terribly, but bad enough to see a doctor. The medicine she gave me worked like a charm, but then I had a baby, and we moved twice, so I haven’t seen a dermatologist to refill my medication in two years. The past couple of months have been hard for our family, and I think all the stress made me break out like CRAZY – it was just like you said, the “before” shot for Proactiv. It’s so embarrassing!! I don’t want to leave the house either. It’s like I’m putting my life on hold until my skin clears up. Now that I’m a mother, it’s even worse. I feel like I spend my days pretending to be an adult, but then I come across as a 15 years old with zits all over my face. I’ve seen a dermatologist 4 times since I first started breaking out 5 years ago. We’ve moved so much it’s been hard to establish a relationship with any doctor in particular. I wish I could say my experience was as good as yours – I feel like I walk into my appointment and the doctor starts prescribing me things like crazy without even listening to my skin history. Then, when the medication doesn’t work, I get mad and quit using the treatment. I stopped using all medications a couple of weeks ago, in order to give my skin some time to heal and breathe. I tried the all-natural / organics route at the beginning of the year, and I feel like it’s partly the reason why my skin has gotten so bad lately. Your story is inspiring, though – it makes me want to keep my follow-up appointment with the derm. How long was it before you knew the medicine you were using was working? Thanks so much for sharing your story!! It helps me to know there are others out there who are going through the same thing!! 🙂

    • Ashlee says:

      Ack! First off: I am so sorry. I honestly have a whole new sense of empathy for people struggling with acne 🙁 My acne midwife and dermatologist both stressed the need to STAY WITH IT. Before I went in and was prescribed a new routine, I had been jumping around from product to product. I’d try something for two weeks, then try something else for a week, then try something else for four days. I was incredibly impatient. I think part of the key is to give your skin time to adjust to a new regimen. I would say within four weeks of making ALL of those adjustments (cetaphil, retin-a, new birth control, antibiotics), I had noticed a difference. I had to ease into the retin-a treatment…..you start out using it every three nights, then every two, then every other, etc. That made my face peel like CRAZY. It was almost worse than the acne, my entire face looked like snake skin. It was super embarrassing but I just kept telling myself to stick with it. And now, in hindsight, a few weeks of flaky skin was nothing. 100% worth it. So this is my advice: see the dermatologist (a good one!), do what they tell you to do, stick with it for 6 weeks (at least), and see if your skin improves. I’d say by the 10-week mark (I know, that is forever), my skin was MOSTLY clear. By 12 weeks, it looked pretty dang amazing. The hardest part is being patient. I am the least patient person I know, so if I did it, you can, too 😉 GOOD LUCK!!

      • Amanda says:

        Thank you SO MUCH!! I totally agree, the hardest part is waiting. When I quit the medicine the doctor gave me, I started using Benzoyl Peroxide on my own, because when I first started to struggle with acne, BP was able to clear it up. But, after a couple of weeks, even though my acne cleared up, the redness and itchiness did not. It looked like I was sunburned all the time, and you can’t hide that with makeup!! I also wanted to scratch my entire face off by the end of the day, it stung so bad. So I quit that, too. 🙁 I have a follow-up derm appointment in a couple of weeks, which I was considering canceling, but after hearing your story I think I might go back. I know she’ll fuss at me for not sticking with any one medicine, but hopefully she can get me back on track with something that will work. Thanks again for your follow-up, you’ve encouraged me to not give up!!

  8. therese says:

    Did you take any kind of probiotic while you were on the anti-biotics? I was prescribed an antibiotic for my acne, but chickened out because I didn’t know what they would do to my gut health etc. I am currently using adapalene as a topical and i think it’s been helping a little, but think i need to go the antibiotic route for something stronger.

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