22 years old and unexpected acne: my journey with hormonal acne and PCOS


I’ve just recently got preoccupied with skincare. There was a time when I completely refused to take care of my skin, and that was because I stupidly saw it as a feminine practice made on a whim, and I didn’t want to be associated with anything feminine, as I went through a phase of rebelling against feminine things and habits. Later on, when that phase was over and I was finally willing to give it a try, I continuously postponed it, due to lack of time and energy to invest in learning the science behind it (I knew there was a lot to learn).

Hormonal acne and PCOS visited me for the first time

Last year, I experienced a breakout for the first time in my life, which struck me as a surprize and caught me completely off-guard. I wasn’t able to find a reasonable explanation as to why I was developing acne at 22. At that time, I didn’t even know that there is such a thing as hormonal acne. I only knew about that acne some people develop when they go through puberty. But because I had never struggled with acne when I was a teenager, I thought that, once puberty was gone, I was going to be spared from that burden for the rest of my life.

I had no clue what was happening to me, but I knew something was wrong, so I rushed to the dermatologist. After some more investigations, I was diagnosed with PCOS, and I found out that the breakout was due to the hormonal changes this syndrome caused within my body. That overlapped with a very stressful period, sleepless nights, food without any nutritional value and an overall chaotic lifestyle and resulted into that terrible hormonal acne.

Actually, it was terrible only in my mind, but the doctors told me it was a mild form. But for somebody who had had only occasional pimples here and there, to have five huge gunks on each cheek and other three on the chin is really a problem. Especially when they persisted and got quite inflamed.

My doctor decided not to give me medication for my PCOS for that moment, but adviced that I should keep it under observation. However, I was told that I needed to follow a specific topical treatment for that hormonal acne and start to properly take care of my skin on long term, because it would return every month, along with my period. He prescribed me a bunch of products and explained in five words how to use them, then rushed out of the room.

You could tell he was very relaxed and not very concerned about my ten acne pimples. He must have seen and treated worse than that. Much worse. But I was quite scared and anxious. After all, it was my face. And all I understood from his quick explanation was that I was supposed to use a face cleanser, not a regular bar soap. He didn’t even mention I needed to have a skincare routine in the morning and one at night, and me, I was completely unaware of this aspect.

Learning how to skincare

22 years old and unexpected acne: my journey with hormonal acne and PCOS

When I arrived home, I was so confused and sad, that I decided to go on the internet and educate myself on how to skincare and try to create a routine for my needs, before I rush again into the doctor’s office for skincare lessons. Being forced by the circumstances and having some more free time because of the lockdown, I thought it was a good idea to understand how those products work, together and separately, so that I make sure I used them correctly and consciously, and I would not do more harm than good.

I thus spent day after day binge-watching YouTube skincare channels and three weeks later I auto proclaimed myself “a skincare expert”. Of course I knew I was nowhere near an expert, and would never be. But to me it was amazing that I was able to figure out how all those ingredients work, what each of them targets, how exactly they can help me and in what way, and how to layer them from first to last.

And, last but not least, the fact that I took the time to watch all those videos and take notes, and that I had the patience and willingness to rewatch any of them whenever I was not sure about something, or even watch more videos on the same topic, all of these made me really happy with myself. But what made me proud was that I have managed to stay committed to and be diligent with my skincare routine since then, especially because I usually have problems sticking with new (and not necessarily my favourite) activities that involve long-term commitment.

I applied what I learned and, in the end, I created a personalized skincare routine that have done wonders for my hormonal acne and my skin, in general. I used the products the dermatologist recommended me (cleanser, retinoid, benzyl peroxide, sunscreen), and I added some more (salicylic and glycolic acid, niacinamide, moisturizer). After I treated my acne, I added one more ingredient for treating the hyperpigmentation left from the acne (vitamin C).

Half a year later, I got a second appointment, with another doctor, just for a check-up. I told her what I used to treat my hormonal acne and what was left behind, and she gladly approved of it, encouraging me to continue with those ingredients and be diligent with taking care of my skin.

Now that I have got rid of that hormonal acne, my aim is maintenance, which goes hand in hand with premature ageing prevention. This is my actual routine:

                 Night-time routine


  • Double-cleansing method: I use grape seed oil + a gentle water-based cleanser (I used one from La Roche-Posay and another one from Cerave)


  • Retinoid serum (I use the 2% Granactive in squalene from The Ordinary) three times a week
  • Niacinamide (that from The Ordinary with Zinc) + Hyaluronic Acid for a boost of hydration (The Ordinary, again) three times a week, when I don’t use the retinoid
  • Salicylic Acid (BHA) + Glycolic Acid (AHA) (both from Paula’s Choice). I use them together, once a week, in the remaining night.

As you can see, I used one active per night and I used them alternatively. Because they are all potent ingredients, I didn’t want to mix them, to avoid irritation.


  • Moisturizing cream (I use Toleriane from La Roche-Posay, or the Cerave Hydrating Cream)
  • A lightweight oil on top to seal hydration (but only in those nights I use the Niacinamide + Hyaluronic Acid)

                  Morning routine


  • I just use plain water, because my face is not oily and tends to dry too much if I use a cleanser in the morning.


  • Vitamin C (The Ordinary’s Ascorbic Acid 8% + Alpha Arbutin 2%)


  • Moisturizer + a lot of SUNSCREEEN (several, my favourites are from La Roche-Posay)

When I say I got rid of my hormonal acne I don’t mean it left me forever. I treated what was worse, but I still get a couple of pimples each month, before my period starts. The thing is that I have managed to have it under control, even with no oral medication for PCOS. And since then, it hasn’t been that bad because I have learned how to deal with those 3-5 pimples that visit me periodically.

Moreover, I became aware of the importance of taking care of your skin in general, so I have also learned how to maintain the health and appearance of my body skin. I thus cured the so-called “chicken legs”, my back acne, my extremely dried hands and chopped lips.

This is not to say that my skincare routine is the recipe of success in the case of hormonal acne or maintenance. Even if you have the same problem, your skin may be different and its tolerance as well. It works for me, but might not work for you. I have normal to dry skin, but it is also very resilient, so I can use almost any ingredient without experiencing irritation, burning, redness or stinging. Imagine that I can use retinoid and vitamin C under my eyes without any problem, but other people can’t even tolerate them on the rest of the face. Others, can be allergic.

Find your own best routine

22 years old and unexpected acne: my journey with hormonal acne and PCOS

So, please, don’t just copy my routine assuming it is going to work for you too. It can serve as an example for you to check out the ingredients and products, but don’t take it for granted. Find your own that is tailored to your needs and goals. What I encourage you to do is educate yourself on how skin products should be used, do your research to see what ingredients are best for your specific needs and how to combine them. I would also advise you to patch test each time you want to use new products and introduce them one at a time, to give your skin time to get used to each of them.

As for the dermatologist, if you have access to one, definitely schedule a consultation. At the end of the day, they are the only ones who can diagnose your skin problems and give you the best treatment, especially if the problem is more serious and you need a combination of oral and topical treatments. But don’t do like me! Go ask them everything you want to know. You have paid for that appointment and they have to take the time and explain to you all you want to know. What you can do like me is learning what you are doing on your skin and why, I am sure this will be helpful.


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