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" For years, I had thought of going off the Pill\u2014not because it made me feel bloated or that it was time to rev up the baby-making machine (reasons a few friends stopped renewing their Rxs). But because after 15 years of popping it\u2014every, single, day\u2014I started to become wary of the constant flood of fake hormones and wondered if my body could actually work its menstruation magic naturally. At one annual exam, I mentioned my jump-ship plan to my gynecologist as he scribbled my normal prescription. Other than a semicurious &amp;quot;Why?&amp;quot; and nod to the obvious fact that I&amp;#039;d have to use another form of protection, he gave his blessing, then handed me my new Rx...which I filled. The reason: As an ex\u2014beauty editor who has interviewed the country&amp;#039;s top skin experts, I am well-versed in the pivotal role hormones play in adult acne (screwing with them often means mayhem). Plus, having clear skin is my thing. If my complexion isn&amp;#039;t near perfection (from the occasional PMS- or stress-induced pimple), I swear it&amp;#039;s all anyone can see\u2014since it&amp;#039;s all I fixate on\u2014and in turn, I can fall down a confidence-crashing rabbit hole. So the thought of instigating any type of acne willingly was enough to make me break out. And break out I did. I took the no-Pill plunge last October. By January, I had full-blown cystic acne: red, inflamed mountains that seemed to start miles below the surface and would linger for weeks. And just as one would heal, another would rear its ugly head. I tried to be optimistic, giving myself a pep talk in the mirror each morning: &amp;quot;Only you can see them; they&amp;#039;ll clear up soon.&amp;quot; Except they didn&amp;#039;t, so I started to lose hope...and my social life...and my self-esteem. Sometimes, I&amp;#039;d just bail on whatever plans I&amp;#039;d been psyched about for weeks, speckle my skin with zit cream, and hit the couch. On date night, I&amp;#039;d suggest a romantic, dimly lit place (pitch-black would&amp;#039;ve been preferable). But the low point was when I stopped speaking up in meetings at work and voicing my ideas\u2014because if I did, every woman in the room would turn to look at me and see the sad state of my skin. Sounds dramatic, I know. And prior to facing acne head-on, I would&amp;#039;ve agreed. But I now understood how horrible it is to be plagued with what felt like a disease, on display for the world to see. Anyone who has experienced breakouts can attest that at some point, it&amp;#039;s less about the zits themselves and more about wanting to show a version of yourself that projects who you are on the inside. And the reflection that I saw every day\u2014a red, blotchy, acne-ridden me\u2014wasn&amp;#039;t who I was or wanted to be. By February, I realized that hitting the acne aisle in the pharmacy was never going to cut it, so I started combing through my contacts and old e-mails, packed full of derms I had interviewed over the years. I&amp;#039;d seen many of them for superficial reasons (like microdermabrasion to look glow-y for a friend&amp;#039;s wedding). But this time, I was desperate. I needed a medical visit with an expert well-versed in all things acne. My emergency call: Neal Schultz, MD, clinical professor of dermatology at Mount Sinai Hospital and founder of BeautyRx Skincare. In the beauty and derm world, he&amp;#039;s known as the acne guy\u2014the go-to for the latest info on problem skin and a staple at national dermatology conferences. I&amp;#039;d interviewed him loads of times, but go see him? No need. Until now. Sitting in his office, my feet awkwardly dangling off the stiff reclinerlike chair, I told Dr. Schultz my traumatic time line and started to cry (note: I am not a crier). He listened, nodded patiently, then explained, &amp;quot;The Pill gives your body extra estrogen, which suppresses androgens, the hormone that causes excess oil production.&amp;quot; Go off and oil levels skyrocket, which can bring on breakouts. But my crazy-angry acne? &amp;quot;The bacteria in your sebum, which feed on excess oil, is creating an excess amount of an enzyme called lipase\u2014and that converts sebum into free fatty acids (FFA), which are extremely irritating,&amp;quot; says Dr. Schultz. (The issue, BTW, is totally genetic.) This irritation prompts excess white blood cells (what we see as puss) to fight off the FFAs, further blocking pores and setting off an acne breeding cycle. I was tempted to call my gynecologist (or just ask Dr. Schultz) for another Pill fix. But Dr. Schultz squashed that thought, saying the &amp;quot;purging&amp;quot; I had so far gone through was half the battle. (&amp;quot;Why turn back?&amp;quot; he said.)The other half required a three-step commitment. First, a simple skin-care routine designed to reduce inflammation. (I left his office with creamy cleanser, alcohol-free toner, oil-free lotion, and a gentle glycolic serum to dissolve pore-clogging dead skin.) Step two: See him at the first sign of a new cyst for a cortisone injection (it nixes inflammation within 24 hours) and for weekly professional-strength glycolic peels (40 percent versus the 8 percent at-home serum, which I would be using nightly) to keep pores unplugged. Last, I&amp;#039;d need an oral antibiotic to halt bacteria and reduce inflammation and white-blood-cell levels. Dr. Schultz&amp;#039;s antibiotic of choice: cefadroxil (it has fewer downsides\u2014fewer stomach aches and yeast infections\u2014than other versions and doesn&amp;#039;t make skin sun-sensitive like the more commonly prescribed tetracycline). I took it three times a day for 30 days, then downgraded to once daily. The irony of going off one med only to go on another didn&amp;#039;t go unnoticed, but it was a game changer. By mid-June (four months after my first visit), my skin had recovered remarkably. The red, swollen pimples had disappeared, and my pores were clear. Plus, I was off the antibiotic, and the weekly pro peels were now monthly maintenance ones. Today, all that remains of my post-Pill nightmare is my trusted skin-care routine. And thanks to a few recent zaps of a Vbeam Laser (to heal leftover red marks), an acne-god of a doctor, and my body for eventually balancing its hormonal issues, my skin\u2014and my confidence\u2014were left unscarred.   If your hormone or stress levels are unpredictable, a steady skin routine can be your rock. Beyond the obvious (regularly cleansing and applying antiacne ingredients to clear and prevent pimples), it establishes consistency. &amp;quot;Skin hates surprises\u2014be it sporadic care or a product it&amp;#039;s not used to\u2014so an easy-to-follow regimen is key,&amp;quot; says Dr. Schultz. Olay Fresh Effects is a new line of six complexion perfecters. Here, Shine, Shine Go Away! Cleanser, $7, and Long Live Moisture! Lotion, $13. "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.cosmopolitan.com/style-beauty/beauty/advice/a4147/birth-control-skin-side-effects/>