I was already in the lowest place I’d ever been: In the early stages of leaving a toxic marriage replete with abuse and betrayal, I was shattered and floundering. My seemingly shiny life as an expat mom blogger in Paris was abruptly over, and my stress and anxiety levels were somewhere near Starlink. Most days were a blur of grief and rosé.
Giant cysts started appearing on my exhausted, middle-aged face. Despite the growing cultural movement of feeling more comfortable in your (aging) skin, my then mental state took these face invaders as the ultimate in humiliation. This wasn’t a one-off, either; I’d been getting these angry, unpoppable volcanos on my chin and jaw for months. Karmic retribution for having perfect skin for most of my life and not fully appreciating it? (I was that lone teenager who got maybe a zit a year throughout high school.)
Because I’d completely lost my appetite, I was skinny as a teenager again — and my sebaceous glands were acting accordingly. Et tu, once-perfect skin? Scouring the drugstore aisles for Clearasil, I wondered where it all went wrong.
Stress and the (Suddenly) Single Woman
Priya Patel, the certified physician assistant who oversees The Pimple Place in Santa Monica, CA, assures me that my woeful acne tale from a few years prior isn’t unusual. “You are not alone. Adult acne happens a lot and is more common in women. It’s always our hormones. We have hormonal shifts, and not just during pregnancy or menopause. Those shifts can cause breakouts,” she says.
Stress, especially at the levels I was experiencing, raises cortisol, increasing oil gland activity, and boom! Breakouts in your fifth decade. And not just whiteheads or blackheads, but painful cysts that don’t easily disappear. “Stress causes inflammation, psoriasis, eczema, and acne,” confirms Patel. “Stress acne is more inflammatory and cystic in nature.”
Since I didn’t have the Pimple Place to turn to back then, I blindly grabbed at solutions: benzoyl peroxide, hydrocolloid patches, clay masks, and even a portable blue and red LED light acne treatment that was a cross between a blush stick and a flashlight. It worked pretty well, actually, and I was bummed when the non-replaceable battery died a few months later.
Patel points out what I did wrong — and right: “Over-the-counter benzoyl peroxide is great as a spot treatment, but 10% is too strong. It’s going to cause more irritation. Using 5% or less is better,” she says. “Blue light therapy works because bacteria can’t survive in that wavelength, and it decreases inflammation.”
It turns out, however, that adjusting my skincare regimen was just a portion of the journey to accepting the state of my new skin.
Breathwork to End Breakouts?
The hormonal war zone on my face reflected my all-encompassing anxiety over my divorce and custody battle. I had to find ways to manage my stress, so I returned to meditation and discovered breathwork, a conscious breathing practice that can elevate mood and mindset. When I got fearful or triggered, I’d remember to breathe, and I carved out time daily for an online meditation or breathwork class. I became a huge fan (and superuser) of Insight Timer, a free app with over a hundred thousand guided meditations. I started eating more and healthy, drinking wine less, and going on near-daily morning hikes — the basics of self-care.
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I also learned how to use foundation to cover up the archipelago of bumps still erupting regularly. For someone who rarely wears makeup, this was humbling. My entire life, people have marveled at my “flawless” skin, but now I’d get self-conscious if I was talking to someone and their gaze drifted to my chin. Was it flaking? Red? Had the foundation worn off? Frankly, I was fine with the mask mandate because it hid my blemishes.
Between treating myself with more care and tenderness, being grateful the pandemic hadn’t devastated my close friends and family and accepting that my divorce and zits weren’t going away, my skin stopped acting out. Mind you, this took about a year, but a month of no breakouts turned into six turned into over a year of being pimple-free.
I think about how the sudden collapse of my outwardly “perfect” life and marriage showed loud and clear on my face. When you’ve identified as something for so long — in my case, a privileged, married mom with “flawless” skin — it’s shocking to realize the struts you’ve built your life upon weren’t that firm. I could no longer rely on the usual touchstones of who and what I am; even my skin refused to cooperate!
This is where the inner work — all that meditation, breathwork, and self-care — came in. I rediscovered what is solid within me, surrendered what no longer was, and accepted that yes, I’m in my 40s, single again, softer in the middle with recurring cystic acne. It wasn’t necessarily pretty, but the transformation is beautiful.
Meet the Experts
Priya Patel is a certified physician assistant who oversees The Pimple Place in Santa Monica, CA.
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