Our columnist is breaking out big time on HRT. Here are her top products for treating 'cystic acne' and covering up the evidence

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There are very few advantages to getting older but one of them, you might have surmised, is the absence of teenage-style breakouts. Wrong. Turns out that one of the side effects of menopausal hormones in general and HRT (in my case a cocktail of progesterone, oestrogen and testosterone) is adult acne.

As a youngster, I rarely had spots – one or two, perhaps, but really nothing major. If anything, my skin has always been one of my few good features, even-toned and relatively hassle free.

But now, as a soon-to-be 50-year old dosed up to the eyeballs with HRT, I find myself experiencing regular outbreaks.

Don’t get me wrong: if this is the price I have to pay for feeling half-way normal again, so be it. But I know it’s definitely the hormones since the blemishes always appear in the same location: on my chin and around the mouth, which is textbook. I say ‘appear’. It’s not really like that. More of a lurk, really, underneath the skin, hard and sore like tiny bits of gravel. All that’s visible on the surface is a slight lump, which, if ignored, usually recedes. In fact, they seem to have a definite life cycle, coming, going, coming, going, all in the same place - before eventually getting to a head after several months of broiling away under the surface.

MORE GLOSS: Sarah Vine, the reality of HRT

Having consulted various experts, I now know that this is what’s known as cystic acne, aka adult acne. It has nothing to do with too much sebum - and indeed if anything my skin is dry and dehydrated - and occurs deeper within the layers of the skin than the teenage equivalent. And yes, it is most prevalent in women who are perimenopausal or menopausal. Hurrah!

my spots hang around for days on end and leave behind redness and pigmentation that takes ages to fade.

Stress plays a part too; and whereas my daughter’s teenage spots flare up and disappear practically overnight, because I’m old, mine hang around for days on end and leave behind redness and pigmentation that takes ages to fade.

So, how do you deal with these pests? I’ve tried a million formulations, but by far the best IMHO is plain old £2.99  Sudocrem . Yes, that’s right, the stuff you use on babies’ bottoms. It seems to calm the whole show down, and because it contains zinc oxide it also has antibacterial benefits. Obviously, it doesn’t really work during the day, but it’s brilliant overnight as a calming treatment.

During the day, a soothing drop of oil is best - either Rosehip ( Neal's Yard Remedies Rosehip Oil  £17.50) - rich in omegas and wonderfully healing and helps fade the pigmentation - or a soothing chamomile ( Darphin Chamomile Aromatic Care  £44 is the best) to calm things down and nurture.

I recommended the latter to a friend who had recently developed rosacea, and she texted me a week later to say it had miraculously disappeared. You can also add either to your existing moisturiser if you don’t like putting an oil directly on the skin.

When it comes to covering up, that is a little trickier. You need something with staying power and robust coverage - but you also don’t want to draw attention to the issue by piling it on too thick. Again, I’ve tried and tested a thousand concealers and foundations, and there are really only two that do it for me. The first is Bobbi Brown Long-Wear Even Finish Compact Foundation  £36. I love this because: a) it comes in all skin tones and b) you can layer it according to the level of the emergency and it never looks cakey. Because my skin is very dry, though, it doesn’t always last as long as I would like.

Whereas the latest release from cult Italian brand Diego Dalla Palma - High Coverage Foundation  £25 will take you from school run to wine o’clock without even trying. Seriously, this stuff is genius. It genuinely provides full coverage - easily enough to conceal even the trickiest of lumps and bumps and craters - but without looking embarrassingly obvious. It is also pleasingly hydrating. Oh, and it has an SPF of 20.

P.S: another side effect of HRT: Denis Healey eyebrows. But more of that next time…

Do you have adult acne? Let us know what you think.

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