Clearing Hormonal Acne – My Experience With Uncouth

You guys may remember my post from May 2022 where I spoke about being diagnosed with Poly Cystic Ovary Syndrome, and having way too much testosterone, which is what has been causing my acne since I was 14 years old (this was the age I hit puberty). I am 36 now, and the only thing that’s ever really cleared up my hormonal acne was being put on the combined birth control pill.

25% Off Your First Order With My Referral Link

I was happy with this as a treatment for quite some time as I think I started my very first pill in May 2022. I was put on various different versions, and the only one that worked was Co-Cyprindiol, as this blocks testosterone. This specific pill was quite strong though and it was giving me all sorts of side effects like nausea, headaches, stomach upset, spotting, and lots more issues, so I stopped taking it in October 2024 per my doctor’s orders, and I was terrified that my acne would come back.

One of my women’s health doctors also told me that it isn’t a good idea to block my testosterone internally, because of causing issues in my intimate area, and also with my Ehlers Danlos Syndrome. I require my testosterone to keep my muscles strong, to protect my joints. This was something that I was really sad to hear because I was thinking it’s either have no acne and feel unwell, or have acne and feel much better. These two options didn’t sit well with me, but then my doctor mentioned topical Spironolactone.

A dermatologist had actually prescribed me Spironolactone for my acne before, in the oral form, but since this can also lower your blood pressure and I have issues with my blood pressure being low anyway, I didn’t want to take that risk. Plus, I’m not supposed to be blocking my testosterone inside anyway, as I now know. When I looked into Spironolactone cream, I couldn’t really find it anywhere! It’s not available on prescription by my doctor either, so I did lots of research online to try to find it.

I came across this company called Uncouth. Uncouth are a personalised, prescription skincare brand (founded by a dermatology doctor) and they compound bespoke formulas using ingredients that you would only be able to get from a private dermatologist: like Tretinoin for anti-ageing, Hydroquinone for melasma, and of course, Spironolactone for hormonal breakouts.

In the UK, they are the only supplier of Spiro cream, so I knew I didn’t have to shop around and just went right ahead and ordered from them after doing an in depth online consultation, uploading 3 photos, and selecting what I wanted. This was all reviewed by their medical team and approved, so I received my personalised formula really quickly.

One of the good things I learned about Uncouth though is that they are also able to prescribe oral tablets if you require them, for conditions like acne, which other companies can’t do. Another thing that I liked about Uncouth is that they ask what you have used before in terms of prescription skincare and they ask if you have any preferences for your formula in the consultation, which of course I did. So they really do listen to you and don’t just throw any recommendations at you.

My personal formula is made up of Tranexamic acid: 4% and Spironolactone: 5%. Each bottle lasts one month, however the non-Spironolactone formulas are 30mls and they last 2 months. When I first got my formula, I noticed that the smell is quite strong, and when I looked this up, it looks like Spironolactone is actually known to have a strong scent, so that was why. I wash my face, then apply it every night before bed, followed by my moisturiser. I keep my skincare routine really simple so that I don’t break my skin barrier and cause any further issues, as I’ve noticed that I can be prone to breakouts that way too, so simple is key!

I didn’t notice any dryness at all when I started with my cream, and I didn’t have to build up any tolerance to it, but they give you the recommended treatment plan for integrating it into your routine. Everything for me has been just fine and I’ve noticed that when I wake up in the morning, my skin looks much drier and clearer, which is perfect, as it can get really oily! It was an oil factory when I came off of the pill.

My face is quite scarred and has a lot of red marks from suffering from acne for 20 years, so keeping my hormonal acne breakouts away is of high importance to me so that I don’t damage my face even more. The Spironolactone will stop the acne from coming up, and the Tranexamic acid is designed to fade red marks, which is super important to me!

I’m into my second month of my treatment now and I think it’s working! I haven’t been on the pill for 3 months, so my acne was starting to come back a bit, but this cream is definitely helping to keep it at bay. I am still getting the odd spot popping up here and there around my jaw, chin or cheek, but that I can absolutely deal with and I think I need to use this formula for at least 3 months to let my body get used to it. Which is why I’m going to be doing another blog post a bit further down the line with updates.

As you can see from my photos below, even though a couple of spots have popped up here and there, there is a lot of improvement in clearing up the red marks too! I noticed that the other day when I was looking in the mirror, my skin looks a lot more unison in terms of colour now, which is amazing, as I hate those left over red marks. They always take longer to heal on me because my skin heals slower with the EDS. I’ve dated each set of photos, and I’ve also included photos from before I started the birth control pill so that you can see how bad my hormonal acne actually was.

So if you’ve struggled with acne around your jawline and cheeks and it just wont go away no matter what you do, it’s more than likely hormonal. I wish I had found that out much sooner! If you don’t want to take any oral medication for it, trying out the Spironolactone formula for your skin might just be the way to go! They have lots of other treatments too for various other skin concerns, but since my concern is specifically acne, that’s what I’m sharing with you.

You can sign up with my referral link and get 25% off your first subscription too, so it’s worth doing! My link is just below:

25% Off Your First Order With My Referral Link

Above is the 25th November 2024

Above is the 7th December 2024

Above is the 10th January 2025

One area to note here for the fading of the red marks is on the right in the photos. There was a triangular shape of 3 dots around the edge of my eyebrow, which has faded so much. Those are they most important for me as they drove me mad! Can you spot any other areas that have improved?

Above was before I even started taking any hormonal treatment at all, so this was around 2 years ago.

And above here is literally the worst my acne had ever been. This was sometime in the 2015-2017 time period. It was absolutely awful and so painful. When I look back at this, I want to cry, and I’m so thankful that my skin isn’t like this anymore. It flared up way worse because of a Vitamin C cream.

So this has been my experience so far with Uncouth, and I’m really pleased! My disclaimer for this post is that I started out by buying the product myself, and was so impressed with it that I reached out to Uncouth for a collaboration. This is not gifted or paid for, but they did offer me a discount on the product, for total clarification, so everything I have shared here is completely honest (as always) and my genuine review. I can’t wait to update you in a couple of months time!