My first appointment with facialist Kristina Holey was nothing like a facial. It was more like a therapy session. But also like a business meeting—I left with action items and a long sheet of notes. This all happened when I was lucky enough to snag an hour with her last spring at Cap Beauty and canceled an afternoon's worth of meetings to make it happen. (She's based in San Francisco, and her time is very valuable.) When I arrived, I climbed up on the treatment bed and, instead of succumbing to a mask and a massage, we just chatted. Casually, and about me, for an hour—all as Kristina took jotted down the minutes. We talked about my skincare routine, my favorite recipes, how often I go to the bathroom and when... The plan I left with wasn't just about products—though hers, made in conjunction with Marie Veronique are wonderful and fix a lot—it was a 12-month vision for the state of my health as reflected on my face. Daunting, but the most useful information I'd ever left a facial with. It's why I'm confident that Kristina's one of the most qualified facialists to address problem skin I've ever met. And when it comes to problem skin, I can't think of anything more frustrating than hormonal acne. So when laying the groundwork for this story, she's the first one I called.

In keeping with the theme of frustration, there's no one quick fix listed below. Hormonal acne is a process—and one that requires a mindset and a holistic look at your life. But that's what Kristina specializes in. Relax, you're in good hands.

See the whole picture

Hormonal acne sucks. Maybe it helps to say it out loud. But if you're a silver linings kind of person, see this process as an opportunity, Kristina advises. "Hormonal acne is a great way to know that something isn't quite balanced internally," she goes on. "Know that by making changes now to support healthy production and elimination of hormones [ed note: yes that means what you think it means] within the body is a lifelong investment that will clear your skin and probably make you feel a lot better." Fix your hormonal acne; fix your life. And, think about seeing a doctor sooner rather than later. Could prove fruitful.

Skincare can't fix everything

"Hormonal acne typically can be minimized by focusing on reducing inflammation," Kristina says. That can happen topically, yes, but it's most useful internally. There's no silver bullet diet for everyone, but if there's a food that doesn't mesh with your system, it could be increasing inflammation that's bringing your whole routine down. Again, it's different for everyone, but Kristina finds "routines that focus on soothing ingredients, oil balancing vitamins such as b5, and microbiome support (vs. bactericidal properties) are more effective in the long run," Kristina says. Salmon, ginger, and blueberry lovers are in luck.

Stop stressing yourself out

Seriously. The most common mistake Kristina sees clients make is stressing their own skin out with products. "People want to dry out, kill all bacteria, and strip away the barrier layer of their skin in order to eliminate symptoms," she explains. "But the most beneficial thing to do is to address deficiencies and add to the skin, focusing on what is required to be healthy. Often our imbalances are resulting from a lack of nutrients, not excess." Sounds like an antioxidant-rich moisturizer is in your future.

Not all advice is good advice

"Often times I meet clients who are adopting many approaches to 'health' at once and not sticking to one plan long enough," Kristina says. "With the internet and blogs, there is an endless amount of advice, so it can get very confusing." It's true! We see it, too. She continues: "Shifting from one thing to another quickly isn't usually very beneficial and can often worsen things. Trust in your approach and be patient." This usually starts with consulting a real expert, getting some bloodwork done to check your hormone and vitamin levels, and sticking to one plan until you have enough data points to support your hypothesis.

When in doubt, reach out

Kristina is in San Francisco and is often booked solid. But she's an angel so she still has time for you. "I do offer online consultations with my colleague, acupuncturist Justine Wenger," Kristina says. "We have done hundreds of these so far and find them to be super effective at targeting symptoms and setting yourself up with a strong at home regimen." Not quite ready for Facetime? "You can get some great information from books like The Acne Answer by Marie Veronique. Try to think about what it takes to heal acne and make sure your products follow that strategy. Don't just use products because of what other people say. The body was made to be able to create healthy skin on its own, so if all else fails, simplify!"

—Emily Ferber

Photographed by Tom Newton.

Next up: an appointment with Renée Rouleau.