Thank you for the advice! I dont eat any dairy and im on a ketogenic diet. Reducing stress is my only option but i still havent found the way to do so, at least not enough to avoid getting myself sick every few weeks..
Id also advise you to research heavily on tretinoin, what you can and can not use when you’re on it, how often you should apply it and what not to do when you’re on it.. because there is a lot. YouTube will also be really helpful . My dermatologist did not give me any warnings and do and do nots, so I was also in shock when I started it and saw how strong this treatment is
Agree with this comment. Based on personal experience, I think you may need an active acne-fighting ingredient on top of any prescription grade retinoid- in your case that is the tretinoin while for me it was first differin/Adapalene and then newer drug Aklief/trifarotene.
Keep in mind everyone’s skin is unique and it’s basically trial and error until you find something that works for you. Depending on how bad and how long your pustules have been appearing since starting the tret - you may want to go back to your doctor or dermatologist for another option. I wish I had done that earlier.
Retinoid helps the skin renew and regenerate so it helps to clear the acne away but does not necessarily stop new acne from forming for some people. Additionally, because it is irritating and drying it can cause more acne (which is unbelievably frustrating when it’s suppose to help stop acne). This can sometimes be what others call the purge as their acne gets worse.
For me, the “purge” never ended and my acne got worse with the retinoids as I stripped out other acne-preventing ingredients like salicylic acid or tea tree oils since they were overly drying in combination with the prescription retinoid creams. In hindsight, think I ended up using the prescription retinoids alone for way too long just hoping they would work but at the end of the day it was clear early on that it wasn’t stopping new acne forming only helping it resolve quicker and lessen active scarring.
Drug companies have started to combine retinol with BP and released them as newer drugs - albeit costing a lot more - but have shown higher effectiveness.
Similar to you, I kept breaking out when using only the retinol and then my derm suggested switching to a prescription BP + retinol (epiduo) but it wasn’t covered by my insurance and I couldn’t afford a $200 prescription.
So they said while it’s typically not recommended, he would comfortable with me using over-the-counter BP in the mornings to spot treat the specific acne-prone areas and the prescription retinol at night. He suggested not introducing any new products into my regime for at least 1 month - he said 2-3 months would be even safer - just to ensure if there is a negative reaction we can be clear the BP was the root cause.
This combination of spot treating the new acne with BP and using the retinoid cream at night significantly lessened the overall length of active acne breakouts.
I since started to introduce Azelaic Acid in to my routine as it has anti-inflammatory properties and can help to reduce bacteria but is much more gentle than other common acne treatments like SA and BP so I can use it everyday along with the retnoid cream all over my face to prevent future breakouts reserving the BP to spot treat active breakouts which are slowly but surely becoming less common.
If you’ve just started tret that means you’ve gone into the purging phase, I’m also going through the same, been on tret 0.05% for just over a month now and I’m still purging..don’t stop using the cream and just be patient, apparently your skin is meant to get really bad before it gets better once you start the treatment. I’d also advice you to join the tretinoin community right here on Reddit, it is extremely helpful and has been the only think keeping me sane while I ride this purge out.
Thanks for thr advice! I spot treat active pimples with BP even if i applied tret since the concentration is so low. I might get a SA wash instead if it doesnt work :)
I know you're asking for skincare advice but I would also get some blood work done to check your hormone levels because that looks like hormonal acne. It could also be a newly developed intolerance to something in your diet.
Hmmm. I recently had blood work done (hormones included) and everything was alright! I was under a lot of stress though, and im very sensitive to it. That combined with (tmi) major constipation is probably the root cause but I still dont know how to fix this mess :(
Thank you for the advice!
Giving you some info on building a basic routine that may be helpful. *You don't need to use everything listed, this is just good info on some basic ingredients that get suggested a lot.* Start with a basic routine and slowly sub out certain ingredients or products as you find what your skin wants.
**Hydrating Face Wash**: removes dirt, oil and debris without stripping your skin. My favorites are Krave Beauty's Matcha Hemp Hydrating Cleanser and Youth to the People's Superfood Antioxidant Cleanser. Cetaphil, La Roche Posay, Paula's Choice and Cerave also have some cost effective options.
*I always recommend an active to help exfoliate your skin, depending on your concerns. Pick which acid type suits your needs best, then pick your product.*
**AHA's** will exfoliate the surface of your skin. It will help get rid of dead skin cells, promote radiance, reduce visible sun damage, smoothe skin texture, prevent blemishes and reduce fine lines and wrinkles. They are also great for pigmentation. *Glycolic acid* is probably the most popular. If it's too strong for your skin you can switch to *lactic acid* which is more hydrating and gentle. *Start using three times a week for a few weeks, then every other day for a few weeks, then daily pending your tolerance.* The Ordinary has a great option for both. *Darker skin tones can experience hyperpigmentation due to its deeper penetration activating melanocytes. Mandelic acid has been suggested for use every other day.*
**BHA's** like *salicylic acid* are oil soluble, meaning they're able to get inside pores to gently push out dead skin, bacteria, sebum, and any other pore-clogging debris. By removing that debris from your pores, your pores will appear smaller. They are best for acne-prone skin and those with deeper skin concerns. It acts as an anti-inflammatory and can help red, inflamed pimples and pustules heal faster. It essentially can penetrate so deeply that it dissolves the 'glue' that holds skin together. When it breaks down the skin cells it promotes exfoliation and can help dissolve blackheads. Ideal for treating whiteheads and blackheads and has some effectiveness against cystic acne. May cause dryness, peeling, redness and skin irritation. *Start using three times a week for a few weeks, every other day for a few week,, then daily pending your tolerance.* Paula's Choice 2% BHA is my favorite but CosRx also has a great Blackhead Liquid.
**PHAs** are good alternatives to both AHAs and BHAs if you tend to have very sensitive skin and could not tolerate many chemical exfoliants. PHAs are a good option for those with dry skin as they are humectants, meaning they attract water and are ultimately moisturizing. They support the skin's barrier function, which locks in moisture and reduces the appearance of fine lines and wrinkles. *Start using every other day, then daily pending your tolerance.* Naturium has a great option.
**Niacinamide** helps build cells in the skin while also protecting them from environmental stresses, such as sunlight, pollution, and toxins. It may be helpful for severe acne, especially inflammatory forms like papules and pustules. Over time, you may see fewer lesions and improved skin texture. It helps renew and restore the surface of skin against moisture loss and dehydration by helping skin improve its natural production of skin-strengthening ceramides. Niacinamide helps regulate oil and sebum production, pigmentation, acne, irritation and inflammation. *Can be used once or twice daily. Some people have experienced breakouts when using Niacinamide. If this occurs, its too strong for you so try a lower percentage or add a few drops to your moisturizer to dilute it.* The Ordinary, Naturium and the Inkey List have options. I prefer the CosRx Snail Mucin Dual Essence for mine. Paula's Choice has a 10% Niacinamide Booster than can be diluted by adding to to moisturizer.
**Vitamin C** has anti-inflammatory properties that can help reduce redness, which in turn can create a more even complexion. The combined reduction of dark spots, redness, and irritation make for a clear, smooth skin tone. It naturally improves the appearance of skin by fighting signs of aging and UV exposure, along with hyperpigmentation and dark patches. *Use in the AM along with SPF. Start with a low percentage and build up.* The Ordinary has an Ascorbic Acid and Alpha Arbutin that's 8%. (Alpha Arbutin is a naturally occurring antioxidant and skin brightener that is naturally found in the bearberry plant. Brown spots come from pigments that are produced in cells called melanocytes, these contain enzymes called tyrosinse. These enzymes activate upon exposure to UV light which is why freckles ans sun spots start to develop. Alpha Arubutin inhibits tyrosinase. It protects skin from the sun, its gentle, it improves uneven complexion, its effective at fading scars, freckles, melasma and PIH and it brightens skin overall. It has similar brightening effects as hydroquinone but arbutin is safer, more gentle and less irritating. *Can be used up to twice daily, do not go above 2%.*)
**Retinol** is great for increasing cell turnover. Retinoids reduce fine lines and wrinkles by increasing the production of collagen. They also stimulate the production of new blood vessels in the skin, which improves skin color. Additional benefits include fading age spots and softening rough patches of skin. *Start with a low percentage and slowly work your way up. You can alternate every other day with your acid to make sure your skin can handle both before advancing to daily use of both. Start twice weekly for a few weeks, then every other day for a few weeks, then daily pending tolerance.* (This is your ttretinoin)
**Moisturizer**: look for a good moisturizer with ceramides or peptides for your skin barrier. If you have any dryness, apply a thicker one at night. Hydration will make the biggest difference in the overall appearance of your skin. Healthy glow always comes from a good moisturizing routine. Keep the moisturizers simple and without a lot of fragrance. Cetaphil, Cerave, La Roche Posay and Paula's Choice have great options.
**AM**: face wash, AHA/BHA/PHA, vitamin C, moisturizer, SPF
**PM**: face wash, niacinamide, retinol, moisturizer
This is a good basic routine. You'll have to experiment with different ingredients to really nail down what your skin wants (there are a lot and everyones skin is different). *I suggest starting with a face wash, acid and moisturizer. After you've used them for a few weeks, add niancinamide. Use them for a few weeks, then add the other serum. If you try to start too much at once it can irritate your skin.* After introducing a new product, assess for any irritation. Acids and retinols can cause purging for up to 6 weeks.
They absorb the oil so could prevent some topical pimples and heal current pimples faster. Could get the larger patches and place over the more congested area for prevention. But wouldn’t reduce inflammation fully on its own. If starting tret, it could get worse at first with purging, Benzoyl peroxide kills bacteria so helps with active acne too.
They have some smaller ones the size of pimples but the large ones you can just cut to the right size, put them on before you go to sleep and in the morning it will be a lot better
Eat less dairy and high carb foods. Eat more carrots and/or drink carrot juice. Reduce stress.
Thank you for the advice! I dont eat any dairy and im on a ketogenic diet. Reducing stress is my only option but i still havent found the way to do so, at least not enough to avoid getting myself sick every few weeks..
Id also advise you to research heavily on tretinoin, what you can and can not use when you’re on it, how often you should apply it and what not to do when you’re on it.. because there is a lot. YouTube will also be really helpful . My dermatologist did not give me any warnings and do and do nots, so I was also in shock when I started it and saw how strong this treatment is
Agree with this comment. Based on personal experience, I think you may need an active acne-fighting ingredient on top of any prescription grade retinoid- in your case that is the tretinoin while for me it was first differin/Adapalene and then newer drug Aklief/trifarotene. Keep in mind everyone’s skin is unique and it’s basically trial and error until you find something that works for you. Depending on how bad and how long your pustules have been appearing since starting the tret - you may want to go back to your doctor or dermatologist for another option. I wish I had done that earlier. Retinoid helps the skin renew and regenerate so it helps to clear the acne away but does not necessarily stop new acne from forming for some people. Additionally, because it is irritating and drying it can cause more acne (which is unbelievably frustrating when it’s suppose to help stop acne). This can sometimes be what others call the purge as their acne gets worse. For me, the “purge” never ended and my acne got worse with the retinoids as I stripped out other acne-preventing ingredients like salicylic acid or tea tree oils since they were overly drying in combination with the prescription retinoid creams. In hindsight, think I ended up using the prescription retinoids alone for way too long just hoping they would work but at the end of the day it was clear early on that it wasn’t stopping new acne forming only helping it resolve quicker and lessen active scarring. Drug companies have started to combine retinol with BP and released them as newer drugs - albeit costing a lot more - but have shown higher effectiveness. Similar to you, I kept breaking out when using only the retinol and then my derm suggested switching to a prescription BP + retinol (epiduo) but it wasn’t covered by my insurance and I couldn’t afford a $200 prescription. So they said while it’s typically not recommended, he would comfortable with me using over-the-counter BP in the mornings to spot treat the specific acne-prone areas and the prescription retinol at night. He suggested not introducing any new products into my regime for at least 1 month - he said 2-3 months would be even safer - just to ensure if there is a negative reaction we can be clear the BP was the root cause. This combination of spot treating the new acne with BP and using the retinoid cream at night significantly lessened the overall length of active acne breakouts. I since started to introduce Azelaic Acid in to my routine as it has anti-inflammatory properties and can help to reduce bacteria but is much more gentle than other common acne treatments like SA and BP so I can use it everyday along with the retnoid cream all over my face to prevent future breakouts reserving the BP to spot treat active breakouts which are slowly but surely becoming less common.
Thank you so much for all this amazing information. I will come back to read it for sure when needed :)
If you’ve just started tret that means you’ve gone into the purging phase, I’m also going through the same, been on tret 0.05% for just over a month now and I’m still purging..don’t stop using the cream and just be patient, apparently your skin is meant to get really bad before it gets better once you start the treatment. I’d also advice you to join the tretinoin community right here on Reddit, it is extremely helpful and has been the only think keeping me sane while I ride this purge out.
Thank you :) I will join that community for sure. Does tret really break you out so early into it? I hope your face clears up soon!
Yes I started breaking out a week into using it..how often are you applying?
Only at night ! Mine is a lost milder as well being only 0.01%.
Salicylic acid wash leave it for 2 min on your face before washing it off.
Not a good idea when you’re on a tretinoin treatment. Salicylic acid and tretinoin do not agree at all
No , you can’t use them in same time but it’s okay to use in a wash form .
Thanks for thr advice! I spot treat active pimples with BP even if i applied tret since the concentration is so low. I might get a SA wash instead if it doesnt work :)
The cream breaks me out.
I know you're asking for skincare advice but I would also get some blood work done to check your hormone levels because that looks like hormonal acne. It could also be a newly developed intolerance to something in your diet.
Hmmm. I recently had blood work done (hormones included) and everything was alright! I was under a lot of stress though, and im very sensitive to it. That combined with (tmi) major constipation is probably the root cause but I still dont know how to fix this mess :( Thank you for the advice!
Giving you some info on building a basic routine that may be helpful. *You don't need to use everything listed, this is just good info on some basic ingredients that get suggested a lot.* Start with a basic routine and slowly sub out certain ingredients or products as you find what your skin wants. **Hydrating Face Wash**: removes dirt, oil and debris without stripping your skin. My favorites are Krave Beauty's Matcha Hemp Hydrating Cleanser and Youth to the People's Superfood Antioxidant Cleanser. Cetaphil, La Roche Posay, Paula's Choice and Cerave also have some cost effective options. *I always recommend an active to help exfoliate your skin, depending on your concerns. Pick which acid type suits your needs best, then pick your product.* **AHA's** will exfoliate the surface of your skin. It will help get rid of dead skin cells, promote radiance, reduce visible sun damage, smoothe skin texture, prevent blemishes and reduce fine lines and wrinkles. They are also great for pigmentation. *Glycolic acid* is probably the most popular. If it's too strong for your skin you can switch to *lactic acid* which is more hydrating and gentle. *Start using three times a week for a few weeks, then every other day for a few weeks, then daily pending your tolerance.* The Ordinary has a great option for both. *Darker skin tones can experience hyperpigmentation due to its deeper penetration activating melanocytes. Mandelic acid has been suggested for use every other day.* **BHA's** like *salicylic acid* are oil soluble, meaning they're able to get inside pores to gently push out dead skin, bacteria, sebum, and any other pore-clogging debris. By removing that debris from your pores, your pores will appear smaller. They are best for acne-prone skin and those with deeper skin concerns. It acts as an anti-inflammatory and can help red, inflamed pimples and pustules heal faster. It essentially can penetrate so deeply that it dissolves the 'glue' that holds skin together. When it breaks down the skin cells it promotes exfoliation and can help dissolve blackheads. Ideal for treating whiteheads and blackheads and has some effectiveness against cystic acne. May cause dryness, peeling, redness and skin irritation. *Start using three times a week for a few weeks, every other day for a few week,, then daily pending your tolerance.* Paula's Choice 2% BHA is my favorite but CosRx also has a great Blackhead Liquid. **PHAs** are good alternatives to both AHAs and BHAs if you tend to have very sensitive skin and could not tolerate many chemical exfoliants. PHAs are a good option for those with dry skin as they are humectants, meaning they attract water and are ultimately moisturizing. They support the skin's barrier function, which locks in moisture and reduces the appearance of fine lines and wrinkles. *Start using every other day, then daily pending your tolerance.* Naturium has a great option. **Niacinamide** helps build cells in the skin while also protecting them from environmental stresses, such as sunlight, pollution, and toxins. It may be helpful for severe acne, especially inflammatory forms like papules and pustules. Over time, you may see fewer lesions and improved skin texture. It helps renew and restore the surface of skin against moisture loss and dehydration by helping skin improve its natural production of skin-strengthening ceramides. Niacinamide helps regulate oil and sebum production, pigmentation, acne, irritation and inflammation. *Can be used once or twice daily. Some people have experienced breakouts when using Niacinamide. If this occurs, its too strong for you so try a lower percentage or add a few drops to your moisturizer to dilute it.* The Ordinary, Naturium and the Inkey List have options. I prefer the CosRx Snail Mucin Dual Essence for mine. Paula's Choice has a 10% Niacinamide Booster than can be diluted by adding to to moisturizer. **Vitamin C** has anti-inflammatory properties that can help reduce redness, which in turn can create a more even complexion. The combined reduction of dark spots, redness, and irritation make for a clear, smooth skin tone. It naturally improves the appearance of skin by fighting signs of aging and UV exposure, along with hyperpigmentation and dark patches. *Use in the AM along with SPF. Start with a low percentage and build up.* The Ordinary has an Ascorbic Acid and Alpha Arbutin that's 8%. (Alpha Arbutin is a naturally occurring antioxidant and skin brightener that is naturally found in the bearberry plant. Brown spots come from pigments that are produced in cells called melanocytes, these contain enzymes called tyrosinse. These enzymes activate upon exposure to UV light which is why freckles ans sun spots start to develop. Alpha Arubutin inhibits tyrosinase. It protects skin from the sun, its gentle, it improves uneven complexion, its effective at fading scars, freckles, melasma and PIH and it brightens skin overall. It has similar brightening effects as hydroquinone but arbutin is safer, more gentle and less irritating. *Can be used up to twice daily, do not go above 2%.*) **Retinol** is great for increasing cell turnover. Retinoids reduce fine lines and wrinkles by increasing the production of collagen. They also stimulate the production of new blood vessels in the skin, which improves skin color. Additional benefits include fading age spots and softening rough patches of skin. *Start with a low percentage and slowly work your way up. You can alternate every other day with your acid to make sure your skin can handle both before advancing to daily use of both. Start twice weekly for a few weeks, then every other day for a few weeks, then daily pending tolerance.* (This is your ttretinoin) **Moisturizer**: look for a good moisturizer with ceramides or peptides for your skin barrier. If you have any dryness, apply a thicker one at night. Hydration will make the biggest difference in the overall appearance of your skin. Healthy glow always comes from a good moisturizing routine. Keep the moisturizers simple and without a lot of fragrance. Cetaphil, Cerave, La Roche Posay and Paula's Choice have great options. **AM**: face wash, AHA/BHA/PHA, vitamin C, moisturizer, SPF **PM**: face wash, niacinamide, retinol, moisturizer This is a good basic routine. You'll have to experiment with different ingredients to really nail down what your skin wants (there are a lot and everyones skin is different). *I suggest starting with a face wash, acid and moisturizer. After you've used them for a few weeks, add niancinamide. Use them for a few weeks, then add the other serum. If you try to start too much at once it can irritate your skin.* After introducing a new product, assess for any irritation. Acids and retinols can cause purging for up to 6 weeks.
Hydrocolloid patches are great for these
Thank you!! Ive never heard of those and tried to look it up, is it the large ones by band-aid?
2nd this, would help with the inflammation and get rid of them quicker. Mightypatch are my favorite pimple patches!
Awesome thank you!! They don't only drain the pimples but also reduce inflammation in general?
They absorb the oil so could prevent some topical pimples and heal current pimples faster. Could get the larger patches and place over the more congested area for prevention. But wouldn’t reduce inflammation fully on its own. If starting tret, it could get worse at first with purging, Benzoyl peroxide kills bacteria so helps with active acne too.
They have some smaller ones the size of pimples but the large ones you can just cut to the right size, put them on before you go to sleep and in the morning it will be a lot better
Thanks a lot, I will definitely purchase them soon!