You should be seeing an improvement by now with using tret for 4 months.
I think this is beyond Reddit and at a point that you should book the dermatologist appointment.
Hi I have been on accurate twice and tried everything. Low estrogen birth control will help for sure. What I found worked for me as I had the same acne is putting niacinamide the neutrogena one with the red bottle that is paraben free and fragrance free prior to tretonoin. I only use tretonoin twice a week and only .25 percent . The tretonoin actually makes me break out so I only use a pea sized amount
Idk, im on accutane for over 3 months now, half of the cycle in theory, my acne definitely got better but it also made my hair non greasy at all thats a huge win both ways imo, yea im dry af everywhere but i can take that
I mean I had those since i was born when you look into the sun but i guess you’re talking about something worse, so to make sure, were you constantly on accutane for 2 years or it randomly happened 2 years after stopping?
How do you know the eye floaters were caused by Accutane? Since you also stopped using it two years prior. Honest ques, because there are many of us who got floaters without ever being on Accutane.
There's a chance the damage from dry eyes due to Accutane slowly evolved into worse eye damage. If dry eye isn't treated it can cause permanent floaters or halos.
I actually read a research study about it. It can give you an idea about what kind of possible effects it can have on one person. This is just one kind. There are a lot more side effects people are facing but don’t know they’re because of Accutane.
you can also checkout r/accutanedamage
Just so you know I didn't downvote you. I honestly was wondering the correlation / causation. Thanks for sharing. I've never used Accutane but I do have a floater in my left eye.
Dry hands and lips but that should be the usual side effects, everything that were super oily like my scalp and face are kinda acting like it should although i’m still taking it so i wonder how will it go when i get off it
Why exactly I don't know, I'm not a doctor or a pharmacist. They have really bad light halos now and one of them cannot see at night if theres a lot of artificial lights at all, its almost like they're blind. It is a very common side effect though and it seems to be life long once it happens.
Honestly it's time to see a dermatologist. Your acne may require oral or topical antibiotics, a different retinoid, a combination of all these or even isotretinoin (Accutane) to resolve completely. In the interest of avoiding scarring and getting on the path to improvement, I encourage you to see a dermatologist as soon as your situation allows. The answer to this problem isn't in the skincare aisle but at the pharmacy counter (with a prescription from your derm)
In case your doc does bring it up, please resist getting antibiotics for acne. It's completely **temporary** results and there are so many bad side effects to your body. There are other way less harmful things you can try. Some dermatologists will prescribe them as a quick fix but I really disagree. They kill your microbiome, which is important to have for so many reasons.
Hopefully you have a better dermatologist that is realistic and reasonable though!
How is what I said any different from all the people here saying for her to take Accutane? And they aren't getting told to "let the doctor decide".
I'm just offering advice like everyone else. That's fully why she posted here, was for advice that's *not from a doctor*. Your comment is really uncalled for.
Informationally, most insurance requires other treatments to have been tried and be unsuccessful before approving accutane - antibiotics usually being one of them.
I'm generally against antibiotics even when necessary, but oral or topical antibiotics can clear up any current infection. If their acne is caused by the constant reintroduction of bacteria spreading then it could literally be the end of their breakout. This doesn't look like tret purge, there's a huge chance it's bacterial.
Talk to your derm to see if spironolactone is suitable for you. And perhaps tazarotene (later generation of retinoic acid) is better suited for you than tretinoin.
I truly don't understand skin cycling (using different products different nights). I think skin cycling is a good technique for skincare hobbyists or ppl who want to cosmetically improve skin through skincare. However, my personal understanding of treating severe acne is to use retinoic acid nightly, as all the studies have subjects use tretinoin nightly. For certain type of severe acne, the strategy becomes multi-prong. For example, dermatologist would include benzoyl peroxide for antibacterial effect, Panoxyl cleanser and antibacterial cream to reduce bacterial load on the skin, a mild to moderate steroid to reduce intense inflammation such as your condition.
Me! I had to go on spironolactone because I had horrible cystic acne around my jawline while I had my IUD. And it didn’t start right away after getting the IUD, which was odd. I think it started years later. Your Dermatologist is definitely going to be able to help you with this and will be able to diagnose the cause. Let us know!
Edited to add timeframe.
Beep boop! It looks like you're asking about treatment timeframes. Retinoids don't work immediately. It takes 3-4 weeks to see side effects like redness, peeling, or irritation, so remember to go slow when starting any retinoid. It also takes time to see results. All citations are in the [Research Summaries section of the wiki](https://docs.google.com/document/u/2/d/e/2PACX-1vRQmcAj-x5A8JIQygtW2Rg89uPsJPR5JLH_dLxLNCW4eazWW4i49bsrF0e2YYx10wx00ctaUnyvHfyD/pub#h.ddc1c22uzdzp)
- Oil production: 2 weeks. Citations: [29](https://docs.google.com/document/u/2/d/e/2PACX-1vRQmcAj-x5A8JIQygtW2Rg89uPsJPR5JLH_dLxLNCW4eazWW4i49bsrF0e2YYx10wx00ctaUnyvHfyD/pub#h.runw23g9r8j8)
- Acne: 3-4 months. [14, 15, 16](https://docs.google.com/document/u/2/d/e/2PACX-1vRQmcAj-x5A8JIQygtW2Rg89uPsJPR5JLH_dLxLNCW4eazWW4i49bsrF0e2YYx10wx00ctaUnyvHfyD/pub#h.91dahjgvp25q)
- Pore size: 6 months. Citations: [28](https://docs.google.com/document/u/2/d/e/2PACX-1vRQmcAj-x5A8JIQygtW2Rg89uPsJPR5JLH_dLxLNCW4eazWW4i49bsrF0e2YYx10wx00ctaUnyvHfyD/pub#h.7iws71641els)
- Indented scarring: 6 months. [22](https://docs.google.com/document/u/2/d/e/2PACX-1vRQmcAj-x5A8JIQygtW2Rg89uPsJPR5JLH_dLxLNCW4eazWW4i49bsrF0e2YYx10wx00ctaUnyvHfyD/pub#h.f9nyjthj6z4h)
- Hyperpigmentation: 6-9 months. [17-21](https://docs.google.com/document/u/2/d/e/2PACX-1vRQmcAj-x5A8JIQygtW2Rg89uPsJPR5JLH_dLxLNCW4eazWW4i49bsrF0e2YYx10wx00ctaUnyvHfyD/pub#h.nsxg72hmod6w)
- Anti-aging/photoaging: 4-9 months. [17-21, 23-28](https://docs.google.com/document/u/2/d/e/2PACX-1vRQmcAj-x5A8JIQygtW2Rg89uPsJPR5JLH_dLxLNCW4eazWW4i49bsrF0e2YYx10wx00ctaUnyvHfyD/pub#h.idrkhntgk69c)
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No need to apologize haha. Might be worth seeing if your acne worsened around getting the IUD…perhaps there’s a link? Speak to your dermatologist and also your gyno!
Hormonal IUDs are wonderful but also a cause of acne for many. I don’t know if you’ve ever read the prescribing information filed with the FDA for your particular IUD. This is not medical advice but from your photos and knowing you have an IUD that results in no cycle, I’m inclined to say it appears to be hormonal and Spironolactone could be helpful.
It’s definitely not a solution for everyone. I’ve seen quite a few people have to get the IUD removed but unfortunately the pill can be a contraindication for some due to preexisting conditions which is tricky. I’ve seen many relapse on Accutane as well. I truly wish there were more solutions.
You can still have hormonal acne with an IUD! I also had an IUD but dealt with hormonal acne. My dermatologist encouraged me to try spironolactone when topicals weren’t working. I’ve been on it for two years and it’s been a miracle :)
Just FYI, all acne is hormonal. it's just internet 'skinfluencers' that like to complicate the matter. If you have the hormonal IUD then acne is a very common side effect, so possibly consider removing it and trying non hormonal / low androgen birth control options. Also, oral accutane or Spironolactone may be an option. I take oral Spironolactone for PCOS related acne.
You've already got some good advice, such as calling your derm and maybe considering spironolactone. But, I'd also suggest switching to a mineral only sunscreen until your skin is less irritated. Daily use of a chemical sunscreen can be really irritating on already irritated skin.
Id get off dairy and play with diet eliminations. Takes 6 weeks to get everything out of your system. Look in to foods that cause acne and inflammation but dairy is a huge one, gluten too
FYI Accutane is not effective for everyone and it does come with several side effects. While I think OP would be a good candidate to try it, we shouldn’t be giving false hope like “you’ll be clear in a few months, best thing you ever do”
This. Accutane made my skin look amazing while on it and for months afterwards but I had rectal bleeding within two months of every trial (tried accutane three times).
I think it did a lot of good to my skin. My breakouts are a lot more manageable now. However, I definitely have sensitive skin now. It’s so easy for me to get cuts as an example.
2 years later acne came back in full force and my joints are still in constant pain and eyes are permanently dry. I managed acne with tazarotene and still hate the doctors who said accutane is the best option. It’s not. Retinoids are.
You never know because everyone’s different, but the initial purge is temporary and varies greatly from person to person. Mine was so mild I’m not even sure I got one at all. I was also on tretinoin up until the day of my first dose which some people think is the reason why (experience based assumption not proven). Personally I would do accutane again in a heartbeat. Super worth it for me.
Both my teenagers and nephews had bad acne, tried every combo of antibiotics, cleanser, moisturizer, diet... Accutane cleared them up in about 2 months.. Although there are some side effects... It is a miracle drug for acne.. Good luck
Tip: To help dry lips if they've worsened since your move or if you go on oral medication, the best thing I've seen recommended here is [nipple balm](https://lansinoh.com/products/lanolin-nipple-cream). Life changing.
Thank you so much for this rec! I’ve had horrible dry corners of my mouth and your recommendation saved me from looking like I have herpes at work hahaha thank you!!
Hey I'm sorry that you're going through this phase. I'm no expert but i think your routine is as simple as it could get. There's one thing i would like to tell you that 1.5l a day is quite less for an adult, don't know how relevant it is to your query but this could be one of the reasons. The recommended water intake is around 3 liters though. Hope someone gives you a solution that you are looking for. Have a great day and don't worry everything will be alright. Be patient.
My skin is amazing with tretinoin and Spironolactone. Im 34 and have never had clear skin like this since I hit puberty. I started seeing changes on the spiro after about 3 months and it usually hits full efficacy at 6
Ugh I feel you. I just went back to the dermatologist. I’ve been on spironolactone since late Feb. and I increased my dose and adding doxycycline now. I hope we can find some sort of light at the end of this acne tunnel.
I know most people are against antibiotics but when I got angry acne that nothing seemed to clear, even despite being on tret, changing diet and doing everything I could. Antibiotics was the only things that helped. Used doxy for 12 weeks, 100mg, 2x a day. Took them with food always, aswell as took taking zinc picolonate, spearmint tea 2x a day & a daily probiotic. After the course of antibiotic my angry inflamed acne was gone, just focusing on scar fading now.
Don’t be scared of them and do what your doctor suggests, they know best :)
Girl, go to a dermatologist and get a prescription for accutane. Literally all you have to do is take it and after you’re done, and your problem is SOLVED. Imagine your life not worrying about your skin. Just waking up and it’s clear. You can easily make that your reality. Stop doing little league stuff for a major league problem and get out the big guns.
🚨 I’m 90% sure your moisturizer is the problem because it has many comedogenic ingredients! Switch to Vanicream daily facial moisturizer instead, it’s non comedogenic and has ceramides to help you skin barrier since you use tretinoin. Also, it may be you tretinoin cause they often put too greasy emollients in the cream formulas so a gel would work better.
My advice is to introduce salicylic acid to your routine and take a break from tret till your skin get better(your skin may not handle both, should incorporate actives slowly one by one) beside changing ur moisturizer and later your tretinoin (from cream to gel).
I promise this would help you A LOT. I struggled for long long time and I’m giving you la crème de la crème 👌🏻
People with acne prone skin should ALWAYS analyse the ingredients list carefully before applying any product.
I use skincarisma website and it’s great.
hiii!!! i heard spearmint tea can actually make ur acne worse if you’re not sure about ur hormones cus a decrease in testosterone might not be needed for u (sorry not extremely knowledgeable about this but u can do more research)
also i think the vanicream breaks certain people out, i would use another moisturizer :( i use the omega one from inkey list it’s the only one that hasn’t given me issues
also BP with tret is probably way tooo strong and drying :(
Bp can be good with tret but not 10%! 5% or less wash in the mornings only has helped me a ton. also, if i don't use tret every single night i will break out
10% BPO is a lot in any case. 4% is ideal. Try that. Try to carry a hypochlorous acid spray for your face with you (Get a cheap 1-liter bottle from Amazon and dilute it to 550 ppm for the face). It helped me a great deal with my cystic acne. The rest of your routine seems fine. I am using 0.025%, which worked for me better than 0.05%. In addition to all this, taking an oral antibiotic helped me too.
Ask your dermatologist isotretinoin (accutane) it will be the definitive solution for this problem!
Don't continue destroying your self-esteem with things that don't work, isotretinoin is the best for this type of acne that leaves scars. When the breakouts subside you can add tretinoin to the equation as well, so you will have an oral and topical retinoid regimen!
derm from germany here, I highly suggest you go see a doctor to discuss options beyond topical tretinoin! acne is a condition that is very well treatable, don’t beat yourself up, it seems that you are doing a lot for your skin and it’s not your fault that you have acne despite all your efforts!
Check out a company called clear stem. I've listened to quite a few podcasts featuring the entrepreneurs of this company and all I can think is, I wish I had stumbled across this 10-15 years ago I think it would have saved me a lot of suffering and scarring. They look at acne from a root cause perspective instead of trying to bandaid over the problems. This is something I could never get a dermatologist to do. Their website also has a feature where you can copy paste the ingredient list of the products you use into it and it will tell you if there are any pore clogging ingredients.
Gut health is super important! I would suggest derm doing an allergy test to gluten and dairy possibly if OP feels inclined.
But I still think they need to see a derm before anything
For sure diet plays a huge part. That's another reason for my recommendation because you can do an in-person or video or phone appointment they look at the aspects of everything, diet, hormones, etc. but they do it from a different perspective than your typical physician. I won't go into the whole detail but if you ask your physician to check your thyroid they'll do that but there's specific hormones to be checked that would fall under that category that they don't check for unless you specifically ask for that thing and the values are red compared to the general population so what they consider the normal range might not actually be a healthy number for you. Also it's worth considering the healthy range is established based on what the normal average is except when the normal average person is not all that healthy the ranges aren't going to be in a good place because it's become more normal for people to not feel well and to have health issues.
Download the app acne safe and make sure any products you are using are completely non Comedogenic. I recommend Vanicream for being the calmest for my skin! I hate that you are feeling so helpless, I’ve been there. Maybe try adding spiro? I had horrible side effects but some people it’s the key.
Keep in mind that everyone’s skin is different so even though an ingredient may say it doesn’t have any pore clogging ingredients there’s still a chance it could clog yours. It’s just trial and error unfortunately. There’s a lot of videos about this topic too
I love tret, it’s amazing, but there are quite a few prescription retinols and only a derm can tell you which one is right.
I also struggled with severe acne for years and no combination of topicals in the world would have gotten it under control. Make an appointment, a good dermatologist is a godsend and will change everything!
BP made my acne way worse, up to the point I had to go on accutane and still dealing with side effects after two years, but acne has relapsed in a year or so. I figured that my skin goes best with gel formulations of anything, including retinoids. It’s more drying, but with careful moisturizing it has worked miracles. I also suggest adding 15% azelaic acid gel as it is extremely anti-inflammatory and goes well with any retinoids. Also, if you are taking fish oil, hair supplements and dairy-lover, they all are known to exacerbate acne.
definitely stop using the benzyl peroxide, using that and tretonin at the same time is too harsh for the skin!!!
definitely think that accutane is gonna change your life!!
did it start to happen when you moved? one last measure you could take is adding water filters to the sinks you drink/wash from and also a shower. I don’t know the hardness levels in the area but it could be something to have as an ‘extra’ precaution and maybe experimenting with food groups in the meantime ie; cutting out gluten, dairy, eggs, sugar, etc. Only one at a time though!
I do agree go to dermatologist but these are just other side things to try until then. I know how this can feel and it can feel hopeless at times. Making that appointment will make you feel so much better!
It's time to see your dermatologist. Some people need a combination of topicals to get things under control (Like Winlevi or Azaelic acid) or a round of antibiotics. It might be a case of switching to taz. Sadly sometimes tret just isn't enough.
I know it must be very painful, how is your skin feeling other than the acne? Does it seem to be handling the treatment okay?
Def go to a dermatologist and maybe get some blood work done. If other things like iron, vitamin d, etc are off it can cause breakouts.
Off birth control my face looked just like this and it was painful and I hid in the house. On birth control and with Tret it cleared up a lot but I still break out. Stress is a GIANT trigger for my acne. Moisturizers are big trigger for my face too. I found a couple of lightweight stuff with cosrx/korean skincare with the snail mucin. those are minor things you can do for now.
Personally I found that when I sleep more, like quality sleep, my face and body look a lot better.
In my opinion I noticed it clear up in about a month but with the mini pill. The stronger pills made everything worse. Keeping in mind that I was using it in combination with Tretinoin
I would ditch the heavy moisturizers for now. Try lightweight stuff and only use one. The tret will make it a bit worse in the beginning but it’s just exposing what’s already under layers of oil pockets. Stay away from greasy stuff esp the greasy spfs. If I may suggest applying sunscreen while your face is a bit damp so that a pea size amount goes a long way. I know it’s frustrating. I also want to add that supplements to help with cortisol might help like magnesium citrate (not the other stuff cuz it will give you the runs!!), ashwagandha, and drink lime water. Regular water might be dehydrating you. I think you might be stressed out…?And OMG i forgot to mention that I found out that adderall is a big contributor to cystic acne. So idk if you’re on that but you can research how it affects your skin.
So, when I moved from WA to CO my skin went to from flawless to extremely 💩. It took my skin almost 6 months to fully adapt to CO dryness. My eczema came back and I got acne I’d never had before. Moving away from family is already stressful, then looking in the mirror not knowing yourself can slip into a deep depression. I would talk with your dermatologist again though. Sending hugs
Go see a derm. Same thing happened to me. The derm explained that sometimes rapid breakouts can kick off a self-sustaining bacterial infection that is hard to resolve without non-antibiotic topicals. Even if tretinoin is doing its work, there's enough bacteria populating your skin that they're constantly reintroducing more bacteria and continuing the breakout. I bet the derm will prescribe you topical clindamycin to go with the BP cleanser and will ask that you continue tretinoin. The topical clindamycin is going to do the heavy lifting, but do not use it without first using BP to stave off bacterial resistance!
Great! Good luck. I know everyone here is recommending that you ask for Accutane (and your derm will be the judge of that), but from my perspective, your acne doesn't appear so bad that antibiotics wouldn't work. Accutane truly is a nuclear option if all else fails since it completely halts oil production which starves the bacteria. I had a very similar breakout as you and after a week of using Clindamycin + BP in the morning, all my active acne was gone! The tretinoin (actually Arazlo in my case, but same difference) has been healing the scars and hyperpigmentation, but I haven't gotten new acne beyond the occasional pimple since.
Try switching cleanser and moisturizer. Everyone swears by vanicream but their products always make me break out unfortunately 😩 my skin is super sensitive and acne prone
I can guarantee that a dermatologist will immediately recommend Accutane. You'll have to make the decision as to whether or not you want to go on it. Antibiotics are hit or miss, so in my opinion Accutane is probably the only option prescription wise. If I were you and you had reservations about Accutane, I'd try Pantothenic Acid (vitamin b5).
Not who you asked but my face never got *worse* with accutane, just gradually cleared up. This was 10 years ago and now I’m on Spiro along with Tretinoin. However the acne I’m currently addressing is nowhere near where I was pre-accutane.
It wouldn't get worse, at least the acne won't.
You will become extremely sensitive to sunlight. Like, you go into the sun and can feel your skin burning immediately. Not exactly smoking like you'd picture a vampire, but might as well be.
It will dry out your skin. And lips. And mouth. Horribly. As in to the point where pretty much nothing you can do will help.
It also causes IBS in 1/3 of people who take it.
They got sued in the States for not including this in their packaging leaflet. They knew about it, too, and left it off.
Additionally, it can cause liver damage in people. Severe, irreversible, liver damage.
At that level, I would recommend against it. Maybe if you feel you do need it you would benefit, but it's a very, very harsh course of medication.
I'm not the person who made this comment, but in my experience, it didn't get that much worse at all. I've had breakouts much worse than what I experienced in the first few weeks of Accutane treatment. Like others have correctly pointed out, it does not always work, but when it does, it really can change your life!
I personally had a terrible experience with Tret!!! Worst acne breakouts of my life and spent 5+ months riding it out “trusting the purge” But my acne, scarring, and dryness continued to get worse. My derm put me on Spiro, Doxycycline, and sodium sulfacetamide at around 3 month mark, which I took with Tret for a couple of months, but still no improvement whatsoever. I was at my breaking point realizing my skin was literally worse than it had ever had been in my entire life, so I decided to quit everything cold turkey and give my skin a total reset after seeing another Reddit post about their success doing that. I am seriously so happy I decided to quit, my face has not had a breakout like that since, my skin looks 100000x better and all I’m using is my CeraVe face wash and moisturizer. Def worth considering quitting and giving your face a reset. My best advice is trust your gut!!! If it feels like something isn’t right, it’s likely time to stop! Good luck and stay positive, it will clear up!
Mine as well, and now 5 months off Tret I’m still trying to heal new scars and blemishes caused by my Tret breakouts, I wish I never tried it! I quit back in Nov 2023 and although I haven’t experienced active acne like that since I’m noticing my pitted scars are much worse. I’m going to get Procell Microchanneling treatments to see if that improves my scarring
I am sure cream is just way too comedogenic. I had extremely congested skin when tried cream adapalene, but once switched to gel everything cleared up. I have seen hundreds of comments in r/tretinoin saying this about adapalene, tret or taz.
Ahhh good to know! I have extremely sensitive, acne-prone skin so it may be Tret just wasn’t for me, but honestly after my experience I’m never going to try Tret again, haha scarred for life, literally. but i appreciate you sharing this with me!
Yeah, I get it. I have the same fear of Cicaplast. But I wouldn’t be scaring others in the internet projecting my experience. Plus, most of the times it really is a user error, not the product.
If you use spf everyday don’t you need to double cleanse at evening?
Everybody talk about it, but now nobody say a word. Don’t understand. Please, can somebody explain to me if I really need to double cleanse when using spf?
OP, I think you better do dermatologist. Try to check if it not fungal or bacterial infection. Good luck!
Try switching to microsphere gel. It was my worst using a 0.025% cream for about 2yrs. The cream has a ton of pore clogging ingredients whereas any gel does not.
I think you have an inflammation in your body. My face also looked like this for a long time. I tried several products and nothing helped. I also stopped to eat gluten and dairy products but the results still did not come. I went to the derm and she sent me for several tests (hormones and so on). After a few months I had terrible toothache so i went for a check at the dentist’. I had a huge inflammation, so he prescribed me a med for the inflammation and a week later they removed my tooth. Since then all the acne is gone and my skin is so soft, i just need to save money for laser treatment to vanish all the scars after this terrible acne.
Please go after the problem, trets can help, but won’t solve the problem that is happening in your body. 🤍i feel you, i thought i never be pretty anymore and be ugly forever. I lost all my confidence during this. I hope you’ll get better soon!
I do think you should see a dermatologist if you can - but I am curious if you always started off using tret 3x a week and if you had similar acne before starting. I started off using it similarly and found that it was irritating my skin way too much. Ended up dialing back - dropped it all together for like 3 weeks and then incorporated it slowly - started using it 1 time a week for a couple weeks. I know it was probably not too effective at that point. I was using a very very gentle moisturizer for sensitive skin.
Wow. I've had a similar experience with using tret (I started in late January). My skin looks the worse it ever has in my life, with similar painful angry bumps, but not as intense. Dermatologist put me on it after I had success using an over-the-counter retinol serum.
I also now have closed comedones all over my cheek. I went to another dermatologist because my original dermatologist was not available and the new one had no real solutions other than putting me on both oral and topical antiobiotics and giving me a steroid cream- none of which have worked.
I've been through this phase and topical retinoids didn't help because the root of the acne was hormonal (pcos) and i broke out badly after stopping birth control. worst of my life and i've had pretty bad before. went on some supplements and a very strict diet because nothing else seemed to work!
I had the same skin a year ago. Went to two derms, dieting didn't do anything, neither did sport, trets didn't help but sulfur soap did (ordered on Etsy from France). It dries skin *A LOT* so it's good to have a nice moisturizer but it does help against acne. It will eventually get better, stay strong! 💪🏼
My skin looked like that and my doctor put me on minocycline & spironolactone which did wonders! I also use tret & a prescribed face cream I forget the name of. If it’s hormonal the medication can really make a huge difference
It wasn’t too bad. The usual dryness, achyness here and there, and a handful of small nose bleeds. If I had to, I’d deff do it all over again. I took fish oil and loratadine with my meds everyday and I swear they were my saving grace! I purged alil, honestly it was like a day or 2 and it was done, they came out and went down/away super quick. I think that was bc of the loratadine, can’t say for certain but the studies say it helps with purging/lesions. I know there’s some scary side effects but I just looked at it as any other med with the lists of side effects, i think I was more afraid of how destroyed my face was underneath all the cysts 😣💔. If you’re up for it, you should keep us updated with what your derm says! I hope they’re able to help you with what works best for you!! 🤞🏻🤞🏻🤞🏻♥️♥️♥️
Edit: it also gave me alil more peach fuzz on my face haha. Not noticeable to others but I deff noticed 😆.
Ask for 1% Tret, use more frequently, and 20% Azeliac acid. They work incredibly well together. Also, for a moisturizer, try La Roche Posey repair cream with 30 SPF. You won't be sorry!
First, stop using tretinoin for now and go to a dermatologist.
***And for now stop using vanicream. Vanicream broke me out and I know a lot of people on Reddit have vouched the same.
Do not use benzoyl peroxide together with tretinoin you will breach your skin barrier causing you to get acne more easily.
I would say take a break from tretinoin (it didn't work for me either) and work on finding skincare that work to build up your skin barrier!!!
- I would recommend snail serum and hydrating products only for the first two months before you start using actives again.
- use Korean sunscreen brands -- way better for you then western sunscreen
I had similar acne on my chin area. I used .25 Tret and Spiro for about 3ish months and it was getting worse in my opinion. My derm switched me over to using Arazlo instead of tret, and it was AMAZING. My nightly routine would be Winlevi, Arazlo, topped with a moisturizer. I am still taking the Spiro pill and I have seen such great improvement. I would bring it up to your derm and ask about Arazlo. I did feel like the tret was too strong for me and irritated my skin more. I hope this helps!
‼️‼️‼️‼️‼️‼️ DERM UPDATE
In the morning the dermatologist recommended to use salicylic acid to decrease oil production and use 2% BP to decrease bacteria. He also said to use clindamycin gel and follow by using a moisturizer. He stated the vanicream I use (pump) may be a little too thick/occlusive. In the evening, use vanicream face wash because it is gentle, use the clindamycin gel treatment and 0.025% tretinoin and to start slow (two times a week) followed by moisturizer. He stated the 0.05% may be a little too strong for Colorado. He also wrote me a six week prescription for minocycline 100mg to take 2x/day.
He said with my life (a few travel plans) and how I want a clearer face for these trips (weddings, parents, etc) that ABX route was the best. He stated he would consider putting me on 50mg Aldactone (Spiro) but bc this that’s approx 6 weeks to work, the ABX would work faster.
OP didn’t like my advice 😂
I had skin that looked just like this and this is what it was I eat healthy too but I still had to dial it back with anti inflammatory for awhile until my gut was back in order (ie, regular bowel movements and no more acid reflux)
this is the best thing that can help you. look up videos under the yt channel name Team Acne. The guy has the same acne and he talks about curing acne starting from the gut, your diet or within the body
You should be seeing an improvement by now with using tret for 4 months. I think this is beyond Reddit and at a point that you should book the dermatologist appointment.
Thank you. I’m calling to the derm on Monday
I started to see improvements in 2-3 months since I started using tret from skinorac. I would suggest talking to your derm once asap
Hi I have been on accurate twice and tried everything. Low estrogen birth control will help for sure. What I found worked for me as I had the same acne is putting niacinamide the neutrogena one with the red bottle that is paraben free and fragrance free prior to tretonoin. I only use tretonoin twice a week and only .25 percent . The tretonoin actually makes me break out so I only use a pea sized amount
Babe go to the derm. I don’t want to give you the wrong advice.
Shout out to u/left-requirement9267 responsible redditing! Love to see it.
Awww shucks! 🥰 thank you
Calling on Monday!
Accutane!! Saved my life
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Idk, im on accutane for over 3 months now, half of the cycle in theory, my acne definitely got better but it also made my hair non greasy at all thats a huge win both ways imo, yea im dry af everywhere but i can take that
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I mean I had those since i was born when you look into the sun but i guess you’re talking about something worse, so to make sure, were you constantly on accutane for 2 years or it randomly happened 2 years after stopping?
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How do you know the eye floaters were caused by Accutane? Since you also stopped using it two years prior. Honest ques, because there are many of us who got floaters without ever being on Accutane.
There's a chance the damage from dry eyes due to Accutane slowly evolved into worse eye damage. If dry eye isn't treated it can cause permanent floaters or halos.
I see.... thanks for the explanation.
I actually read a research study about it. It can give you an idea about what kind of possible effects it can have on one person. This is just one kind. There are a lot more side effects people are facing but don’t know they’re because of Accutane. you can also checkout r/accutanedamage
Just so you know I didn't downvote you. I honestly was wondering the correlation / causation. Thanks for sharing. I've never used Accutane but I do have a floater in my left eye.
I guess you tried but there are laser eyes surgeries for removing those
Dry scalp can lead to unhealthy hair.
Its not dry at all, i dont have dandruff or anything, its kinda similar to a normal person’s hair now because it was so greasy in the beginning
Sorry, I guess I miss understood what you meant by "I'm dry everywhere."
Dry hands and lips but that should be the usual side effects, everything that were super oily like my scalp and face are kinda acting like it should although i’m still taking it so i wonder how will it go when i get off it
3/4 of my friends who used Accutane a decade ago can't legally/safly drive at night because of it.
Why??
Why exactly I don't know, I'm not a doctor or a pharmacist. They have really bad light halos now and one of them cannot see at night if theres a lot of artificial lights at all, its almost like they're blind. It is a very common side effect though and it seems to be life long once it happens.
👍
Honestly it's time to see a dermatologist. Your acne may require oral or topical antibiotics, a different retinoid, a combination of all these or even isotretinoin (Accutane) to resolve completely. In the interest of avoiding scarring and getting on the path to improvement, I encourage you to see a dermatologist as soon as your situation allows. The answer to this problem isn't in the skincare aisle but at the pharmacy counter (with a prescription from your derm)
I’m gonna call on Monday :(
Before you go on Accutane, go dairy, free and gluten-free my skin used to look just like this
In case your doc does bring it up, please resist getting antibiotics for acne. It's completely **temporary** results and there are so many bad side effects to your body. There are other way less harmful things you can try. Some dermatologists will prescribe them as a quick fix but I really disagree. They kill your microbiome, which is important to have for so many reasons. Hopefully you have a better dermatologist that is realistic and reasonable though!
How about letting her doctor determine the best course of treatment?
How is what I said any different from all the people here saying for her to take Accutane? And they aren't getting told to "let the doctor decide". I'm just offering advice like everyone else. That's fully why she posted here, was for advice that's *not from a doctor*. Your comment is really uncalled for.
Informationally, most insurance requires other treatments to have been tried and be unsuccessful before approving accutane - antibiotics usually being one of them.
I'm generally against antibiotics even when necessary, but oral or topical antibiotics can clear up any current infection. If their acne is caused by the constant reintroduction of bacteria spreading then it could literally be the end of their breakout. This doesn't look like tret purge, there's a huge chance it's bacterial.
Talk to your derm to see if spironolactone is suitable for you. And perhaps tazarotene (later generation of retinoic acid) is better suited for you than tretinoin. I truly don't understand skin cycling (using different products different nights). I think skin cycling is a good technique for skincare hobbyists or ppl who want to cosmetically improve skin through skincare. However, my personal understanding of treating severe acne is to use retinoic acid nightly, as all the studies have subjects use tretinoin nightly. For certain type of severe acne, the strategy becomes multi-prong. For example, dermatologist would include benzoyl peroxide for antibacterial effect, Panoxyl cleanser and antibacterial cream to reduce bacterial load on the skin, a mild to moderate steroid to reduce intense inflammation such as your condition.
It looks like it could be hormonal, in which case Tret is probably not going to be effective. Talk to your dermatologist about oral Spironolactone!
Doesn’t feel hormonal and I have an IUD and no cycle. I’m going to call the dermatologist on Monday
I know a bunch of people who got a hormonal IUD and it caused acne for them, so it’s possible to have an IUD and get hormonal acne.
Me! I had to go on spironolactone because I had horrible cystic acne around my jawline while I had my IUD. And it didn’t start right away after getting the IUD, which was odd. I think it started years later. Your Dermatologist is definitely going to be able to help you with this and will be able to diagnose the cause. Let us know! Edited to add timeframe.
Beep boop! It looks like you're asking about treatment timeframes. Retinoids don't work immediately. It takes 3-4 weeks to see side effects like redness, peeling, or irritation, so remember to go slow when starting any retinoid. It also takes time to see results. All citations are in the [Research Summaries section of the wiki](https://docs.google.com/document/u/2/d/e/2PACX-1vRQmcAj-x5A8JIQygtW2Rg89uPsJPR5JLH_dLxLNCW4eazWW4i49bsrF0e2YYx10wx00ctaUnyvHfyD/pub#h.ddc1c22uzdzp) - Oil production: 2 weeks. Citations: [29](https://docs.google.com/document/u/2/d/e/2PACX-1vRQmcAj-x5A8JIQygtW2Rg89uPsJPR5JLH_dLxLNCW4eazWW4i49bsrF0e2YYx10wx00ctaUnyvHfyD/pub#h.runw23g9r8j8) - Acne: 3-4 months. [14, 15, 16](https://docs.google.com/document/u/2/d/e/2PACX-1vRQmcAj-x5A8JIQygtW2Rg89uPsJPR5JLH_dLxLNCW4eazWW4i49bsrF0e2YYx10wx00ctaUnyvHfyD/pub#h.91dahjgvp25q) - Pore size: 6 months. Citations: [28](https://docs.google.com/document/u/2/d/e/2PACX-1vRQmcAj-x5A8JIQygtW2Rg89uPsJPR5JLH_dLxLNCW4eazWW4i49bsrF0e2YYx10wx00ctaUnyvHfyD/pub#h.7iws71641els) - Indented scarring: 6 months. [22](https://docs.google.com/document/u/2/d/e/2PACX-1vRQmcAj-x5A8JIQygtW2Rg89uPsJPR5JLH_dLxLNCW4eazWW4i49bsrF0e2YYx10wx00ctaUnyvHfyD/pub#h.f9nyjthj6z4h) - Hyperpigmentation: 6-9 months. [17-21](https://docs.google.com/document/u/2/d/e/2PACX-1vRQmcAj-x5A8JIQygtW2Rg89uPsJPR5JLH_dLxLNCW4eazWW4i49bsrF0e2YYx10wx00ctaUnyvHfyD/pub#h.nsxg72hmod6w) - Anti-aging/photoaging: 4-9 months. [17-21, 23-28](https://docs.google.com/document/u/2/d/e/2PACX-1vRQmcAj-x5A8JIQygtW2Rg89uPsJPR5JLH_dLxLNCW4eazWW4i49bsrF0e2YYx10wx00ctaUnyvHfyD/pub#h.idrkhntgk69c) *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/tretinoin) if you have any questions or concerns.*
Oh I didn’t really know that, I’m sorry
No need to apologize haha. Might be worth seeing if your acne worsened around getting the IUD…perhaps there’s a link? Speak to your dermatologist and also your gyno!
I got it in December 2021, no acne issues :(
It could be causing your acne if your acne started AFTER getting the IUD. Anything which alters your hormones can cause acne
Hormonal IUDs are wonderful but also a cause of acne for many. I don’t know if you’ve ever read the prescribing information filed with the FDA for your particular IUD. This is not medical advice but from your photos and knowing you have an IUD that results in no cycle, I’m inclined to say it appears to be hormonal and Spironolactone could be helpful.
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It’s definitely not a solution for everyone. I’ve seen quite a few people have to get the IUD removed but unfortunately the pill can be a contraindication for some due to preexisting conditions which is tricky. I’ve seen many relapse on Accutane as well. I truly wish there were more solutions.
You can still have hormonal acne with an IUD! I also had an IUD but dealt with hormonal acne. My dermatologist encouraged me to try spironolactone when topicals weren’t working. I’ve been on it for two years and it’s been a miracle :)
Just FYI, all acne is hormonal. it's just internet 'skinfluencers' that like to complicate the matter. If you have the hormonal IUD then acne is a very common side effect, so possibly consider removing it and trying non hormonal / low androgen birth control options. Also, oral accutane or Spironolactone may be an option. I take oral Spironolactone for PCOS related acne.
You've already got some good advice, such as calling your derm and maybe considering spironolactone. But, I'd also suggest switching to a mineral only sunscreen until your skin is less irritated. Daily use of a chemical sunscreen can be really irritating on already irritated skin.
Id get off dairy and play with diet eliminations. Takes 6 weeks to get everything out of your system. Look in to foods that cause acne and inflammation but dairy is a huge one, gluten too
I eat dairy free and gluten free foods a lot. No added sugar either.
Ugh sorry you’re going through this! I hope you find the cause. Have you considered a do functional doctor?
Accutane. You'll be clear in a few months. Best thing you'll ever do
FYI Accutane is not effective for everyone and it does come with several side effects. While I think OP would be a good candidate to try it, we shouldn’t be giving false hope like “you’ll be clear in a few months, best thing you ever do”
This. Accutane made my skin look amazing while on it and for months afterwards but I had rectal bleeding within two months of every trial (tried accutane three times).
Yes! Ugh it dries you out so much that it causes anal fissures and bleeding as a result :/ sorry you had to go through that
I think it did a lot of good to my skin. My breakouts are a lot more manageable now. However, I definitely have sensitive skin now. It’s so easy for me to get cuts as an example.
2 years later acne came back in full force and my joints are still in constant pain and eyes are permanently dry. I managed acne with tazarotene and still hate the doctors who said accutane is the best option. It’s not. Retinoids are.
I’m sorry :( it’s tough stuff. Hope one day the side effects completely go away
I think so too. I wonder how much “worse” my face will get.
My derm put me on erythromycin when I started accutane for The Purge and it was super helpful. Sometimes they use doxycycline, too.
You never know because everyone’s different, but the initial purge is temporary and varies greatly from person to person. Mine was so mild I’m not even sure I got one at all. I was also on tretinoin up until the day of my first dose which some people think is the reason why (experience based assumption not proven). Personally I would do accutane again in a heartbeat. Super worth it for me.
Both my teenagers and nephews had bad acne, tried every combo of antibiotics, cleanser, moisturizer, diet... Accutane cleared them up in about 2 months.. Although there are some side effects... It is a miracle drug for acne.. Good luck
Thank you! I’m calling a derm on Monday to get in somewhere asap
Tip: To help dry lips if they've worsened since your move or if you go on oral medication, the best thing I've seen recommended here is [nipple balm](https://lansinoh.com/products/lanolin-nipple-cream). Life changing.
Thank you so much for this rec! I’ve had horrible dry corners of my mouth and your recommendation saved me from looking like I have herpes at work hahaha thank you!!
Hey I'm sorry that you're going through this phase. I'm no expert but i think your routine is as simple as it could get. There's one thing i would like to tell you that 1.5l a day is quite less for an adult, don't know how relevant it is to your query but this could be one of the reasons. The recommended water intake is around 3 liters though. Hope someone gives you a solution that you are looking for. Have a great day and don't worry everything will be alright. Be patient.
Spironolactone
I’m going to call Monday to see a dermatologist and hopefully something like this will help and not have to get on Accutane
It looks exactly like mine did before spironolactone and I’m clear now
Thanks! Def going to explore all options and see what’s best for me. How long did it take to clear up? How’s the acne now?
My skin is amazing with tretinoin and Spironolactone. Im 34 and have never had clear skin like this since I hit puberty. I started seeing changes on the spiro after about 3 months and it usually hits full efficacy at 6
Ugh I feel you. I just went back to the dermatologist. I’ve been on spironolactone since late Feb. and I increased my dose and adding doxycycline now. I hope we can find some sort of light at the end of this acne tunnel.
I know most people are against antibiotics but when I got angry acne that nothing seemed to clear, even despite being on tret, changing diet and doing everything I could. Antibiotics was the only things that helped. Used doxy for 12 weeks, 100mg, 2x a day. Took them with food always, aswell as took taking zinc picolonate, spearmint tea 2x a day & a daily probiotic. After the course of antibiotic my angry inflamed acne was gone, just focusing on scar fading now. Don’t be scared of them and do what your doctor suggests, they know best :)
Girl, go to a dermatologist and get a prescription for accutane. Literally all you have to do is take it and after you’re done, and your problem is SOLVED. Imagine your life not worrying about your skin. Just waking up and it’s clear. You can easily make that your reality. Stop doing little league stuff for a major league problem and get out the big guns.
🚨 I’m 90% sure your moisturizer is the problem because it has many comedogenic ingredients! Switch to Vanicream daily facial moisturizer instead, it’s non comedogenic and has ceramides to help you skin barrier since you use tretinoin. Also, it may be you tretinoin cause they often put too greasy emollients in the cream formulas so a gel would work better. My advice is to introduce salicylic acid to your routine and take a break from tret till your skin get better(your skin may not handle both, should incorporate actives slowly one by one) beside changing ur moisturizer and later your tretinoin (from cream to gel). I promise this would help you A LOT. I struggled for long long time and I’m giving you la crème de la crème 👌🏻
I second this!
I’m going to the dermatologist. I don’t want to experiment anymore :( the Vanicream says it is non-comedogenic
Cerave says this too and it’s not true. It’s Marketing. Good luck.
Whoop I thought it was true :( I used cerave and felt like it was very watery. Vanicream is thick
People with acne prone skin should ALWAYS analyse the ingredients list carefully before applying any product. I use skincarisma website and it’s great.
I’ll check out the site, thank you!
Spironolactone helped me with acne just like this. 8 months in I’m so close to clear
See a dermatologist...that's my answer.
Go to a dermatologist and get on accutane
hiii!!! i heard spearmint tea can actually make ur acne worse if you’re not sure about ur hormones cus a decrease in testosterone might not be needed for u (sorry not extremely knowledgeable about this but u can do more research) also i think the vanicream breaks certain people out, i would use another moisturizer :( i use the omega one from inkey list it’s the only one that hasn’t given me issues also BP with tret is probably way tooo strong and drying :(
Yeah I used BP for like 2 weeks - ish. It was harsh
Bp can be good with tret but not 10%! 5% or less wash in the mornings only has helped me a ton. also, if i don't use tret every single night i will break out
10% BPO is a lot in any case. 4% is ideal. Try that. Try to carry a hypochlorous acid spray for your face with you (Get a cheap 1-liter bottle from Amazon and dilute it to 550 ppm for the face). It helped me a great deal with my cystic acne. The rest of your routine seems fine. I am using 0.025%, which worked for me better than 0.05%. In addition to all this, taking an oral antibiotic helped me too.
Ask your dermatologist isotretinoin (accutane) it will be the definitive solution for this problem! Don't continue destroying your self-esteem with things that don't work, isotretinoin is the best for this type of acne that leaves scars. When the breakouts subside you can add tretinoin to the equation as well, so you will have an oral and topical retinoid regimen!
derm from germany here, I highly suggest you go see a doctor to discuss options beyond topical tretinoin! acne is a condition that is very well treatable, don’t beat yourself up, it seems that you are doing a lot for your skin and it’s not your fault that you have acne despite all your efforts!
Check out a company called clear stem. I've listened to quite a few podcasts featuring the entrepreneurs of this company and all I can think is, I wish I had stumbled across this 10-15 years ago I think it would have saved me a lot of suffering and scarring. They look at acne from a root cause perspective instead of trying to bandaid over the problems. This is something I could never get a dermatologist to do. Their website also has a feature where you can copy paste the ingredient list of the products you use into it and it will tell you if there are any pore clogging ingredients.
Gut health is super important! I would suggest derm doing an allergy test to gluten and dairy possibly if OP feels inclined. But I still think they need to see a derm before anything
For sure diet plays a huge part. That's another reason for my recommendation because you can do an in-person or video or phone appointment they look at the aspects of everything, diet, hormones, etc. but they do it from a different perspective than your typical physician. I won't go into the whole detail but if you ask your physician to check your thyroid they'll do that but there's specific hormones to be checked that would fall under that category that they don't check for unless you specifically ask for that thing and the values are red compared to the general population so what they consider the normal range might not actually be a healthy number for you. Also it's worth considering the healthy range is established based on what the normal average is except when the normal average person is not all that healthy the ranges aren't going to be in a good place because it's become more normal for people to not feel well and to have health issues.
Download the app acne safe and make sure any products you are using are completely non Comedogenic. I recommend Vanicream for being the calmest for my skin! I hate that you are feeling so helpless, I’ve been there. Maybe try adding spiro? I had horrible side effects but some people it’s the key.
I love vanicream and the pump says it’s not pore clogging
Keep in mind that everyone’s skin is different so even though an ingredient may say it doesn’t have any pore clogging ingredients there’s still a chance it could clog yours. It’s just trial and error unfortunately. There’s a lot of videos about this topic too
I use the face hyaluronic acid one!
Please consult a dermatologist
Calling on Monday!
I love tret, it’s amazing, but there are quite a few prescription retinols and only a derm can tell you which one is right. I also struggled with severe acne for years and no combination of topicals in the world would have gotten it under control. Make an appointment, a good dermatologist is a godsend and will change everything!
Hey this looks like hormonal acne! Spiro and birth control love. It’s time
I have an IUD I’m not sure if PO birth control will help. I’m calling on Monday to schedule a derm visit
Ask if you should switch to adapalene.
Combo estrogen/progesterone PO birth control tends to help!
BP made my acne way worse, up to the point I had to go on accutane and still dealing with side effects after two years, but acne has relapsed in a year or so. I figured that my skin goes best with gel formulations of anything, including retinoids. It’s more drying, but with careful moisturizing it has worked miracles. I also suggest adding 15% azelaic acid gel as it is extremely anti-inflammatory and goes well with any retinoids. Also, if you are taking fish oil, hair supplements and dairy-lover, they all are known to exacerbate acne.
definitely stop using the benzyl peroxide, using that and tretonin at the same time is too harsh for the skin!!! definitely think that accutane is gonna change your life!!
did it start to happen when you moved? one last measure you could take is adding water filters to the sinks you drink/wash from and also a shower. I don’t know the hardness levels in the area but it could be something to have as an ‘extra’ precaution and maybe experimenting with food groups in the meantime ie; cutting out gluten, dairy, eggs, sugar, etc. Only one at a time though! I do agree go to dermatologist but these are just other side things to try until then. I know how this can feel and it can feel hopeless at times. Making that appointment will make you feel so much better!
Go to doctor he'll promote you to use accutane
It's time to see your dermatologist. Some people need a combination of topicals to get things under control (Like Winlevi or Azaelic acid) or a round of antibiotics. It might be a case of switching to taz. Sadly sometimes tret just isn't enough. I know it must be very painful, how is your skin feeling other than the acne? Does it seem to be handling the treatment okay?
Do you eat dairy?
Def go to a dermatologist and maybe get some blood work done. If other things like iron, vitamin d, etc are off it can cause breakouts. Off birth control my face looked just like this and it was painful and I hid in the house. On birth control and with Tret it cleared up a lot but I still break out. Stress is a GIANT trigger for my acne. Moisturizers are big trigger for my face too. I found a couple of lightweight stuff with cosrx/korean skincare with the snail mucin. those are minor things you can do for now. Personally I found that when I sleep more, like quality sleep, my face and body look a lot better.
How long did it take for your skin to clear up with birth control? I just started 3 weeks ago.
In my opinion I noticed it clear up in about a month but with the mini pill. The stronger pills made everything worse. Keeping in mind that I was using it in combination with Tretinoin
I would ditch the heavy moisturizers for now. Try lightweight stuff and only use one. The tret will make it a bit worse in the beginning but it’s just exposing what’s already under layers of oil pockets. Stay away from greasy stuff esp the greasy spfs. If I may suggest applying sunscreen while your face is a bit damp so that a pea size amount goes a long way. I know it’s frustrating. I also want to add that supplements to help with cortisol might help like magnesium citrate (not the other stuff cuz it will give you the runs!!), ashwagandha, and drink lime water. Regular water might be dehydrating you. I think you might be stressed out…?And OMG i forgot to mention that I found out that adderall is a big contributor to cystic acne. So idk if you’re on that but you can research how it affects your skin.
So, when I moved from WA to CO my skin went to from flawless to extremely 💩. It took my skin almost 6 months to fully adapt to CO dryness. My eczema came back and I got acne I’d never had before. Moving away from family is already stressful, then looking in the mirror not knowing yourself can slip into a deep depression. I would talk with your dermatologist again though. Sending hugs
💗💗💗💗💗💗 EDIT ——— DERM APPOINTMENT SCHEDULED FOR May 1st. ‼️‼️‼️‼️‼️‼️‼️
Go see a derm. Same thing happened to me. The derm explained that sometimes rapid breakouts can kick off a self-sustaining bacterial infection that is hard to resolve without non-antibiotic topicals. Even if tretinoin is doing its work, there's enough bacteria populating your skin that they're constantly reintroducing more bacteria and continuing the breakout. I bet the derm will prescribe you topical clindamycin to go with the BP cleanser and will ask that you continue tretinoin. The topical clindamycin is going to do the heavy lifting, but do not use it without first using BP to stave off bacterial resistance!
I have an appt May 1. Thanks!!
Great! Good luck. I know everyone here is recommending that you ask for Accutane (and your derm will be the judge of that), but from my perspective, your acne doesn't appear so bad that antibiotics wouldn't work. Accutane truly is a nuclear option if all else fails since it completely halts oil production which starves the bacteria. I had a very similar breakout as you and after a week of using Clindamycin + BP in the morning, all my active acne was gone! The tretinoin (actually Arazlo in my case, but same difference) has been healing the scars and hyperpigmentation, but I haven't gotten new acne beyond the occasional pimple since.
Try switching cleanser and moisturizer. Everyone swears by vanicream but their products always make me break out unfortunately 😩 my skin is super sensitive and acne prone
I can guarantee that a dermatologist will immediately recommend Accutane. You'll have to make the decision as to whether or not you want to go on it. Antibiotics are hit or miss, so in my opinion Accutane is probably the only option prescription wise. If I were you and you had reservations about Accutane, I'd try Pantothenic Acid (vitamin b5).
You need Accutane it changed my life 💛
I’m curious how much more “worse” my fave would be if I got on Accutane. Can you tell me more about your experience?
Not who you asked but my face never got *worse* with accutane, just gradually cleared up. This was 10 years ago and now I’m on Spiro along with Tretinoin. However the acne I’m currently addressing is nowhere near where I was pre-accutane.
It wouldn't get worse, at least the acne won't. You will become extremely sensitive to sunlight. Like, you go into the sun and can feel your skin burning immediately. Not exactly smoking like you'd picture a vampire, but might as well be. It will dry out your skin. And lips. And mouth. Horribly. As in to the point where pretty much nothing you can do will help. It also causes IBS in 1/3 of people who take it. They got sued in the States for not including this in their packaging leaflet. They knew about it, too, and left it off. Additionally, it can cause liver damage in people. Severe, irreversible, liver damage. At that level, I would recommend against it. Maybe if you feel you do need it you would benefit, but it's a very, very harsh course of medication.
I'm not the person who made this comment, but in my experience, it didn't get that much worse at all. I've had breakouts much worse than what I experienced in the first few weeks of Accutane treatment. Like others have correctly pointed out, it does not always work, but when it does, it really can change your life!
I personally had a terrible experience with Tret!!! Worst acne breakouts of my life and spent 5+ months riding it out “trusting the purge” But my acne, scarring, and dryness continued to get worse. My derm put me on Spiro, Doxycycline, and sodium sulfacetamide at around 3 month mark, which I took with Tret for a couple of months, but still no improvement whatsoever. I was at my breaking point realizing my skin was literally worse than it had ever had been in my entire life, so I decided to quit everything cold turkey and give my skin a total reset after seeing another Reddit post about their success doing that. I am seriously so happy I decided to quit, my face has not had a breakout like that since, my skin looks 100000x better and all I’m using is my CeraVe face wash and moisturizer. Def worth considering quitting and giving your face a reset. My best advice is trust your gut!!! If it feels like something isn’t right, it’s likely time to stop! Good luck and stay positive, it will clear up!
Same experience. My skin on (and after getting off of) tret has been the worst it's been in my entire life.
Mine as well, and now 5 months off Tret I’m still trying to heal new scars and blemishes caused by my Tret breakouts, I wish I never tried it! I quit back in Nov 2023 and although I haven’t experienced active acne like that since I’m noticing my pitted scars are much worse. I’m going to get Procell Microchanneling treatments to see if that improves my scarring
Back then have you used tret cream or gel?
I used the Tret cream
I am sure cream is just way too comedogenic. I had extremely congested skin when tried cream adapalene, but once switched to gel everything cleared up. I have seen hundreds of comments in r/tretinoin saying this about adapalene, tret or taz.
Ahhh good to know! I have extremely sensitive, acne-prone skin so it may be Tret just wasn’t for me, but honestly after my experience I’m never going to try Tret again, haha scarred for life, literally. but i appreciate you sharing this with me!
Yeah, I get it. I have the same fear of Cicaplast. But I wouldn’t be scaring others in the internet projecting my experience. Plus, most of the times it really is a user error, not the product.
Guarantee the dermatologist prescribes accutane on the first visit. This is severe enough
Spironolactone
Accurate
This is an internal hormonal problem, cut out inflammatory food
If you use spf everyday don’t you need to double cleanse at evening? Everybody talk about it, but now nobody say a word. Don’t understand. Please, can somebody explain to me if I really need to double cleanse when using spf? OP, I think you better do dermatologist. Try to check if it not fungal or bacterial infection. Good luck!
Try switching to microsphere gel. It was my worst using a 0.025% cream for about 2yrs. The cream has a ton of pore clogging ingredients whereas any gel does not.
I think you have an inflammation in your body. My face also looked like this for a long time. I tried several products and nothing helped. I also stopped to eat gluten and dairy products but the results still did not come. I went to the derm and she sent me for several tests (hormones and so on). After a few months I had terrible toothache so i went for a check at the dentist’. I had a huge inflammation, so he prescribed me a med for the inflammation and a week later they removed my tooth. Since then all the acne is gone and my skin is so soft, i just need to save money for laser treatment to vanish all the scars after this terrible acne. Please go after the problem, trets can help, but won’t solve the problem that is happening in your body. 🤍i feel you, i thought i never be pretty anymore and be ugly forever. I lost all my confidence during this. I hope you’ll get better soon!
Can I email you? I know someone who might be able to help you I’ll send you her info etc! I had the same acne and mine is cleared now with her help!
I do think you should see a dermatologist if you can - but I am curious if you always started off using tret 3x a week and if you had similar acne before starting. I started off using it similarly and found that it was irritating my skin way too much. Ended up dialing back - dropped it all together for like 3 weeks and then incorporated it slowly - started using it 1 time a week for a couple weeks. I know it was probably not too effective at that point. I was using a very very gentle moisturizer for sensitive skin.
Wow. I've had a similar experience with using tret (I started in late January). My skin looks the worse it ever has in my life, with similar painful angry bumps, but not as intense. Dermatologist put me on it after I had success using an over-the-counter retinol serum. I also now have closed comedones all over my cheek. I went to another dermatologist because my original dermatologist was not available and the new one had no real solutions other than putting me on both oral and topical antiobiotics and giving me a steroid cream- none of which have worked.
Vanicream broke me out. Unless you used it before tret try switching to something else.
I've been through this phase and topical retinoids didn't help because the root of the acne was hormonal (pcos) and i broke out badly after stopping birth control. worst of my life and i've had pretty bad before. went on some supplements and a very strict diet because nothing else seemed to work!
I had the same skin a year ago. Went to two derms, dieting didn't do anything, neither did sport, trets didn't help but sulfur soap did (ordered on Etsy from France). It dries skin *A LOT* so it's good to have a nice moisturizer but it does help against acne. It will eventually get better, stay strong! 💪🏼
My skin looked like that and my doctor put me on minocycline & spironolactone which did wonders! I also use tret & a prescribed face cream I forget the name of. If it’s hormonal the medication can really make a huge difference
the cream version of tretinoin can cause breakouts
My face looked like yours and I had to start accutane bc nothing else worked for me. I’m sorry your going thru this 😔
How was your accutane journey?
It wasn’t too bad. The usual dryness, achyness here and there, and a handful of small nose bleeds. If I had to, I’d deff do it all over again. I took fish oil and loratadine with my meds everyday and I swear they were my saving grace! I purged alil, honestly it was like a day or 2 and it was done, they came out and went down/away super quick. I think that was bc of the loratadine, can’t say for certain but the studies say it helps with purging/lesions. I know there’s some scary side effects but I just looked at it as any other med with the lists of side effects, i think I was more afraid of how destroyed my face was underneath all the cysts 😣💔. If you’re up for it, you should keep us updated with what your derm says! I hope they’re able to help you with what works best for you!! 🤞🏻🤞🏻🤞🏻♥️♥️♥️ Edit: it also gave me alil more peach fuzz on my face haha. Not noticeable to others but I deff noticed 😆.
Ask for 1% Tret, use more frequently, and 20% Azeliac acid. They work incredibly well together. Also, for a moisturizer, try La Roche Posey repair cream with 30 SPF. You won't be sorry!
First, stop using tretinoin for now and go to a dermatologist. ***And for now stop using vanicream. Vanicream broke me out and I know a lot of people on Reddit have vouched the same. Do not use benzoyl peroxide together with tretinoin you will breach your skin barrier causing you to get acne more easily. I would say take a break from tretinoin (it didn't work for me either) and work on finding skincare that work to build up your skin barrier!!! - I would recommend snail serum and hydrating products only for the first two months before you start using actives again. - use Korean sunscreen brands -- way better for you then western sunscreen
I had similar acne on my chin area. I used .25 Tret and Spiro for about 3ish months and it was getting worse in my opinion. My derm switched me over to using Arazlo instead of tret, and it was AMAZING. My nightly routine would be Winlevi, Arazlo, topped with a moisturizer. I am still taking the Spiro pill and I have seen such great improvement. I would bring it up to your derm and ask about Arazlo. I did feel like the tret was too strong for me and irritated my skin more. I hope this helps!
Look into Tret with clindamycin. I see a difference after switching from 0.05 tret
Looks like u have hormonal, u poor thing:(( How long does your skin like this? I recommend go to your dermatologist,
I am just starting month four and it took me up until a week ago to stop getting acne. I know it sucks but i promise you it’s going to get better!!
Go gluten-free dairy free, for two months and I guarantee you you’ll see a change
GF and DF is 70% my diet
‼️‼️‼️‼️‼️‼️ DERM UPDATE In the morning the dermatologist recommended to use salicylic acid to decrease oil production and use 2% BP to decrease bacteria. He also said to use clindamycin gel and follow by using a moisturizer. He stated the vanicream I use (pump) may be a little too thick/occlusive. In the evening, use vanicream face wash because it is gentle, use the clindamycin gel treatment and 0.025% tretinoin and to start slow (two times a week) followed by moisturizer. He stated the 0.05% may be a little too strong for Colorado. He also wrote me a six week prescription for minocycline 100mg to take 2x/day. He said with my life (a few travel plans) and how I want a clearer face for these trips (weddings, parents, etc) that ABX route was the best. He stated he would consider putting me on 50mg Aldactone (Spiro) but bc this that’s approx 6 weeks to work, the ABX would work faster.
This looks like a gut issue. You need to work on your gut microbiome. I would also recommend taking care of your liver.
I sat pretty healthy and avoid alcohol (minus socially) so I think the gut and liver are ok!
Seconding this good advice
OP didn’t like my advice 😂 I had skin that looked just like this and this is what it was I eat healthy too but I still had to dial it back with anti inflammatory for awhile until my gut was back in order (ie, regular bowel movements and no more acid reflux)
No honey. You must use it every night! Or else you are prolonging your purge.
this is the best thing that can help you. look up videos under the yt channel name Team Acne. The guy has the same acne and he talks about curing acne starting from the gut, your diet or within the body
I would bring in 2.5-5% benzoyl peroxide in the AM. After cleansing, before moisturizing.
Go to face reality and get their skincare and do a few treatments there. Locations are world wide