The information below is taken from a thread in the Acne Research forum.

Here is my question to LabGirl:

LabGirl ... could you please explain, in your usual awesome level of detail, what goes on with people's skin during the initial 3 months on retinoids?

There has been quite a bit of discussion about this lately ... someone actually went so far as to call the initial breakout a myth. She basically said that any pimples that show up during that time were going to show up anyway. Do you think that is true?

Also, do you think the severity of the IB (assuming it isn't a myth) correlates to the severity of the acne someone had going into the treatment?


And here is her awesome answer:

This is a really good question since many scientists still don't know exactly how retinoids work. Dr. Albert Kligman is the original patent holder on using topical retinoic acid to treat acne (he has done tons of research on this topic, and has 40 years of studies on acne, sebaceous gland function and retinoids).

Anyway. A retinoid is any molecule capable of binding to and activating a retinoid receptor. There are many types of retinoid receptors, RAR-alpha, RAR-gamma, RXR (retinoid-X receptor), and their activation does all different things (cis-13 retinoic acne or Isotretonin acts on the retinoid-X receptor, and can inhibit cellular proliferation....especially of the sebocytes, whereas trans-retinoid acid stimulates the other retinoid receptors...as well as the RXR and increases the proliferation of keratinocytes.)....it's not really that simple and the retinoid receptors actually interact with eachother and form heterodimers that control various types of cellular proliferation in epithelial tissue and also in other types of tissue.........

Okay so in the first few weeks of treatment with topical retinoic acid (or other topical retinoid), the skin cells begin to proliferate rapidly. This really only takes a few days to have an effect, but you don't see the effects instantly (although you may feel them). As you already know a retinoid makes skin cells proliferate and desquamate in only 5-6 days (it usually takes a month). This may be why.......but we don't know for sure ....

Physiological and retinoid-induced proliferations of epidermis basal keratinocytes are differently controlled

Within a couple weeks the epidermis thins out. This is when you begin to see the derided initial breakout. Is it really an initial breakout? Is the skin actually purging itself???.....well yes and no.....

You may see after about 2-3 weeks of treatment a bunch of tiny bumps (whiteheads, comedoes, clogged pores, etc). As the skin cells rapidly proliferate inside the pore ducts the microcomedo swells up. At the same time the stratum corneum is becoming thinner. It's usually 8-9 cell layers thick, but by using a topical retinoid it becomes only 4-5 cell layers thick. This happens to the entire epidermis. The granular layer is also smaller and the granules contain less keratin. The proliferating skin cells don't have the chance to become hyperkeratinized as they loose their nuclei and cytoplasm, flatten out and become enclosed in the cell envelope of the corneocyte.

Since the epidermis is thinner the comedoes (which actually form in the dermis), become visible through the thin epidermis.......this also makes you more sensitive to UV radiation.....so wear a good sunscreen...

So what about the inflammatory initial breakout? Some of the comedoes may become inflamed.....if you are prone to inflammatory acne. Retinoids do cause a bit of irritation, and this can induce inflammation. Sometimes the pores are so blocked up that it takes weeks to resolve the comedo, and the bacteria and sebum trapped inside, and the irritation from the retinoid make it a perfect opportunity for a pimple to form. The reason it seems like an initial breakout is because it speeds up the rate of cellular proliferation. Those may or may not have become pimples without the retinoid. But in the worse case scenario you will get about 15 months of pimples in only 3 months.

I have another theory about the initial breakout phenenmon. Since the retinoids thin out the epidermis they cause increased transepidermal water loss. Water in the skin is important to normal desquamation. Water is necessary for the destruction of the desmosomes and tonofilaments that hold the cells of the stratum corneum together. If there isn't enough water present in the skin, the cells don't desquamate properly.....this is why you get flakes .......the cells are stuck together in clumps.......this is bad if it happens inside the pores.......Dry skin is bad for acne, since abnormal desquamation inside pore ducts can cause the formation of comedoes.

An initial breakout can be controlled by using a topical or oral antibiotic in the first 12 weeks of treatment. After that you shouln't need as much bacterial control, since the pores aren't easily blocked and most of the comedoes will have resolved themselves. BP just irritates the skin and increases barrier damage. Moisturizing is crucial on a retinoid, since the epidermal barrier is compromised due to the thinning of the epidermis. A good moisturizer is one that contains about 3-5% glycerin. Glycerin is a great ingredient and really improves the barrier function of the skin, by filling in the extra-cellular matrix between the corneocytes ....and it promotes healthy desquamation of skin cells by drawing water into the skin from deeper dermal tissue and it is known to activate certain genes in the keratinocytes (just don't tell the FDA).

Okay when I get to work I'll look up some more stuff.........

I didn't even mention the effects topical retinoids have on the dermis........they reduce shallow scarring and wrinkles by stimulating the fibroblasts in the dermis to produce Collagen I and III.....which fills in shallow scars and plumps up wrinkles........another reason to stick with it even if the initial breakout makes you think that "this can't be good for my skin".....eventually it will be........

Hello. Since I was 12, I've suffered from moderate acne. When I was 15, I went to my first derm and she prescribed Benzaclin and Trentinoin, this stuff worked wonders and I was nearly 100% clear for a year....then it all came crashing down in the past few months, my skin has gotten sooo bad. I'm not here complaining about a few pimples, we are talking big inflamed ones on my cheeks, slight red and purple scarring (I just recently started to scar ) and four dozen comedones on my forehead, and getting acne where I never had it before (on my temples, chin, and upper lip) Basically, it has infested my entire face, I have never been so humiliated or felt so low on confidence before. Eight weeks ago, I was prescribed differin (by a diff derm) and it did nothing for me. Now, just a couple days ago, I was prescribed "Tazorac" I'm praying this medication will work for me and finally put an end to my acne struggles.

Thus, I start my Tazorac log. I will try and update everyday on my progress.

At the begin of 9th grade my acne started to take a turn for the worse. Now at the age of 15 my cheeks are covered with inflamed acne and a hell of a lot of post-inflammatory hyper-pigmentation. I have fair indian style skin so it stands out a lot. Fortunately using salicylic acid i was able to control the acne on the rest of my face so now the last area to conquer is my cheeks (which are very bad).

A few days ago my gp prescribed retin-a apon request. i wanted retin-a as it would help prevent and resolve acne as well as improve the condition of my skin.

my new regiem incorporates retin a 0.1 gel, salicylic acid, moisturiser with vitamin e, vitamin d pills, fish oil, ice gel, green tea, aloe vera and a great cancer council suncreen (spf 30+).

I know its a lot for a 15 year old but my acne is reallllllllllllyyyyyyyy baaaaaaaaaddd.....

so my log began 5 days ago:

day 1: applied retin a to both cheeks at night. (no moisturiser at night, as i dont want to dilute the retin a hence weakening it strength)

day 2:In the morn. there were some light flakes around cysts and pustules but overall no dryness. during the whole skewl day i was applying suncreen during lunch and recess breaks. Washed my face at night let it dry and applies retin a to cheeks.

day 3: today a huge (1.5cm) cyst appeared on my right cheek im really tempted to use hydrocortisone (but i know i shouldn't) so instead i drank a strong green tea with an ibuprofen 200mg (there both potent anti inflamatories).Also some of the pustules were crusting (a good sign, it means they'll fall of with just a bit of pih). I came home and in the shower under the hot water the psutules came off (no mess) and i noticed that my face felt creamy. At first i thought it was the loads of sunscreen that i put on. but on closer inspetion it was my skin coming off (little pices of dead skin). I made sure i didnt over do it. Reapply retin a.

day 4: skin is not dry a little bit of flakes around cysted and pimples, other than that its fine. Also the cyst seems bigger. No exessive peeling in the shower today. Took some green tea and ibuprofen. Reapplied retin a at night.

Day 5: finnaly the cyst has started to come down (actually its come down quite fast, it ussually takes from a week to a month). I put some ice gel on it today just to speed things up.

hey guys i went to the derm and she pescribed me with a bp8.5% cleanser morning qnd night and once a day at night apply ziana gel. i will keep u posted on my progress.(:

For a bit of background im 20 years old with no history of acne, however i think this was due to the fact that ive swam since i was 12 and being in the pool constantly exfoliated my skin. ive recently stopped swimming because of CALIFORNIA STATE BUDGET CUTS (grrrrr) and im convinced that my skin has no idea how to exfoliate properly.

i am plagued with tonnssss of whiteheads which occasionally become inflamed and full of gunk. gross. unfortunately i scar easily as well so any pimple leaves its mark for at least 2 months . . .if im lucky. . . . im hoping that retin a micro helps because im tired of gross bumpy looking skin and scars (the bane of my existance!!!). Also when i do get those pussfilleddisgusting zits they last FOREVER i mean they dont heal like a normal person (i.e a couple days) they slowllllyyy deflate then leave a circle of discoloration that has to peel off.



for the past week ive been:
AM
SA facewash

PM
SA facewash
RAM .04
topical erythromycin when i think something feels inflamed

should i be using the topical before or after the RAM? ive been using it after . . .


DAYS 1-6
New whiteheads popped up on my cheeks and a slight pink flush. on a side note my skin is super resiliant and can withstand just about any acne treatment (i supposed this is from constant immersion in chlorine water?) AHA/BP/SA never sting/burn even at the highest consentrations. so far ive had some slight flaking, but no burning, scaling, or stinging. the new whiteheads are super tempting to pop, but ive learned the hard way that popping a whitehead almost always becomes infected.

DAY 8
whiteheads seem to be growing in size/going to make their presence known soon . . .ugh that means NOTICABLE ZITS more of that pink flush, its not too pink its looks like i just got back from the gym or running. i had some dying zits on the left and right cheeks which definitely seem to be peeling off, this is good.

Yeah I'm Ben 23 from the UK. This log is gonna show how I face life with acne etc. A very brief history of my acne is below:

My acne started when I was about 14/15 and it was pretty annoying. I didn't really do anything about it til I was 16 and my parents more or less kept shouting at me til I went to the doctors. The dr gave me benzamycin gel and for a few weeks my acne, which was moderate at this point, seemed to subside, but it was only a mild improvement. I kept on using the benzamycin though, but although acne pissed me off at this point, it didn't ruin my life. When I was 17 I went back to the Dr's because my acne was still pretty bad. He added 100mg of doxycycline per day to my prescription. This made little difference. Round about june 2000 I stopped the Benzamycin and the doxycycline as they didn't seem to be doing anything for me. Over the next coupla months my acne went very quiet and I got barely any outbreaks which made me feel a bit more confident. Then after the summer my acne came back and really exploded. I was getting huge papules, pustules and possibly nodules. I was not a pretty sight. In early 2001 I went back on benzamycin and doxycycline, but again it didnt do much. In about may 2001 my doxycycline got increased to 200mg per day. After a week I looked in the mirror and a helluva lot of my acne had just gone. I was pretty shocked at the improvement and my acne gradually disappeared. After about 6 weeks I was more or less 100% clear. My life turned fucking great! Girls were suddenly interested in me and lots of other things in my life just seemed to come into place! I got a GF and for the next year or so, things were great. I would get maybe 1 whitehead a month and the occasional papule. Every 3 or 4 months I would have a breakout of 5 or 6 spots, but they cleared up pretty quick. I must add that my skin has been oily all throughout this story. After about 15 months, production of benzamycin stopped in the uk. I got put on to zineryt and it broke me out like crazy. I was really upset that I had finally got clear and then my skin fucked up again overnight. I went back to the doctors and they put me on isotrexin which gave no improvement. Then followed about 6 months of hell with my skin. I suffered a few scars in that time, nothing major, but noticeable. My personality also changed. No longer did I wanna go out about 3x a week. I avoided my friends as well. It certainly affected my relationship with my GF, I just wasn't the person she'd met when we first started going out. But I was too embarrased to tell her what was making me feel like this. around xmas 2002 I went on 5%BP and erythromycin. It got a little bit better, but nothing major. In spring 2003 benzamycin was available again, I went back on it but it didnt seem to work as well as it had previously, maybe it was because I was on erythromycin tablets now instead of doxycycline. Then a new dr at my surgery whose speciality was dermatology took me off the erythromycin tablets as I'd been on them for several months. My acne got worse again! I went back on the erythromycin and over the next 6 months, i got fairly clear and got a lot of confidence back. Then after 6 months I again got taken off the oral antibiotics and just had benzamycin to play with. I thought that my skin would fuck up again, but I actually stayed pretty damn clear for about 3 1/2 months, but then one day my skin started breaking out again. I saw a derm a couple of times but didnt get on roaccutane. I got put on differin and some oral antibiotics which did little good. I felt really shit in this time. I was exceptionally close to getting on roaccutane in the past summer, but high liver enzymes meant I never got to go on it. I did get put on differin and benzamycin though, which I'm still on 5 months later and its got me pretty clear. I still get 3-5 spots a week, but no more pustules and only 1 or two whiteheads a month. I dont look great though, no matter how much mild acne I have, it still looks bad. My oily skin makes it all look worse too

Well thats a not so brief history of my acne hell! I thought the new year was a good time to start a blog up, so here it is! At the minute I'm on differin in the morning and benzamycin at night. I've also just changed my cleanser from clean and clear oil free to cetaphil cleanser, hopefully this will help with the redness that my face seems to have. I'm also using lukewarm water to wash my face with instead of cold water, I read that cold water can help to irritate your face and that makes sense to me.

Hello everyone, I'm new here and decided to join since I started using topical antibiotics.

So I've been on Clindamycin for 12 days now; putting it on every morning. I've been on Epiduo for 10 days and I'm putting it on every night before bed. I was my face with 10% BP twice a day and just use cold water to clean off my face throughout the day so as not to cause extreme dryness. Well I guess I am starting to experience the initial breakout and I am getting these deep, painful, red spots and they look really ugly. I was able to use a needle to 'pop' 2 spots; I know it is bad to pop them, but they are exrremely painful, even when I raise my eyebrows, but usually I try not to pick at these spots prematurely since I have noticed that they do take longer to heal. Well just last night I went to sleep with these red spots and put on epiduo on them and woke up this morning with the skin peeled and they were just completely red with the effect that blood is running out, but I applied some neosporin during the day and it seemed like the redness went down. the majority of my acne runs up my right cheek to the temple and over my forehead. I currently have one red spot that is healing on my left cheek. I guess I'm a bit luckier than some people who have it full blown on both cheeks and down the jawline. I have been feeling a bit depressed with the way I look the last few days because of the breakout and I can't even begin to think how you(who have it a bit worse) might feel. I REALLY feel sorry for some of you, but I hope your skin improves ASAP. I'll keep everyone up to date as much as I can because I work almost full time and I am currently in school full time as well.

I've had mild/moderate acne since I was a teen (I'm 24 now), and in the past I've tried Retin-A, Tazorac, Differin, BP, and antibiotics. None of those really worked for me before, however I was never very good about using the topicals since they made my skin so flaky. For the past two years I've not been using anything at all, and I usually only suffer from comedones around my nose and chin, and occasional inflammatory acne or cysts, also around my nose and chin, ESPECIALLY before my period.

I had a particularly bad breakout before my last period that had me desperate for a solution; I'm really sick of looking in the mirror and seeing huge red spots (I'm one that doesn't want to go outside if I'm breaking out). So recently I went to a new doctor and esthetician to once again battle my acne.

I've never posted on this board before, however I have lurked around for quite a while, especially after being prescribed new medications, to see what others' experiences were like. I decided keeping a log might help me stick with my regimen this time.

OK my regimen (which began 7/15):

AM
Benev Glycolic Face and Body Wash
IS Clinical Moisturizing Complex (+two drops Benev Pure Titanium Dioxide SPF 30)
Paula's Choice Skin Balancing Super Antioxidant Mattifying Concentrate (this helps my makeup go on smoothly, so I don't bother with this if I'm not wearing makeup)

PM
Benzoyl Peroxide 5% Wash
Tretinoid Cream 0.05% (my esthetician has me using a pea sized amount mixed with the moisturizer 3x per week)
IS Clinical Moisturizing Complex

I've also been diagnosed with PCOS (polycystic ovarian syndrome), which means that my acne is likely a result of that. So, in addition to the topicals, my doctor has me taking daily supplements:

Chiral Balance (aka d-chiro-inositol) (for PCOS)
Vitex 750 (for PCOS)
Zinc (specifically for my skin)
Vitamin B
Omega-3 Fish Oil
Vitamin D (to combat deficiency)
Multivitamin

Whew. The only other thing to mention is that I occasionally use the Paula's Choice carbon mask, which really keeps my oiliness in check and also (slightly) reduces redness. This is probably not something I would recommend for everyone though, especially those with sensitive skin, as it tingles a lot when I first put it on (and my skin really isn't very sensitive). However, it works really well for me.

The IS Clinical moisturizer is amazing. Really. My skin became flaky as soon as I began using the tretinoid, however the IS Clinical has been totally keeping it under control. I'm still able to use my Bare Minerals powder; in the past my flakiness prevented me from using any sort of makeup.

Also, I used to get small red bumps on my upper arms and thighs, as well as ingrown hairs on my legs from shaving. The glycolic wash (I've been using that for about a month and a half now) has really effectively gotten rid of these problems.

Anyway, I've been breaking out a lot over the past few days, but I'm not sure if it's because of IB or an upcoming period (mine are irregular, so they're hard to predict). I still have a stubborn spot healing on my forehead from a cyst about a month ago. There are also several healing spots around my chin, which are peeling/ flaking and looking much better already. I have an active (well, healing now after it popped in the shower) inflamed spot on the left side of my nose, and I can feel another one coming up on the right side (yippee). Inflamed spots keep popping up along my jaw line, and there's one on my upper lip that's healing.

I'm also attaching pictures to track my progress. Yuck.

Hello all Im a 16 year old from massachusetts and i, too, suffer from acne. ive been told by my dermatologist that "its not so bad!" but honestly, like many of you, its a huge deal to me. i mean NOBODY likes seeing their face breakout and horrible. So I decided to sign up on this website to track my changes! i have tried EVERYTHING from proactive, to prescriptions. it has worked but my acne just keeps coming back =[ so i went to the derm. yesterday and she prescribed to me "clindamycin phosphate topical gel" Any of you have good/ bad things to say? feedback would be much appreciated!

my current skin regiment is:
1) wash face with sodium sulfacetamide (10%) and sulfur (5%) wash (derm. prescribed)
2) Tretinoin Cream topical 0.05%
and newly added 3) clindamycin phosphate topical gel
4) i also moisturizer with Neutrogena Oil-Free spf15 moisturizer

any and all feedback would be MUCH appreciated

[attachment=22866:Photo_210.jpg] thankkkgoodness for makeup
[attachment=22867:Photo_262.jpg] makeup!
[attachment=22868:Photo_52.jpg] ew no makeup
[attachment=22869:Photo_53.jpg] =[

Ok i understand that RETIN A is not a spot treatment and not suppose to be used as such, but i was wondering has anyone here tried that? I have this nodule on my chin that will not go down and was wondering if i applied the RETIN A i have on it would it help speed up the healing process? Also wanted to try it on a few red marks.

I just never wanted to run RETIN A all around mouth and chin in fear of IB everywhere else when i only get a couple of monsters here and there.

Hi, I am back, and I am a 38 yr old mom of 3 who has struggled with acne since my early 20's.

I have been away for the org for a bit because I got my acne under "control" and have dealt with Peri-oral dermatitis for 2 years and thought I got that down to a science for me.

Unfortunately, I have had a few months of flare-ups of non-inflamed acne and the pod and finally my primary care doc sent me to a derm.

Boy, my first time in all my years to an actual derm, thought it would be some great experience, but it wasn't. She looked at me for 2 seconds...literally, ok maybe 5 and handed me Tazorac.1% and Finacea samples and scripts for both with one for solodyn - which is mino I guess, but I am not going to fill unless I have to.

What was amazing to me is that she didn't explain anything to me, like what Taz is going to do to my skin, the ib that is possible and how little you should use. Finacea also will have some effects on my skin from reading on hear for the past 2 years and what kind of cleanser to use, etc...etc... it scares me and saddens me to think that there are so many people out there, young and old that go to a derm and have this experience and may give up because they don't have someone to sit down and talk to them to ask questions...why is this happening, is it hormones, food, stress,.... how yo use these meds, what to expect, how long it will take, and all the others questions that my primary care does with me. I truly respect that and wish all docs were that way. It again made it crystal clear to me that your health and your body is in your control only, and you can't leave it in the hands of others to decide it's fate....

Ok - off my soapbox...

I have been on doxy for 2 weeks and it has started to clear up the stuff along my jawline, the pod and the some issues going on near my temples. I currently have been using:
- nucelle 10% am with 2% SA after
- Green Cream 9 in the pm
- eye cream
- washing with 10% bp wash am & philosophys cleanser in the pm
- aha as a moisturizer

Now - as of Friday using
- finacea in the am
- Tazorac every other night(going to use every night after applying cerave)
- gentle cleanser
- aha on off nights, to deal with the peeling if any...

Current status,
skin clearing up, oily a bit and redness and discoloration. Many under the skin bumps...small and non-inflamed, mostly on my chin, up along my jawline to the temples.

The reason to keep this log is to see my personal progress, and watch how it changes during the pms time. Since I am getting older, my wickeness 4 days before until I start is awful. I feel sorry for my poor kids and husband... my PCP gave me YAZ to try, but I am scared to start hormones yet and glad to take suggestions or comments from those my age starting to see major changes in that area!

Ok - here I go...t

Ok so I went for the first time a few days ago to see a derm, she prescribed me Benzaclin gel 50gm and Tazorac 0.05% I haven't used the Tazorac yet I'm kinda nervice lol she said my face is suppost to peel. not sure how bad I've been kinda looking through some things here but haven't found much.

Has anyone else ever been on this duo? how did it work for you, is there an IB with tazorac? I think the Benzaclin is actually working pretty well, I haven't had many new breakouts in the past couple days of use and my face seems a tiny bit clearer (atleast from the day I got the stuff)

She told me that every third night I should use the Tazorac until I get use to it then slowly bump up to every night, and then I guess to the 0.1% cream

If anyone has any recommendations on if I can/what I should use as a cleanser and a sunscreen to use that would be awesome, because it kinda seems like she is trying to push her products on me for everything, I already paid $116 for these 2 damn things! I can't believe I did really, I just hope it works so bad.

If anyone has any info/experience on this stuff that'd be awesome if you could let me know!

Yesterday I went to the dermatologist and she told me to stop using Benzaclin, Tazorac, and Minocycline and she prescribed me Epiduo and 150mg Doxycycline.

She told me to use Epiduo every morning and night, and also to take the 150mg Doxycycline every morning and night.

I have read other posts on Epiduo and people said that Epiduo + Doxycycline = horrible results.
But I'm going to do what my doctor told me to.

So right now I use Aveeno Clear Complexion Cleanser, then apply the Epiduo, and then apply Cetaphil moisturizer every morning and night. Then I make sure to eat anything and take my 150mg Doxycycline. Every few days I'll use MAC Volcanic Ash Exfoliator and do a MAC Volcanic Ash Thermal Mask (unless those really irritate my skin using the Epiduo and the Doxy).

Soooo we'll see how this turns out and I'll try to update every week with the results.


Does anybody have any input or advice about Epiduo or Doxycycline? or using them both together?

Hi guys,

My dermatologist has prescribed me a new combination topical which consists of Adapalene 0.1% mixed with a 2.5% BP solution. The product has been named Epiduo and is being marketed by Galderma.
I use it only at night which is the recommended frequency. Been using the product for a good 3 weeks now, and am very happy about the results.

About me:
33 year old F with recurring t-zone acne and bacne, as well as chest breakouts. I guess my acne is mild to moderate (no cysts). I was on Diane and then Yaz for 12 years but had to stop because of increasing hormonal discolorings in the face.

I also use Murad's Acne Body Wash each morning which I find to a great supplement to the Epiduo. For the face I use a mild cleanser and skin tonic and oil-free moisturizer. I also have to moisturize the chest area, since the Epiduo/Acne body wash combination is proving a little harsh for my skin.

My aim is to get 100% acne/bacne free and this log will document if and how I will succeed.

At the moment, my chest is already 90% clear, back is 70% clear and face 50%.

I am continuing to use Cetaphil and Epiduo. I use Epiduo all over at night and just a little bit in problem areas in the AM. Honestly, it works great, is so easy and convenient, but you have to stick with it, I have extremely oily skin and leave in MIAMI, so i don't have the dry skin problem. However if I was to use too frequent I do get dry. Thats when I use every night only or skip one day. but let me tell you, for me it works. HOwever I do get some pimples on my upper mustache and outside cornes of the eye, I know its ridiculous, I don't know what it is, but I suspect that this is bc of the washer, I am looking into another washer like Eucalyptus but am not sure, I am pretty busy so I don't bother and the acne is not bad at all, but embarrassing... any body got suggestions for a Cleanser with EPiduo...?????? thanks..

I'm so pleased with this change I thought It'd never be close to this good I know its not perfect but its the best its ever been since I was 10 haha!
I used tetralysal 300 for a bit but it made me feel sick so I stoped taking it, now I just wash my face with clean and clear and use differin cream of dermatologist.
Btw I dont have a tan on the 2nd pic its just better lighting

Any tips on how I could make my scarring and remaining spots go quicker?

P.s. Its all over my face but this side is the worst.

Milly:)

hi everyone!

thought i'd keep a log of my progress because other people's logs helped me out a ton in figuring out my next steps to clearer skin

i was on differin .01% cream from march 08 until dec 09. when i realized it wasn't working as well, my doctor bumped me up to the .03% gel. that worked for a little while, but again, my skin is progressively getting worse. (i was completely clear all last summer until about december)

so today i picked up my prescription of clindamycin topical solution (which i've used before) and my retin-a micro .1%...

i'm a LITTLE worried about another initial breakout from the retin-a micro, but am hoping since i used differin in the past, it wont be as bad... any insight/experience with this, anyone?!

last night was my first night applying retin-a micro ... i was expecting it to be worse than what it was, for some reason. i was also expecting to wake up this morning with a red face... but not yet... *fingers crossed* ... no peeling, irritation, or redness!

i'm also not going to ease into it like some people have... i feel like i've been on differin for so long that i'm sort of past that stage.

here is my regimen:

- wash with Dove Beauty Bar for Sensitive skin
- apply clindamycin solution
- wait about 20 minutes, then apply retin-a micro .01% (not sure if i have to wait or not, just out of habit from using differin.)
- still trying to decide if i should moisturize after, but when i do, i've always used Olay Hydrating Fluid for Sensitive Skin.

pretty simple. wish me luck, guys!

My Day 4 of Retin A Micro

29 year old female. Been dealing with acne for about 15 years. Stupid health insurance will no longer cover the Benzaclin that I have been on for years. So I haven't used it in about 3 weeks - Just enough time to let the face fester. Wonderful. Found a tube of Retin A Micro .04% in the beauty drawer that is overflowing with products. Worth a shot as it is Tier 2 in the drug formulary. Here is my journey.

Washing face in AM & PM with Clinique Mild Cleanser, followed by Clinique Mild Toner and applying Bare Vitamins Rev-Upper. At night putting on the RAM. And moisturize in the areas that need it with Arbonne FC5 Oil Absorbing Day Lotion with SPF 20. Using Clinique Clarifying Foundation and Powder. Wow - I guess I never realized how much Clinique I buy....

So today I feel lousy. I am in a bad mood because my face is filled with ugliness. I awoke yesterday to a huge nasty cyst on the side of my nose that hurts SO super bad - I can barely put on powder or yawn. I hate it and want it to go away along with all the rest of the stuff on my face. I did the RAM for the 1st 2 nights in a row. Yesterday woke up with dryness so I skipped it last night and just applied the moisturizer. This morning - again with the slight dryness but will put the Retin A Micro on tonight and the moisturizer as well. We shall see how I do. Trying to stay positive.

P.S. A picture of my cute doggy, her name is Demi, she is a 2 year old Boston Terrier.

[attachment=22237:Demi_cuteness.jpg]

i am starting to get a tiny bit of redness from retin a...pinkness, more like haha. as lon as i five my skin a break, will it calm down? this stuff cant make you permanently red can it?

I've been on Differin for two weeks now, and I've had some changes in the way my skin works.

Instead of lots of little pimples, I have been suffering from larger ones, and ones that feel under the skin, instead of my other pimples which seemed to be on the surface.

I don't know much about different types of acne, but that is just how it feels. That one type is big, pus-filled lumps under the skin (post-differin) and one is whiteheads/blackheads (pre-differin).

Is this worse for me? Or is this a normal part of the skin purging process?

Any help would be appreciated.

Thankyou.

hi guys! i actually been using differin cream 0.1% for 6 weeks already (9 weeks if you count the irregular uses for the first 3 weeks).

i've been dealing with mild / moderate acne for 2-3 years already. it didn't get too bad until last year when i started putting makeupforever concealer all over my face (it evened out my skintone and covered pores). then i realized that i could no longer go outside without makeup because of increased whiteheads and red marks. pimples usually take 2-3 days to go away on my skin but they leave behind marks that last months.

I've noticed a huge increase of whiteheads on my face after using differin, especially on my cheeks. they been around for more than a month already and i'm just afraid it won't go away. in addition to that, i have a lot of red marks around my cheeks. some of the more recent ones are from picking at my blackheads. i'm thinking maybe because my skin is thinner, it is more prone to damage if i pick at it? but it is so discouraging to touch my skin - it feels so bumpy with all those nasty comedones underneath.

my acne is at the worst it has ever been and i cannot go out if i don't apply makeup (i'm using clinique clarifying foundation with salicylic acid). I'm hoping the foundation is not clogging my pores and giving me more whiteheads.

so right now, in the mornings i'm using cetaphil oily skin cleanser, gm collin gel with salicylic acid (i'm running out so i won't be using this anymore), clindamycin, neutrogena oil-free lotion spf 15 and clinique clarifying foundation.

at night, i use cetaphil oily skin cleanser, st.ives pore scrub from time to time, differin .1% cream, and the jojoba moisturizer from this site. i read somewhere that you should wait 30 minutes before applying moisturizer because it might decrease the effects of differin?

i'm wondering if i should add an aha or bha toner to my regimen. i'm thinking about paula's choices. but i'm scared my skin can't handle it because it is getting a bit flaky in the mornings after i apply foundation.

is anyone else using differin cream having good results?

I am moving my log from the retinoid section, as I am no longer using Differin. Differin did not work out well for me at all (I used it for 8 wks). It made my chin break out horribly and left my forehead bumpy. I think my skin just didn't care for the stuff!

As of now, I have congested skin on my forehead, temple, nose/under eyes. No obvious acne and no inflammation, just general bumpiness and a few small whiteheads. This has been my ongoing problem since January or so. My chin has a little bit of active acne left, along with some bumps and spots that are healing, along with a few marks. All of that was due to using the Differin. I had no active acne there when I started! This is the area I really want to improve the most.

So here is the new plan:

I am being treated by an esthetician who specializes in acne treatment. I went in for a consultation yesterday. She tested my skin using 15% mandelic acid and 20% glycolic acid - neither of which caused any stinging. So, she says this indicates I do not have sensitive skin. She looked at my forehead (where I have been using the Differin) and said that it almost looks like an allergic reaction.

She set up a very specific routine using some high potency products, but ones that based on my skin sensitivity test, won't be too strong for it. Some of the products are only used every other night at first, others are only left on for 20 min at first, and then you gradually leave it on longer. All old products are gone, and I have a bunch of new ones as part of this regimen. I also go in for bimonthly facials to help the process along. I know this will all be $$$, but I think it will be worth it. Oh, and I am also taking doxycycline to help prevent inflamation.

Here is the routine for weeks 1 and 2:

A.M.

-Wash with Silica Facial Scrub
-Ice skin for a few min
-Apply Salicylic toner
-Apply Glycolic 10% serum every other day
-Apply oil free sunblock (also functions as moisturizer I think)


P.M.

-Wash with Silica Facial Scrub
-Ice skin for a few min
-Apply 10% BP - leave on for 15 min (Days 1-3), then wash off. I guess you gradually build up to leaving it on all night
-Apply Vivant Mandelic 15%
-Apply moisture balancing cream (first 2 wks only)

Whew!! And this plan changes on a daily basis!! I think she may add a Vitamin A product later on. I am going to put my trust in her knowledge and stick to this routine. She said I have noninflamatory acne and that she thinks she can get me clear quickly. Her treatment guide says 6-12 weeks - so hopefully since she said "quickly", that means I'll be on the lower end of that time frame! She also gave me a list of do's/don'ts - including not using fabric softener, what foods to avoid (sushi, salted foods, peanut butter, dairy - and some others).

Today is my offical Day 1. I'll update this evening after the PM product routine. Wish me luck!

I am a 30 yr old F whose acne seems to have gotten way more problemmatic in the last few months. Since I've been a teenager, I've always had a few zits every month, often hormonal, but I've never felt like I needed to do anything about it until now. Somehow in the last four months I've gotten a number of cysts that take forever to come and go. Maybe 2 at a time or so, but since they stick around for so long, my face hasn't really been clear in this time period -- mostly in my T-zone, also by my ears. I also have generally large pores and blackheads on my nose, and light scarring from old acne. Not too much though. I'm also starting to get some wrinkles.

I asked my doctor about what could be done, and she prescribed clyndamycin swabs, which did help make my good skin look smoother, but I was still getting cysts. I saw another doctor (for something else, but I mentioned the acne), and, since I had two cysts developing on my forehead, she prescribed Retin-A micro 0.04%, and told me to start at once every three nights.

I used it the first night I had it, and then read a million RAM horror stories on the web, and hesitated for a week or so. In fact, I even started with the DK Regimen and my face looks pretty decent. But I am getting greedy and would love for some marks to go away and for my face to look great, including maybe even wrinkles going away a bit.

So, tonight I'm starting again with RAM. I of course am fearing the dreaded initial breakout, especially as I have professional activities in the fall during which I really cannot have horrible cysts on my face. (Note: the past four months of bad skin, I have really only gotten cysts -- no other kinds of zits.) But we'll see. I can always stop, right? Though I know that you have to keep going to see results.

ok so i'm not gonna go into how i started to get acne cause its a weird long story bottom line isssss i went from pretty much perfect skin to mild/moderate acne and odd skin texture within about 3 months . it sucked .

i tried sodium sulfacetimide (ovace) wash, and it didnt work . allergic to benzoyl peroxide, and otc products did nothing ... several dermatologists gave me different diagnoses, but i ultimately decided to stick with one who gave me retin-a micro .04% ..

i'm on my 17th day of retin-a . i was prescribed monodox which im still on but it didnt/doesnt do anything really .. about 2 weeks into monodox i started retin-a which is when i started to notice a difference .

status now: skin is smoother, less comedones, peeling, skin looks just better in general ... red marks clearing but i think my IB has started on my forehead =/ i must resist the urge to pick !! hopefully this purging period will be tolerable .

Hi. I'm DancingCactus. My acne is restricted to a few occasional pimples. However, I have nose blackheads and forehead uneven texture and bumpy red marks, leftovers from previous acne I'd like to fix. As you can see from the picture below. And the sooner one starts to combat aging, the better, isn't it? Hence this blog.
[attachment=18458:Image022.jpg]

My skin is not sensitive at all, but rather hardy and oily in T zone. The routine below is instrumental in maintaining my current satisfactory skin condition:

Morning:

1. Wash with Cetaphil Gentle Skin Cleanser:
With just 0.5% of SLS, it's quite mild. First and foremost I want to minimize irritation. Wet face with lukewarm water, then gently massage skin with it. After which rinse off and splash face with cold water. It's actually kind of fun. )

2. Moisturize with Cerave Cream:
Dab a few dots on forehead, cheeks and chin. Then I gently even it out with back of my hand. Softly, I stress. Because I used to wonder why my face get so red and flushed after putting on the moisturzer, it turned out I dragged my hand across face like a tractor. Now I konw better.

3. Protect with Sunscreen
I wear sunscreen daily, rain or shine, indoors or out. Force of habit I suppose. Most importantly, and I put on lots of it. (Don't be scared now folks) Again, I gently even out the sunscreen, and leave it be to sink in on its own.

Evening:

1. Wash with Cetaphil Daily Facial Cleanser For Normal to Oil Skin:
Gentle Skin cleanser doesn't cut it now. Instead, Daily Cleanser dissolves away all the sunscreen I slathered on effortlessly. No greasy residue either. That's all I expect from a face wash: cleans well, rinses off well. No fuss, no muss.

2. Moisturize with Cerave Cream:
It's a rather bland moisturizer, no irritation, no visible benefits either. Just very... bleh. Am I committing cardinal sin by expecting too much out of a simple moisturizer?

3. Moisturize with Paula's Choice Exfoliating 2% BHA Lotion:
It received good reviews for ridding black heads, though frankly, I haven't noticed any difference.

By the way, I also have Daniel Kern's BP gel, but I get so little pimples, besides, it doesn't correct red marks, so I rarely use it. But it's effective against occasional zits.

Topicals I'd like to try:

1. Retin-A:
Acne reducing, red mark lightening, real anti-aging, (Not just the "appearance" of aging) what can be better? I received a bunch of Retin-A gel from AllDayChemist.com, and can't wait to start reaping the benefits. This what the tube looks like:
[attachment=18461:image001.jpg]

By the way, I used Retin-A 0.025% generic cream some months back, but discontinued using it after a while. Didn't experience any negative side effects at all when I started though, weird.

2. Tazorac:
Retinoid with the similar effects as Retin A, except more effective with shrinking pore size reportedly.

2. Avene Diacneal.
Mixture of 0.01% Retinaldehyde and 6% exfoliating Glycolic acid. Reportedly just as effective as 0.05% Retin-A, but a lot less irritating. Avene also incorporates their patented active ingredient Retinaldehyde in their Eluage, Ystheal and Retrinal (available in USA) lines. But Diacneal is the most potent and promising.

3. Azelaic acid
The active ingredient in Skinoren cream and Finacea gel. It has anti-bacterial and lightening properties to improve red marks leftover from acne. And it speeds up skin turnover. Just what I need. Can be used during the day. This may provide more bang for the buck than any moisturizer.

4. SkinCeuticals CE Ferulic serum
An antioxidant serum that improves complexion and combats sun damage? I'm sold. Though I probably won't try it until I got the more important stuff like sunscreen and retinoid out of the way.

Diet to be incorporated into the routine:

1. Green Tea
I like how tea's fresh clean taste lingers, and it has antioxidant properties. Woo hoo! Let's see if I can keep it up.

2. Fruits and veggies
I'm pretty bad in this regard, my grandma once said I'm a carnivore. )

This is about it, my goal is to have a smooth, even, acne-free complexion with minimum efforts. Too ambitious? We will see.

Ever since adding differin back into my regimen, I've slowly gotten back to where I was before I has stopped using Differin. There was the intial breakout (again) and it lasted for quite some time (more than 4 weeks). But now I'm slowly starting to heal, well sort of. Anyone else get areas that are brokeout cleared, and then areas where you were clear brokeout? That explains my forhead and cheek areas.
My forhead was pretty clear, and just oily, but now i had bad cystic breakout at the ends of my eyebrows, and one near my forhead. It leaves me saying to myself, wtf? However I'm thinking this is due to not washing out hair products that I use for my hair (wax, hairspray, pomade, etc.). So that could contribute to that...but anyways, my cheeks are getting clear (I mean on my face...lol). My left side barely has one or two pimples while my right side has a few...but then below my face/neck area on my right side I had a nasty breakout there too (perhaps from shaving?).
Anyways, I thought I'd let other people know about my differin usage. Now I only have three breakout areas to heal up and I should be pretty much clear! (hopefully soon so I can do something about my unveven skintone...)

I thought i'd write a log now since I'm clearer than i've ever been.

First I'm 23, I started dealing with acne when I was 17. It showed up out of no where. Instead of listing all the things I've tried that didn't work I'm gonna list the things that did

Bactrum & Retin A & Clindamycin & AHA

I took 3 months worth of Bactrum with Retin-A every night and was completely clear back in October of '07. I slacked on my regimen and my acne came. Being that Bactrum is so potent my derm. declined when I asked for another 3 months prescription.

So, right now my regimen is:

A.M.
NATURE'S PLUS NATURAL BEAUTY CLEANSING BAR(main ingredient Olive Oil which helps with old acne marks)
3+ drops of Jojoba Oil
Dan's 10% AHA
Clinque Super-Defense Moist. w/ 25spf

Makeup:
Estee Lauder Double-Wear foundation
COASTAL CLASSIC CREATIONS 'SAND DUNES' BLUSH (PEACH) 100% organic
Physician's formula loose power

P.M.
Clinque Wash Away Gel (makeup remover)
NATURE'S PLUS NATURAL BEAUTY CLEANSING BAR
Retin A .1%
Wait 30 mins to an hour then apply 3+ drops of jojoba oil.

Using Retin-A and clindamycin constantly has cleared my skin up significantly, added 10% AHA has just pushed it to the next level. I'm still looking to find an all natural make-up remover and sunscreen. Hopefully replacing those two products will get my skin from mostly clear to perfect!

Hey all,

Im doing this for you guys, as well as myself so I can timeline my progress. So heres all about me.. Im 20 years old, Male, with taned taned skin. I've had like a pimple a week all through highschool which didn't bother me at all unitll university when I saw the same people everyday with a pimple everyday. It was out of control. I tried basically everything (benzoyl peroxide, tea tree oil, ACV, EVOO, salyic acid, caveman.. everything with little relief)

So I decided to go and see a derm, he perscribed to me retinsol A 0.01%, doxycycline, and clindoxyl gel (clindamycin + BP)

Im only taking 1 pill 100mg of doxy a day
retin a at night
and clindoxyl in the morning

So Im at day 5 with no improvement, Ive been alternating nights between retin a and clindoxyl to ease things in.. so lets say this is day 1


wish me luck and a big change... I hate this curse!!!