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........

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]

Alright, here's the start of my log!

I have been on yasmin and retin a micro .04 a about a month...i have been easing very slowly into retin a to try and avoid redness/flakes i was using it every 3 nights the last 2 weeks and am now using it every 1 or 2 nights...i dont have much redness, but even after i wash it off in the morning my face is a bit burny/dry for the day...im scared to smile because it will make me flake so much!! argh! feeling discouraged but am going to tough it out another 6 weeks at least! derm gave me an antibiotic to help get over the miserable initial breakout. i have heard this stuff is great if you can be patient, all i can say at this point is that my patience better freaking pay off!!! also i now let the retin a absorb for about 10 min. then apply moisutrizer, my derm says this is fine and will not cut the concentration of retin a. i'll keep you posted!

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.

HY , I'M ON MY SECOND WEEK WITH DIFFERIN 0.1% CREAM . I'M ON THE PEELING PROCESS AND NOW WHEN I PUT IT ON MY FACE BURNS LIKE HELL 4 A COUPLE OF MINUTES. ANYWAY I CAN MANAGE THIS IS NOT SO BAD AND I CAN SEE ALREADY SOME POSITIVE CHANGES ON MY SKIN . !!!!!!!!!!!BUT NOW THE BIG PROBLEM IS THAT I HAVE A LOT OF NEW LITTLE RED VEINS ON MY NOSE AND ONE UNDER MY LEFT EYE!!!!!!!!!!! CAN YOU GUYS PLEASE TELL ME IF THIS VEINS WILL DISAPEAR OR I'LL HAVE THIS NEW PROBLEM FOR THE REST OF MY LIFE ??? I'M THINKING TO QUIT DIFFERIN . PLEASE LET ME NOW SOMETHING ASAP . THX 4 ALL

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!

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.

OK so i have been using ziana for about a week now and so far i could tell you that the first week is really bad purging week, but i got through with it and i cant wait for the 2nd week to pass so i could update again, but anyways week 1 first 4 days was purging acne here and there but it was all just little bumps though maybe just one mid size one but its clearing up as i could see, my face started peeling for the first 3 days also it was really bad, so far im just hanging in here onyl a few positive results with ziana and hopefully that wont be the case on week 2 so again i have about 2 active acne on my left cheek ones a cyst and one is a mid size acne and on my right cheek i got about 2 active small ones and the rest are just red marks and two small acne on my jaw line and one just at the right side of my mouth and so far its all clearing up getting small in size and hopefully will disappear by the 3rd week cant wait so thats all for now! i'll keep you guys updated every week

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!

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!

Hey all,

About a year ago I started using differing .1 at night. The initial outbreak was horrible, but after that my skin cleared up quite nicely to the point that I only had a few small spots in my face. Differin also gives me very little irritation (as oposed to other topicals!).

The last few months I have been breaking out again, mainly around my mouth. I am thinking about using differin both in the morning and at night. Does anyone here use differin twice a day? Does it make a difference compared to once a day?

I think my skin can handle it since differin gives me so little irritation.

Any help would be very much appreciated!

hye guyess, just need some advice with my regimen, i've been on duac for about 3 months and it helped flattened my acne now there's only a couple (4-5) pimples on both cheeks but quite a lot of pigmentation, i wasn't satisfied as i didn't get fully clear so doctor recommended me differin and mino on top of that, i was also using a salacylic acid cleanser and all that combined, i started becoming flaky and then x-ma started spreading to my neck now and makes me look like i have potato skin, luckly i had my first derm appointment today and he said im using wayyyyy to much, now he want's me too just use water to wash my face and only use the differin ONCE at night with the mino twice a day, he also said i shoulden't get any peels and stuff for my pigmentation and differin will make it fade with patience, i'm a bit hesitant as i'm scared that duac could have been working after those month's and that differin won't be my holy grail, i paid 150 for just a quick 5 minute visit -.- , should i fully follow his instructions?

hey, im a male college student who before this recent flare up of acne (past 6 months) had almost perfect skin. i would go out drinking for weeks on end, get no sleep, and eat total crap and have very manageable skin.

Long Story
my old regimen was proactiv in the morning, ziana at night and a cycle or two of antibiotics. Well at some point i decided i was sick of getting sunburn and dropped the ziana, stopped taking antibiotics, and switched to that neutrogina skin care package that was basically the same thing. stupid choice.

shortly after i started getting more acne, then i tried adding in 100 new things to make it go away, and that just made a mess of my face. i was on dans regimen for 3 weeks until my doc said i should do it in the morning and put ziana on at night, with some antibiotics for the IB. Im just hoping to be clear again so i can be my old self. ill never take clear skin for granted again.

advice for people who are on a retinoid: dont pick your goddamn face. it makes my face so fragile that if i even try and get rid of a pimple without the upmost care, HUGE red mark. literally take a layer of skin off. be careful

Short Story

Week 1:
started off fine, then the peeling really set in. 500mg tetracycline every night, lotsa ziana, 2 pumps of BP in the morning. face isnt looking to pretty

Week 2:
i added in niacin no flush, zinc, and a b complex vitamin in hopes of quicker clearing. Had a pretty good effect for 1 week until my IB set it. down to 1.5 pumps of bp in the morning cause of flaking. good days and bad days.

Currently Mid Week 3:
well the IB from ziana started, something about antibiotics/ziana makes me get cysts. got 2 ugly ones that im putting mupirocin on in hopes of them fading. My right side of the face is oddly clear with only red marks, while the left side has a small cyst. ugly cyst on the chin. forehead clear as usual.
edit: started mixing my ziana with moisturizer at night, results are wonderful. much less peeling.

ill get some pictures when i have the time

peace

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:)

I have been on tazorac for a while now and i notice that i get a layer of dead skin/flaky skin on my face, i normally rub it off and then use cetaphil cleanser and moisturizer. Even after i moisturize i still get some flakes on my face and towards the end of the day my skin flakes up..

no matter how much i scrub or moisturize, i still get the dead/flaky skin sitting on top of my face every day, morning and night. I use cetaphil antibacterial bar soap, wait 15 minutes, moisturize with cetaphil moisturzer. At the night, same thing and after i moisturze i put on a pea size of Tazorac. What should i do? Should i buy a scrub? And if so should i replace the cleanser with the scrub? I am looking at these two:

Neutrogena

StIves

i'm not sure if i should use these scrubs or if this will "exfoliate" my skin of this flakiness

should i either scrub my face hard with the cetaphil, gently wash with cetaphil, or buy a scrub?

any help/advice/tips would be greatly appreciated! please and thank you

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.

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.

A little background: I'm 18. I don't really have acne anymore due to the use of AHAs and BHAs, and I think I just kinda grew out of it, but I really wanted to try out a tretinoin cream for the long term benefits, fix my acne scars, and for the occasional breakouts I get.

Before the Retin A Micro my skincare routine was

AM (BEFORE):
Clarisonic (Sensitive) + Alpha Hydrox Foaming Face Wash
Cosmedicine Speedy Acne Recovery
Skinceuticals CE Ferulic
Neutrogena Age Shield SPF 55

PM (BEFORE):
Clarisonic (Sensitive) + Alpha Hydrox Foaming Face Wash
Alpha Hydrox 12% Glycolic Souffle
ROC Multi Correction Night

Currently it is

AM:
Clarisonic (Delicate) + Alpha Hydrox Foaming Face Wash
Skinceuticals CE Ferulic
Cerave Lotion
Zia Natural Men Eye Cream SPF 15
Neutrogena Age Shield SPF 55

PM:
Clarisonic (Delicate) + Alpha Hydrox Foaming Face Wash
Alpha Hydrox 12% Glycolic Souffle
<wait 30 mins>
Retin A Micro 0.1%

If you have any questions about anything just ask!!

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.(:

I'm 27 and I finally decided to visit a dermatologist for the first time in my life about 3 weeks ago. Best thing I ever did.

I've been on the birth control Yaz for about 4 months and although it did get rid of my hormonal acne, I got a sudden outbreak of clogged pores (little zits) everywhere on my face about a month ago. I think the combination of oily skin and humidity just drove my skin nuts. Like hundreds of little zits everywhere, which I had never had before. I've always had mild acne but this was crazy. My face felt like sandpaper and I looked like a red mess.

The dermatologist prescribed me generic retin a cream (.025%) and duac. It cost me $20 total since I have insurance. I've been using retin a about 2-3 times per week at night and duac on alternate nights about 2-3 times per week. In just 3 weeks, I have cleared up tremendously (50-75%). I really doubted my dermatologist when she prescribed retin a and duac because I've never used anything other than benzoyl peroxide face wash (which used to work but wasn't enough at this point).

The only downside is that retin a makes me peel but there is no way around it since that is how it works. You skin peels so that you are revealing new skin while at the same time, washing away clogged pores. I still have some red marks on my face.. mostly on my chin from past hormonal breakouts so let's see how I do. I am supposed to see the dermatologist in about 3 more weeks as a follow-up.

I just received my tube of Retin-A from canadapharmacy.com and it is set to expire in March 2010, which is only 4 months away.

How long was your Retin-A good for since you bought it? I would expect more than 4 months of usuage of a 20g tube.

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%.

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.

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.

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

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?