Dr. Fulton answering a question about retin-a
I am using Retin A® but I do not seem to clear up.

When I developed Retin A® in 1969, it was quite an irritating formula. The more the skin peeled the better the acne would respond. However, during this peeling phase all the acne impactions are coming out so there may be an appearance of flare up of the acne condition as all of the impactions are being evacuated. Once all the pores are clear, the acne is under control and not visible . Also, if a patient is considering Retin A®, they should use the Retin A® gel and not the Retin A® cream. The Retin A® cream contains isopropyl myristate, which is an aggravator of the acne condition and sometimes patients will get worse because the formulation of the Retin A® cream. There are also new formulations of the Retin A® on the market, such as Micro Retin A® that are better formulated creams than the previous product. The key is to keep the skin visibly peeling in order to get a rapid clear up. If there is no peeling whatsoever, your particular formulation is not working very effectively on your skin. You should see at least a little peel once a week to know you are at the right therapeutic level. Also, you may need to work with your physician or esthetician during this early phase to help extract out all the acne impactions that are coming to the surface. This will lead to a more rapid resolution of the problem

hope this helps a feel people, maybe you guys ahve read it.
Particularly interesting part is that he wants deliberate irritation (visible peel) for acne to rapidly clear up.

Topical retinoids are very effective anti-acne AND anti-aging products. They transform your skin cells over time, speeding up the rate at which skin cells form and making them less "sticky". Retinoids also increase collagen production. Long-term retinoid use results in smoother, more even and glowing skin. Topical retinoids are not effective spot treatments, but are meant to be used all over your face, and on a regular basis.

A lot of people get started with retinoids but give up quickly -- usually because they have not been properly taught about how retinoids work, and what to expect in the early weeks.

Here are some key things to remember:

1) IRRITATION

Topical retinoids are irritating to the skin, and you MUST ease into them gradually. Here is a general schedule that I suggest people follow when first starting out:

Week 1: once every 3 days
Week 2: once every 2 days
Week 3: 2 out of 3 days
Week 4: daily

Pay attention to your skin! Red, sore, "sunburned"-looking skin and excessive peeling are signs of irritation. If you experience either, STOP using the retinoid until your skin has gone back to normal. Then pick up the schedule where you left off.

Moisturizing with emu oil (or just adding it to your favorite moisturizer or sunscreen) will help to reduce redness, dryness and inflammation.

2) INITIAL BREAKOUT

Retinoids work by forcing the comedones that are clogging your pores to come to the surface. It takes about 3 months for your pores to clear, and during this time, you will probably see some breakouts. Blackheads may appear larger and more noticeable as they surface; small hard bumps may form; and if you are prone to inflammatory acne, you will probably get pimples. (A short course of antibiotics can help people with inflammatory acne get through this initial breakout, but I do not recommend taking antibiotics for more than 2-3 weeks.)

3) SKIN FRAGILITY

Retinoids make your epidermis thinner and more fragile (don't worry, though, because they actually thicken and strengthen the underlying dermis). DO NOT PICK AT YOUR SKIN! Trying to squeeze out a blackhead can leave you with a red mark for weeks. Be patient.

Be sure to use a very mild cleanser with no other active ingredients while you are getting accustomed to the retinoid, and cleanse your face with lukewarm water no more than twice a day. Once is probably better. Retinoids compromise your skin's barrier function, and excessive washing is going to result in dehydrated skin. You can reinforce your epidermal barrier and reduce dehydration by supplementing your diet with fish oil and moisturizing with emu oil.

4) PEELING SKIN

Some peeling is normal. Not only are your skin cells regenerating very quickly, but they are not sticking together as cohesively, and you will see surface peeling. Gentle exfoliation can help get rid of the shedding layer of skin; you can use a soft facial brush or a silica microbead scrub. BE GENTLE! You can do a lot of damage if you aren't.

5) SUN SENSITIVITY

Retinoids increase your skin's sensitivity to the sun. Wear sunscreen during daylight hours. If you are getting laser or light treatments, be sure to tell them you are using topical retinoids; you may need to avoid product use for a week or so before a treatment.

6) PRODUCT APPLICATION

You should apply retinoids to clean, dry skin and wait at least 10-15 minutes before applying moisturizer. Many retinoids degrade in sunlight (Differin is an exception, as it's not a true retinoid), so it's best to use them at night.

If you are also using benzoyl peroxide as part of your regimen, do not apply it and the retinoid at the same time, as BP oxidizes retinoids. Usually, you'll want to use BP in the mornings, retinoids at night. Differin (adapalene) is an exception to these rules.

Salicylic acid and retinoids work very well together. (SA loosens comedones; retinoids push them out.) You can use SA in the AMs, retinoids at night, or you can layer the products at night. If you are layering, the general rule is to cleanse; apply SA liquid or gel; wait 30 minutes; apply retinoid.

If you want or need an acne prescription, see a doctor and get it legally. If you get prescriptions illegally online you could easily hurt yourself or waste your money.

- Independent studies have been performed on the sale of Internet-bought prescriptions. Often the prescription contains no active ingredient, little active ingredient, or in a worst case scenario toxic amounts of active ingredient.

- Drugs bought without a prescription can actually be a completely different compound from what the buyer intends.

Acne.org prohibits the illegal trade of any form of drug or prescription drug. If you see a post from someone selling a prescription, please report it immediately. Thanks.

Time to call in the real expert!

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?

Any and all information would be much appreciated ... thanks, hun.

(I am not entirely sure this thread belongs in the Research section, but I'm reasonably certain of finding you here.)

Has anyone every heard of this? Or even better has anyone used it? Whats the sucess rate like?
My doctors put me on it while i'm waiting to see a derm, but i have a feeling he just gave me it to shut me up while im waiting for an appointment
i'm also on minocycline
Thanks
J
xxx

I didn't get any responses to the last thread I made, maybe because I'm new! So hopefully I will get more help this time, haha.

I'm a 20 year old male and have been on 100mg minocycline once a day, and 10% sodium sulfacetimade/5% sulfur product called Prascion every night. It's been pretty great and the past couple weeks I haven't had any pimples, typically I'll get a couple a week, once in a while a bigger one on the chin or lower cheek area.

But, like I'm sure many others have experienced-- I'm still not happy with my skin! I know I should be, and in regular lighting I think it looks great, but if I ever look in a makeup mirror or any bright light, alll the problems become apparent-- blackheads on the nose, some red marks on the forehead, lots of acne marks and so forth. If you run a hand over my skin it feels entirely smooth, and from a distance looks entirely smooth, but it's just very upsetting to look at it in a bright light/close up and see that it's not all that great.

I'm going to the derm tomorrow, but I'm been reading a lot about Retin-A micro and the initial breakouts people experience. So

1. Is it possible that the minocycline and maybe putting on the sulfur in the mornings after washing my face of the retin-a micro I put on at night......is it possible that breakouts will be reduced?

2. Does the harshness of breakouts on a retin-a product depend on how many pimples you currently get? I mean if I have had say 4 in the past 2-3 weeks, is my skin suddenly going to be bad again? Is it possible NOT to have an initial breakout?

Thanks so much guys.

Hello Acne forum,

I've had this question on my mind for a long time and figured it is about time to finally answer it. Instead of making an appointment to the dermo just to answer a question, I figured I'll ask it where professionals hang out "after hours"

So I've been using Retin-A for months now (cream based, .025%) and I've been experiencing the same issue since I first started using it.

Whenever I apply more than a TINY amount I'll get white bumps everywhere that I apply it. My current regimen is to put a small half-to-one-grain-of-rice sized amount on my face every or every other day. I mix it in with moisturizer and apply it after I get out of the shower. I mix it in with moisturizer because it would not be able to cover my face on its own.

If I apply it consistently every day for a week or accidentally add more than a grain of rice to the moisturizer mix, I end up getting white bumps on my face that look very much like whiteheads.

I have been using the cream for a long time now -- about a year, and I'm still experiencing the same issues. I noticed this after about three weeks of first using it.

I thought that the whiteheads were a sign that my skin was being highly irritated after three weeks of starting treatment so I reduced the frequency and amount of my applications to where it stands now.

The problem is that I'm walking a fine line between over applying and getting whiteheads or under-applying and getting acne.

Oh I forgot to mention: I have anxiety that I always take out on my skin. Whenever I'm stressed or tired or zoning out, I often pick at my face in the mirror. The white bumps that form from Retin-A cause me to stay in front of the mirror for as long as an hour sometimes and pick at every last one, leaving my skin looking like a warzone and causing me more grievances than a few acne pimples would have. I have tried saying "no, don't pick" but I only manage to do that for a short period of time before I give in.

I don't know what to do -- am I truly applying enough to my face or did I never hit that point of having the cream "really begin working"? (I never had any peeling or redness from the medication because I never applied it heavily enough to allow for that).

What are your takes? What could it be? Is it a bad reaction to Retin-A? A bad regimen? Hmmm....

School just started and I really don't want to experience any bad peeling.

Also how can I manage the medication with my anxiety?

Edit:
Also, I wanted to mention that I have been using Sulfacetamide Sulfur for years now as a face wash because I also have mild Seborrheic Dermatitis (and it dually helps with acne) and the sort of acne I suffer from is very mild: if I don't apply enough or any Retin-A, I get occasional deep pimples that hurt and take a long time to go away, leaving a hard dense scar in the aftermath. I normally don't have more than a single one on my face at any time but it is still annoying.

So my face is so super dry. My chin and upper lip is about to flake off!! I am applying moisturizer constantly throughout the day while at work. It is soooo embarrassing!! I have read on the forum that Jojoba Oil is supposed to help with flakes and dryness. But alot of the posts are dealing with the Oil with BP... Can the oil be used with Retin A Micro or is that advised against? And at what point of my skin care regimen should I be applying it?

Regimen

AM
Clean face
Use Toner
Apply Moisturizer
Apply Makeup

PM
Clean Face
Apply Toner
Apply Retin A Micro
Wait more than 20 minutes - Apply Moisturizer

Where would I add in the Jojoba Oil?
Thanks!!

HY ALL ! I'M NEW HERE AND I WOULD LIKE TO KNOW YOUR OPINION ABOUT USEIN DIFFERIN CREAM 0.1% . I DON'T HAVE A LOT OF ACNE ..I HAVE SOME PIMPLES BUT I DO HAVE LARGE PORES AND COMEDONES AND BLACKHEADS. DO U THINK THAT I CAN USE DIFFERIN CREAM ? MAYBE IS BETTER IN YOUR OPINION TO TRY SOMETHING NOT SO HARD? I'M REALLY TIRED TO WAKE UP EVERY MORNING AND SEE THAT THE MORE I DO FOR MY FACE THE LESS I GET. REALY APPRECIATE YOUR HELP ! CRIS

I have been using Retin-A Micro gel the last few nights, and I have had very little dryness/irritation so far. I was wondering, is it okay to use AHA lotion as a spot treatment at the same time as it?

Also, after applying the RAM, can you apply a moisturizer after it? I have been putting on Olay mosturizer about 15 minutes afterwards. I'm not sure if I'm supposed to do that, and maybe that's the reason I haven't been experiencing much irritation.

Please let me know if you have any advice! Thanks!

This is my last new topic, promise

So the pharmacy here in France only had cream Retin-A, but they did have an alternative in the 0.05% which was this LIQUID thing called Effederm! I'm a bit puzzled about how to apply it, I'm scared of over applying and it's hard to figure out how much is a pea-sized amount! Anyone ever have experience with something like this?

hi guys, i met my new derm today and she was very caring to my situation. she gave me cards to activate so that i won't have to pay more than $25 on any of my prescribed drugs (refills as well). she also left me with about a month supply of sample for ziana, aczone and epiduo as well as a 3 day sample of DORYX. other samples include moisturizers and cleansers such as CeraVe and Cetaphil 50SPF facial moisturizer along with discount cupons!


so i was prescribed:
DORYX (150mg)
ZIANA
ACZONE
EPIDUO

she even gave me a treatment routine as follows:

morning: apply sunscreen to entire face
night: apply ziana to entire face, then apply aczone as a spot treatment and lastly apply epiduo to the entire face.


anyone been on this kind of cycle? has it worked for you?

and one more question, after applying the 3 topical gels, once they have dried i should be applying moisturizer right?

Hey,

Sorry I've been inundating this place with posts lately, but this one's serious! I'm living in France and was prescribed Retin-A CREAM by a Dr. (NOT a dermatologist) for my acne. I just read how the Retin-A cream is not even meant for people dealing with acne, but the pharmacy here just told me they don't carry the gel in France! Is this the right thing to be taking for my skin?? I liked it because I usually have normal-dry skin, but have noticed that my IB is taking a long time (in my 7th week, breaking out since I started, worst in my life!)
Pleeeease someone help me with this, especially if you have been on the Retin-A cream and found it successful!

So I've been looking on this site for awhile and seeing people's logs on Retin-A. I'm 26 with adult acne (never really suffered from it in my teens, but for the last two years or so had mild-moderate acne, mostly around my chin, usually inflamed, but not enough to be cysts, and general clogged pores). I decided I wanted to do something about it was was prescribed Retin-A 0.05%. Since I was prescribed this in Europe, where I lived, and didn't know a lot about it, I didn't really realize the stuff about the bad initial breakout until I read up on it about two weeks into it. Funny, if I had known about the IB and how bad it could be I'm not sure I would have started! But I figured I already put in a few weeks so I might as well see it through.
So even though I do flake a bit in the morning (mostly around old pimples) I still feel like I've adjusted well to the 0.05. And even though I'm only in my 7th week (not very far I know, since I know it usually takes 3-6 months or more) I'm still breaking out and, most annoyingly, EVERY single little thing that comes up on my face, whether I pick at it or not, leaves a red mark that lasts waaaaaay longer than normal, like weeks and weeks. (Anyone else experience this?) So even if I'm maybe not having as many new pimples a week, I feel like my face is just accumulating into one big mess of red marks.
I know from reading through some people's logs (amorfati, etc) that they really started to see improvement when they upped their does from 0.05 to 0.1 percent. What is the point that you come to when you think this is a good option? People who did this, did you wish you did it sooner?? It's just so hard to know if what's happening is normal, or if I could be speeding up the process if I was only on the right dose.
Anyone who can help me with this, and any advice on getting those red marks to fade quicker, would be REALLY appreciated.

Thanks!!!!

I just noticed that my recently filled prescription of RAM 0.04% says to "Apply 4x Daily". That seems like way too much. This is the second one i've been on, i had .025% before and it seemed to help, but not much. What do you guys think? Is 4x daily way too much ? How many times per day do you apply it?
Thanks!

Hey guys,

Been cruising these forums for awhile, just decided to join cause I have some questions. I've been on Retin-A %0.05 for about six weeks now, and am starting to see some results. I've also been getting really into the natural oils too, cause they also seem to really work. But my question is:

Will applying my topical anti-biotic and %100 tea tree oil for spot treatment in the evening right after my Retin-A (10-15 mins) affect my Retin-A's effectiveness in any way?

A word of warning for anyone trying this too, in the first weeks of my Retin-A when my skin was pretty sensitive and dry, tea tree oil dried out my face soooo much more and made it worse, painful! I had to wait until my skin had adjusted, and now I use it for spot treatment no problem. It actually seems to really work.

Thanks for anyone who can help on this!

Background: 27 year-old female, mild acne during high school, worsened during undergrad, annoyingly persistent since. Would classify as mild to moderate with pustules. Post-inflammatory hyperpigmentation has always been an issue. Breakouts became increasingly inflammatory with cystic lesions on chin. Family history of acne, and severe scarring.

Past products: Salicylic acid (pads, gels, and every other form), benzoyl peroxide (ProActiv, etc.), AHA's, series of facials, exfoliation, tea tree oil, sulfur-based treatments, birth control pills. I've tried gentle, I've tried aggressive. I've tried washing my face multiple times/day, and I've tried leaving it alone.

What I hadn't used: anything prescription.

Now onto the good stuff...

OBAGI Nu-Derm: Recommended by an aesthetician at a medical spa. Pricey, indeed, but so was the collection of products I was using. Consists of 0.05% Retin-A, 4% hydroquinone, and AHA's.

Here's the regimen (I was very compliant with this-- never missed anything, no matter how tired I was! I was super dedicated to fixing my face.) AM: wash, tone, hydroquinone, AHA, SPF35. PM: wash, tone, hydroquinone, Retin-A.

Weeks 1-2: Peeled like crazy! Tried to work shorter hours, avoided going out because I was peeling so badly.

Weeks 3-4: Redness and breakouts galore. When I went in for my 4-week follow-up, they thought it a bit unusual that I would have this reaction this late into the treatment. They were expecting a significant improvement. My skin is stubborn, oh well.

Weeks 5-6: A bit better, not much. Went in for red/blue light treatments, and my skin started to turn around. Unsure if it was due to the lights or the treatment finally taking a turn for the better.

Weeks 7-8: Fewer breakouts! Finally!

Weeks 9-10: Even fewer breakouts, hyperpigmentation starting to fade and even out. Is patience finally paying off?

Other lifestyle changes: consistently exercising (cardio 3-4x/week), eating better (more fruits and vegetables, less processed stuff), multivitamin/omega-3/birth control pill daily.

Photos can be found here: . (If this link doesn't post, which I'm not sure it will, it's under my galleries... it's the only gallery I have.) I realize that they are not the best quality (webcam) and it's not consistent on the lighting. I also realize that I didn't start at the beginning of my treatment (started at about week 4), but I wasn't feeling like taking self-photos while I was mega-peeling. Despite all this, I think the photos do show the improvement.

Cover-up: I love makeup. Period. I've been using mineral makeup since it's better for your skin, and less comedogenic. Was using BareMinerals for the past 2 years, now using CoverFX, and would recommend it. BareMinerals has more titanium dioxide (read: sunblock), but I'm using SPF35 moisturizer anyway. CoverFX has better color, less splotchy. Also, to counteract the redness, used a green primer (using Smashbox Photo Finish Primer in green).


...I'll continue to post. Heck, if no one reads it, it's cathartic anyway, and I figure it'll be good for me to document my own progress. Good luck to all!

Hi everyone,

I've been using the Retin-A Gel .025% for about a month now. I had a really bad peeling phase in the beginning with lots of redness, but I haven't gotten an IB yet and the redness has started to go away.

I've also been using moisturizer with the Retin-A at night about 30 min to an hour after application of the Retin-A. It doesn't matter how long I wait, or really what moisturizer I use, but when I apply the moisturizer I get lots of clumping on the surface of my skin. My question is whether other people have experienced this as well?

I'd really prefer to keep using a moisturizer at night as it leaves my skin feeling better than without one. I've heard that all of the Retin-A absorbs into your skin in out 20 minutes or so, so I wonder if the clumping is a result of an interaction between the Retin-A vehicle (not the trentinoin itself) and the moisturizer?

Many thanks,
Dan

I've been using Retin-A for about a month now nightly, and my skin is hardly peeling (it is dry around my nose though) and in the morning sometimes it's actually greasy. The clogged pores around my jawline are starting to diminish, but the breakouts around my temple and forehead aren't budging.

My question is if this has anything to do with my makeup? I used bare minerals powder because it's the only thing I feel safe to use that's a mineral foundation -- everything else makes me look shiny. I also put concealer (I don't know if it's non-comedogenic) from Benefit called Boi-ing on my dark circles and on the breakouts. After lots of trial and errors with other concealers, this stuff is the only thing that works. Could my makeup be stunting my efforts???

FYI- I occasionally use a primer from ClearPrep that has 1.0% salicylic acid in it, or I'll just use Cetaphil facial moisturizer.

ive been using RAM .04 for almost 2 weeks now and i want to start using BHA (salicylic acid). i have paulas choice 2% BHA liquid and was wondering if i should use it before or after the RAM .04??? my skin isnt sensitive to BHA and i have had good luck with it in the past!!! i like to keep things simple so the least amount of products is definitely ideal.

ANY advice or stories/personal experiences about BHA/RAM would be great!!!

Hi!

I'm currently about to start my Tretinoin treatment (0.1%), and been reading a long on the forum to hear some experiences around it. But I can't find much info on the long-term effects of it. So here's my question to those who've been using Tret.

+ Does Tretinoin give you a permanent effect AFTER stopping the program?
So it can go under the category of a cure, like f.ex Accutane.

- OR does it only work AS LONG as you use it? (and the the effect usually disappears after stopping the treatment - as in most cleanser products etc.).

And around scarring. I know about the initial and continuing breakouts during the first months of the treatment.. And it sounds like this can cause more acne scars.
As I already have enough of those to deal with ( ) as it is.

+ Will Tretinoin soften these marks, as well as older scars, so you don't end up with a clean skin, but full of terrible footmarks as a reminder of the treatment as well?

All inputs appreciated. As you understand I have quite a few concerns about the effects of it.

I've been using Ziana gel (only at night) for almost 4 weeks now. Should I continue using it to get results or go back to my dermatologist?

I was prescribed Ziana gel yesterday along with Solodyn antibiotics. However, I have decided not to continue taking the antibiotics even though I have only taken one pill so far (this is not because of side effects but because I am afraid that my acne will eventually become even worse much later on). I have noticed that Ziana is part anti-biotic, so I was wondering if the acne bacteria will eventually become accustomed to it? If it does, will the acne come back even worse once the gel stops working? I recently saw an ad for epiduo which doesn't contain an anti-biotic, so will that work better? Please help!

Or can it just rub off on your pillow while you're sleeping. Cause that would make the prescription pretty point to use a night.

Today is day 96 using retin-a .025% gel. For the first time in a long time my skin looks amazing. I have one and ONLY one tiny blemish on my chin right now that isn't even noticable. This is huge improvement from the hundreds of blemishes on my face 3 months ago. So I really encourage everyone who uses a retinoid to stick it out for at least 3 months. I'll be honest, it really sucks getting there, but when you do, its great. My skin hasn't been this smooth since I was eight years old!

Question!

I have been on differin xp .3% gel for the past 7 months and have experienced some improvement but am no where near clear or happy. I have heard about another topical called Tazorac but that it has some harsh side effects in the beginning. Since I have been on differin would my skin be able to tolerate tazorac better and avoid the initial breakout? Does anyone have any feedback on tazorac? THANKS!

If you're American and you're uninsured, or if, like me, you have an insurance company which won't cover Retin-A Micro, this message is for you.

I went to a couple of pharmacies in my town (in North Carolina) when I was looking to have my prescription filled. The first one offered to sell me a 20 gram tube of 0.1% for $98, and the second sold me the same for $92 (or $4.60 a gram).

When I began to run low on Retin-A Micro, I started to look for pharmacies online which could fill my prescription legally* and for a lower price, and I found one in Ontario which looked promising. I printed out the form for my dermatologist to fill out and fax, and I went to his office to ask him to send my prescription to Canada (I must admit that I was a bit nervous because I thought he might not believe that it was legal, or that, even if he didn't doubt its legality, he would still be suspicious enough of the Canadian pharmacy to refuse my request).

Fortunately for me, though, my dermatologist's office contacted me later to let me know that they were going to fax the prescription. The 20 gram tube of 0.1% goes for $28.79 ($1.43 a gram) at the Canadian pharmacy, and the 45 gram tube goes for $45.94 ($1.02 a gram). My dermatologist wrote a new prescription for me so that I could order the larger tube. The shipping and handling charge is about $17 per order (not per item). 6 days after placing my order (I was told that the first order would take 10-15 days to arrive), I received my Retin-A Micro gel from Ontario! For the 45 gram tube of gel, I paid $63.07 (and that's including the shipping and handling charge). Plus, the customer service was wonderful.

So remember that it's possible to save some money by ordering meds from a good pharmacy in Canada. Obviously, though, if you want to order a prescription medication from any other country, you should exercise caution and do some research beforehand to make sure that it's legal and that the pharmacy is reputable.

Best of luck to you all.



*Yes, you can obtain some prescription medications from another country legally. You can't order certain drugs, like Valium, but you can order Retin-A!

[attachment=22584:ram1.JPG] [attachment=22585:ram2.JPG]

Hi,

I'm wondering what would be a good facial cleanser to use while I'm treating my skin with Isotrexin (isotretinoin 0.05% + erthromycin 2.00%). If someone else who has used a similar gel could let me know what face wash you used, I'd really appreciate it!

Also has anyone here used a salicylic acid face wash at the same time as one of these gels? I was recommended the Neutrogina 2-in-1 visibly clear wash, but I am a bit concerned that the combination of the salicylic face wash and the reinoid gel might be a bit much for my skin. I'm currently using a face wash called 'Freederm facial cleanser' - maybe someone has experience of using that in conjunction with a retinoid gel?

Sorry for all the questions but I'm a curious person

Thanks in advance

So I just tried to take Accutane for 2 weeks, and had horrible side effects. Now what? I've tried almost everything, lastly Tazorac and Renova. Antibiotics don't work, in pill or topical form. Nor do any over the counter products. I'm getting married in less than a year and I really don't want to look like this on my wedding day, or in general. Thanks for any help!

Suppose to use aczone everyday, tax daily after 1st 4 weeks, and duac everyday.

I have been doing that mostly. Some days I dont get aczone on till 12, or even 3pm, and then follow rest of routine. Taz daily usually ill see how skin face feels after 3 straight days, and may skip a day. Last night an afternoon I didnt use anything just to give me a break.

Hopefully im close to getting past IB stage. I have had some breakout, but not "bad bad" I guess. I still get some bumps/pimples, but hopefully it will be stable after a few more weeks.

I have my 2nd dr visit 11/23. The 1st one he gave me the aczone, tax, and duac.