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[pita]

I have mild to moderate acne which has gotten worse since I've entered my 20s. My acne changes a lot, but I'm not sure why. Sometimes I'll have terrible forehead breakouts, other times I get cysts and clogged pores on my cheeks that hang around for months. Lately, my main problem has been my chin and the area around my mouth, where I get rosacea-like papules and pustules which are worsened by sun, heat, exfoliation, and anything harsh. It looks to me like perioral dermatitis.

I went to the doctor about a month ago and he said it wasn't rosacea or PD, but acne, and I was prescribed Retisol-A 0.01% (it's a tretinoin cream that inexplicably contains sunscreen, despite the fact that you're supposed to apply it at night). The doctor didn't give me the greatest advice. He told me not to wear sunscreen or moisturizer while using Retisol, to exfoliate with a cloth every day, to wash with something strong (he actually recommended dish detergent) and to disinfect my face from time to time with alcohol gel. I did this for about a week and the effects were horrifying, as you might imagine. My whole face was red and inflamed, and as a result the papules and pustules on my chin and around my mouth flared up worse than I have ever experienced. I read up on the internet and changed my regimen around, so it's now like this:

Morning:

Wash with spectro jel and pat dry
Apply Cetaphil lotion spf 15

Evening:

Wash with spectro jel and pat dry
Apply Dove sensitive essentials lotion OR
Wait 20 minutes then apply a pea-sized amount of Retisol
(I'm going to work my way back up to nightly application, but right now it's just too irritating)

It's been a month since I've been using the Retisol and my forehead is quite clear. My cheeks are mostly clear except for a few pores that seem to be purging themselves, but the area around my mouth and chin is absolutely ridiculous. I have tons of these stupid fleshtoned bumps that occasionally come to a head and then look even worse. There's hardly a patch of skin on my chin that is not broken out. I'm very worried that this is more than just an initial breakout, since my skin has a habit of responding like this when I use harsh products or subject myself to extremes of temperature and weather. I'm going to stick it out for a while longer because I've heard stories about initial breakouts that last for two months, then clear to reveal beautiful skin, but I'm still very nervous about the whole thing. I have a follow-up appointment with the doctor on Wednesday. If he gives me more crazy advice, I'll just make my next appointment with a different doctor. I'm using the clinic at my school, so I could just call up and ask for an appointment with someone else.

Anyway, that's my story. If anyone has any advise about my regimen or my acne, I'd be happy to hear it. I'm particularly interested in any product that could help control the initial breakout on my chin and around my mouth.

Thanks for reading this post. It's a little bit long.

[amorfati]

Welcome!

I can sympathize with a lot of what you are saying here -- acne that gets worse in your 20s, but not in any consistent way, bad doctors, and also a terrible initital breakout.

Mine was indeed horrible -- it started on my nose, where I got 11 pimples (some cysts and some pustules) in the course of a week or so -- indeed, my entire nose was broken out. Then it made it's way around my face week by week -- upper lip, chin, and forehead. It was truly truly awful, especially since I never considered my skin too bad before. HOWEVER, I'm writing to stay STICK WITH IT! Well, I'm sure that for some people, retinoids simply never work, but after 6-7 weeks of an initital breakout, my face is finally clear, and is on its way to looking better than ever.

In terms of things that helped with the IB, tea tree oil and benzoil peroxide both were useful for me -- BP in the morning, as it interferes with reitinoids if used at the same time, and TTO whenever. Then again, my skin is decidedly unsensitive, and my face was massively oily during my IB and could certainly handle the drying effects of these things. I do wish I had started using them earlier in fact.

Anyway, best of luck to you -- hang in there!