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Advice Needed Post Roaccutane

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#1 Roisin75

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Posted 05 April 2012 - 06:51 AM

I finished my Roaccutane course mid February and was very pleased with the result. However, within 2 weeks I had a massive spot in the middle of my right cheek. Since then I have had a couple of smaller spots and a little bit of congestion on my nose.

I had my follow-up appointment with my (NHS) derm today. I have been really stressed and worried about my skin - but when I talked to him he was all smiles and said how pleased he was with my results. He said that I should expect the odd spot now and again and that the overall result was great. I asked him if maybe I should be using a topical retinoid to help prevent any further problems and he basically shrugged his shoulders and seemed pretty indifferent to the whole idea. He said that he would prescribe me Differin if I wanted but he wouldn't discuss Retin-A because he said it was too irritating. To be honest I was really hoping he might, as I am 36 and could really do with some help on the anti-ageing front!

So I have come away with a prescription for Differin. My question is, should I use it? Is it something that I can use long-term? Could it damage my skin if I use it for many years? Also, forgive the vanity, but could it help with ageing?!

I have been looking at other over the counter options and I have noticed a product called Triacneal by Avene which contains AHA and Retinal. I am wondering if it might be better to use something like this?

Has anyone been prescribed Differin post Roaccutane? If so, what have your experiences been?
Roaccutane course completed 19th February 2012

#2 Roisin75

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Posted 06 April 2012 - 07:47 AM

Anyone?!
Roaccutane course completed 19th February 2012

#3 momiji_girl

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Posted 06 April 2012 - 08:15 AM

Hi Roisin75,

I finished my Roaccutane course on February 28th, and went straight back on to Differin. Actually, I never went off it but let my derm think that I had.

I've used Differin 1% gel for 5 years (since the start of my adult onset acne at age 30) and love its anti-aging effects. Do I look 35? Hell no! Dedicated use of sunblock on account of the increased photosensitivity of Differin is likely a significant factor, but whatever, I look younger than I am.

It's your skin and your decision, but my advice is to go for the prescription-only Differin over anything you can get over the counter. Did any over the counter product help you when you were battling acne? If not, why trust it now?

If no-one else replies, the good folks in the Differin forum might be able to weigh in.

Edited by momiji_girl, 06 April 2012 - 08:20 AM.

Finished 40mg Accutane/day, 7-month course on 28 Feb 2012

Morning
  • wash with cetaphil gentle cleanser
  • moisturize with cetaphil daily moisturizer
  • apply high SPF sunblock
Night
[*]wash with cetaphil gentle cleanser
[*]differin gel, wait a while and then
[*]moisturize with cetaphil daily moisturizer

drink LOTS of water, eat at least 7 serves of fruit and veg everyday, lots of nuts and fish and just say no to processed/junk foods

#4 leopard1

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Posted 06 April 2012 - 09:09 AM

i am currently on accutane 20mg, i'm only on day 24 and don't know how long i will be on it. i've been contemplating accutane for about 6 months now and unfortunately it was differin that made me decided to go on accutane. my face was okay except for around the chin and jaw area but i had PIH and was on tretinoin (cleared me up but made me oily), so drem gave me differin to see if that could get rid of PIH, well i wish i NEVER EVER tried it. it was okay for a month- no real changes in skin until my face exploded- you can see the pics in my gallery from before and after diffeirn. it was terrible for me. i know everyone's skin is different so take this only so far but you should really be careful when trying new things.maybe your face is just adjusting to not being on accutane? i really dn't know but maybe give it a chance

#5 momiji_girl

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Posted 07 April 2012 - 06:52 AM

Ohh, Leopard1 it sounds like you got the dreaded 'Initial Breakout' (IB) associated with the retinoids. It's absolutely awful, I know, and is the reason I didn't give up my differin when I started accutane. I got an IB when I briefly stopped differin and then went on it again and I had no desire to relive the experience when I started using it again after being off it for my accutane course. I planned to continue it for the anti-ageing effects and glow it gives my skin.

When I started accutane my derm said it was possible that I would get an IB, but it was unlikely because accutane is like an oral retinoid and I was already using a topical retinoid without issue. And she was correct, in that I did not get an IB with accutane. By the same token, Roisin 75, your skin has adapted to oral retinoid (accutane) and a topical is unlikely (though possible) to cause an IB.

If anti-ageing is all you're after, maybe one of the OTC products will do? I think the primary criticism of many products is that the active ingredients are in concentrations too low to be effective but good old googling should be able to help you figure out which products are actually effective for anti-ageing. And if they're good for acne-prone skin, too, that's even better.

Good luck with the accutane, Leopard1.
Finished 40mg Accutane/day, 7-month course on 28 Feb 2012

Morning
  • wash with cetaphil gentle cleanser
  • moisturize with cetaphil daily moisturizer
  • apply high SPF sunblock
Night
[*]wash with cetaphil gentle cleanser
[*]differin gel, wait a while and then
[*]moisturize with cetaphil daily moisturizer

drink LOTS of water, eat at least 7 serves of fruit and veg everyday, lots of nuts and fish and just say no to processed/junk foods

#6 Roisin75

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Posted 07 April 2012 - 08:13 AM

Hi Momiji_girl and leopard1 - thanks for the advice. I think the two of you have just presented both sides of my dilema!

I have been on Differin before - before Roaccutane - it did not improve my acne - which I think was too far gone by then to respond to something so mild. It did however dramatically improved the quality of my skin which became soft and glowing.

My reasons for starting it would be:
Hopefully it would prevent any future acne - and my skin is showing indications that me and acne are not 'done'.
The general improving quality that it has on my skin's texture.
The anti-ageing side of a retinoid.

My reservations are:
Fears of an initial breakout - it has been 7 weeks since I came off Roaccutane.
That I would become reliant on a product that my GP/derm could decide I don't need anymore - triggering problems all over again.
I am not sure if Differin is suitable for 'long-term' i.e indefinite use.

I am REALLY stupidly confused over this.

Edited by Roisin75, 07 April 2012 - 08:15 AM.

Roaccutane course completed 19th February 2012

#7 momiji_girl

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Posted 07 April 2012 - 09:31 PM

Hi Again Roisin,

Making regimen decisions is terrifying. On the one hand, maybe it works. On the other hand, maybe it makes your skin go crazy.

The IB fear is there no matter which retinoid you use if you use one. 7 weeks still seems to be in the 'ok' window though, considering that it takes your skin so long to be rid of accutane side effects. My derm was completely unperturbed about me 'beginning' differin again 8 or more weeks post accutane.

Do you think your skin could tolerate Retin-A? (I imagine you've been through that forum and the product reviews). Retin-A is really strong stuff. But you know your skin better than anyone because you live in it. If you think yes your skin could handle Retin-A, do you think you could stand your ground with your GP and get him/her to write you a script for it, while also making a derm appointment as a follow up? And if your regular GP balks completely, could you to a busy clinic where doctors allow patients more input in their care simply because they don't have time to intervene in every case? (How I got to continue using doxy off and on for 3 years before deciding it was stupid to do and time for accutane.)

An IB may not happen with either Differin or Retin-A; an IB might happen with both. If you're keen to use a topical retinoid for acne control and anti-ageing and want to choose the best one for you, why not go with the principals that have worked for you in the past? For me, Ms Sensitive Skin, my acne-fighting principals are 'gentle and slow'. I've needed to go for gentle products, with as few topicals as possible, and with as few products as possible in all toiletries. So gentle differin has been a good product for me. If your skin has taken well to stronger measures, maybe a stronger product is the way to go here? It's your skin. Go with your instincts on this one.

Any GP or derm who won't prescribe a retinoid because a patient with a history of acne doesn't 'need it' (ie, doesn't have active acne at consultation time) clearly doesn't understand the point of a retinoid and doesn't need your business. I think you can put that worry to rest.

I remember reading ages ago in the Retin-A posts about a woman who'd been on Retin-A micro for two decades and whose skin looked like a woman half her age (by her own admission, but she was probably not lying). Anyone else in the forums who's been on any retinoid for a long time? I wonder if a poll would be useful.

Aargh, decisions decisions. I have a derm appointment in a week. I'll ask her about studies regarding long-term (indefinite) use of topical retinoids and pass on what I find out. Or I can just be quiet now, and let you figure things out for yourself without adding to the confusion :).
Finished 40mg Accutane/day, 7-month course on 28 Feb 2012

Morning
  • wash with cetaphil gentle cleanser
  • moisturize with cetaphil daily moisturizer
  • apply high SPF sunblock
Night
[*]wash with cetaphil gentle cleanser
[*]differin gel, wait a while and then
[*]moisturize with cetaphil daily moisturizer

drink LOTS of water, eat at least 7 serves of fruit and veg everyday, lots of nuts and fish and just say no to processed/junk foods

#8 Roisin75

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Posted 08 April 2012 - 09:25 AM

Do you think your skin could tolerate Retin-A? (I imagine you've been through that forum and the product reviews). Retin-A is really strong stuff. But you know your skin better than anyone because you live in it. If you think yes your skin could handle Retin-A, do you think you could stand your ground with your GP and get him/her to write you a script for it, while also making a derm appointment as a follow up? And if your regular GP balks completely, could you to a busy clinic where doctors allow patients more input in their care simply because they don't have time to intervene in every case? (How I got to continue using doxy off and on for 3 years before deciding it was stupid to do and time for accutane.)


Aargh, decisions decisions. I have a derm appointment in a week. I'll ask her about studies regarding long-term (indefinite) use of topical retinoids and pass on what I find out. Or I can just be quiet now, and let you figure things out for yourself without adding to the confusion Posted Image.


Hi Momiji_girl thanks for your perspective! I have decided to use the Differin. I am from the UK and we have the NHS here so you tend to get what you're given unless you decide to go private. I suggested Retin-A to my derm - because I could see myself using it long-term, but he refused to prescribe it because it's so irritating. This seems ridiculous to me because I have seen from the boards here that post-Accutane, many people are prescribed it. I think I will see how the Differin goes. If it works for me, who knows, maybe one day in a few years I might be able to afftord a lovely, sympathetic, private dermatologist!

I would be very grateful if you could pass on any info from your derm on the long-term use of retinoids - particularly Differin as I know it has a different make-up from Retin-A. Thank you for your help!

I noticed that you have been on Roaccutane too and that you used Differin before that - did you find that Differin wasn't strong enough at that point?
Roaccutane course completed 19th February 2012

#9 momiji_girl

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Posted 09 April 2012 - 04:52 AM

Hi Again Roisin75,

I hope the differin works out for you, and I will definitely post what info I get from my derm about long-term retinoid use.

Differin has worked wonders for my skin tone, clarity, and fine lines, and has done a good job controlling my acne, which went from zero to moderate in one week, and then mild to not really a problem once the differin kicked in and I got over the horrible, horrible IB. But it never got me 100 clear for a long period of time. And then in the last year before taking accutane, I got these permanent little bumps on my forehead. What really sent me to accutane, finally, was thinking about how I was unhappy with my skin even with differin plus intermittent courses of doxycycline. My derm sighed mightily when she heard about me taking doxy off and on. 'You're antibiotic resistant. You should have done this (accutane) ages ago.'

I'm hoping that accutane has reset my skin, and that differin will help me maintain what accutane's given me. Accutane + follow-up retinoid seems to work for so many people, so I'm just seeing what happens (with fingers crossed).
Finished 40mg Accutane/day, 7-month course on 28 Feb 2012

Morning
  • wash with cetaphil gentle cleanser
  • moisturize with cetaphil daily moisturizer
  • apply high SPF sunblock
Night
[*]wash with cetaphil gentle cleanser
[*]differin gel, wait a while and then
[*]moisturize with cetaphil daily moisturizer

drink LOTS of water, eat at least 7 serves of fruit and veg everyday, lots of nuts and fish and just say no to processed/junk foods