55 replies to this topic

[RoseLilium]

Stumbled upon this website last month when I was having my horrible initial breakout from daily use of Differin, and I am glad that I found it, as I have been struggling with a very bad outbreak recently due to stress, and lack of sleep, and poor diet because I was in my last semester of university. I am a 22 year old female. I just graduated, so the stress levels have definitely gone down - it's a rest period for me now My acne can be described as mild, and is concentrated mainly on my chin and cheeks.

I started to have acne problems when I was 17, which was also triggered by stress and a period of emotional turmoil in school, when I began to ignore my skin - when I was 17, I did not bother to cleanse or moisturise. I just washed with water. By the end of the year, my forehead was covered with whiteheads, and my cheeks were dotted with many red pimples. There began my battle with acne... I made so many mistakes in an attempt to get rid of them, which caused more outbreaks and a worsening of my skin condition - Expensive facials + extractions, exfoliations, scrubs, toners, masks. I did all these things for about one and a half years before going to see my dermatologist when I was 19. She took a look at my skin, told me to throw out all the exfoliators, scrubs, toners, masks, and told me to quit facials. I did, and my skin cleared up dramatically in a month.

Part of the reason why my skin cleared up was also due to the tretinoin cream she prescribed for me. I followed a basic cleanse, moisturise, treat (3-step routine) day and night. I also used clindamycin gel as a spot treatment. At that time, I had no inkling about the potency of the tretinoin cream, so I just used it like a normal medication when I cleansed my face every night. After using it for about 3 months, I decided to quit using it since my face had no more pimples, and was so smooth. I also figured out that it was causing my skin to turn red and become very sensitive, which was part of the reason why I stopped using it.

When I turned 20, I stopped using retinoids altogether and enjoyed clear skin because I was undergoing a period of rest/lack of stress although I was in school. I started to use Differin on-and-off when I turned 21, since June 2011 and it worked like a charm for me until February 2012. I had a terrible outbreak of pimples on my cheeks and chin due to late nights, 4-5 hours of sleep, non-stop stress and emotional turmoil early this year. So I have gone back to Retacnyl Tretinoin (0.05%), albeit with much apprehension because I did not want to look like a boiled lobster.

I officially started on my retinoid journey on 29/03/2012 a few weeks before my final exams and it was an awful period of time from thereon. I have never been overly self-conscious about my acne before, but the breakout and initial breakout was that terrible. In April, I stayed at home most of the time; every morning, I would look at the mirror and notice flakes of dead skin concentrated around my chin and mouth. The initial breakout was non-stop and made all the whiteheads come to a surface, and I avoided going out as much as I can because: 1) I did not want to socialise and bump into friends due to the horrible condition of my skin (it never looked THAT bad before) and; 2) to avoid the sun because I live in a tropical climate where the weather is humid and hot all-year round. So it has been about 11 weeks since I started using Differin. At the end of 5 weeks, I got so discouraged by the initial breakout that I stopped using it for about 6 days - but I decided to suck it up anyway, and tough it through. My dermatologist switched my usual clindamycin gel with Isotrexin gel which is made up of erythromycin 2% and tretinoin 0.05%. I have faith in the treatment, having seen the good results in the previous years.

Here's my log (29/03/2012 - 08/06/2012):
29/03/2012 - 29/04/2012 ~ Differin Adapalene 0.1%, PM
30/04/2012 - 05/05/2012 ~ Rest period (off Differin)
06/05/2012 - 13/05/2012 ~ Retacnyl Tretinoin 0.025%, PM
14/05/2012 - 19/05/2012 ~ Retacnyl Tretinoin 0.05%, PM
20/05/2012 - 07/06/2012 ~ Differn Adapalene 0.1%, AM and Retacnyl Tretinoin 0.05%, PM

It's been about 11 weeks into my retinoid journey, and the scars from my initial breakout are fading away rapidly. Currently, there is a huge whitehead on my chin about to pop, three active red pimples on my left cheek. My problematic area, my rights cheek (which broke out horribly during the initial breakout) has no active pimples now, and is left with marks which are fading away rapidly and several comedones which are going to erupt soon. However, I am STILL breaking out in random places, but the intensity and amount is decreasing. Although there have been slow and steady results, I know there is still much room for improvement! I look forward to the day where my skin is flawless, when I do not have to use make-up at all while going out.

Current regimen:
AM
1) Cleanse with clinique liquid facial soap mild
2) Moisturise with my dermatologist's moisturiser
3) Pea-sized amount of Differin all over face
4) Isotrexin over problem areas

PM
1) Cleanse
2) Moisturise
3) Pea-sized amount of Retacnyl all over face
4) Isotrexin over problem areas

Practical tips:
Do not pick, do not scratch, stay out of the sun, patience and perseverance, gentleness, water must not be overly warm, moisturise generously, wait for at least 30 minutes after cleansing and moisturising prior to application of retinoid, use only a small pea and dot all over face in small dots and spread evenly all over face.

Edited by RoseLilium, 08 June 2012 - 12:33 AM.

[RoseLilium]

Okay... The Differin AM and tretinoin PM routine is getting a little too strong for my skin. I suspect that the Isotrexin has a role to play too. Although the progress has been great for the past week (there were days when my skin was glowing and was smooth in places where there are no breakouts and pus-filled whiteheads), there is a tingling and burning sensation when I put on my moisturiser, after I cleansed my face this evening. It is so painful! My skin feels tight and looks much smoother this week, as compared to several weeks ago. However, the redness is unbearable and I feel like taking a break from retinoids

It is my 5th week on tretinoin cream 0.05% and my 34th night, to be exact. I think I'll just cut out the isotrexin gel tonight, and the differin tomorrow in the morning. I do not want to go out looking like a boiled crab... Because it's a Saturday and I'll be meeting lots of people.

I am really determined to stick it out with the retacnyl tretinoin cream because I have a feeling that all will turn out well in the end. I am willing to take a break from differin and isotrexin but not retacnyl.

[RoseLilium]

Day 35.

Yesterday night I used retacnyl cream 0.025% coz I figured out that my skin was too dry. Cleansed, moisturised copiously, waited 30 mins, and applied a small pea. That's all.

And this morning, I just cleansed and moisturised. But my skin is soooo dry and is flaking, peeling, scaling and itching, especialy around my mouth area. It's really quite gruesome, and my face turned a bright RED when I talked, laughed and spoke to people today. So it's such a relief that I'm home finally. My mum, younger sis, and a friend commented on the redness ~ Sigh. Plus I am a shy person so when I talk to people (especially someone I have a crush on), I blush and blush ... And turn beetroot red! The side effects of tretinoin are not fun at all.

On a happier note, the huge whitehead which had been festering on my chin decided to pop quietly by itself overnight. The white hard oil just came out like a grain of rice, and the area of skin surrounding the head just turned brown, crusted over and when I cleansed my face, I gently peeled it away. Also rubbed away at some dead skin on my jawline and mouth area. Currently, one or two tiny baby zits cropped out on my right cheek, but they are not the pus-filled lurking kind which stays on for days, and are quite unnoticeable.

The only thing bothering me now is the scaliness, flakiness and redness -

But it's okay. I accept this problem happily and will continue to press on with the retacnyl tretinoin cream. I'll be using the 0.025% tonight, and will bump it up to 0.05% next week when my skin gets less flakey. In the meantime, I will use an ultra rich moisturiser which contains squalane oil to help with th dryness and the red/brown marks.

PM
Cleanse
Moisturise + wait 30 min
Small pea of 0.025%

Edited by RoseLilium, 11 June 2012 - 07:23 AM.

[RoseLilium]

Day 37 (the day here refers to the use of tretinoin and not differin)

Got a little freaked out by the scaliness and dryness a couple of days ago, so I decided to stop using differin and isotrexin in the daytime, and just stick to tretinoin 0.05% at night (spot treating active pimples with a thin layer of isotrexin all over). Peeling, dry, flakey - sloughed on a lot of moisturiser after cleansing today. My forehead remains clear, but new zits have sprung up on my nose and chin - 1 on my nose and 3 little ones on my chin, right smack in the centre of the field of red/brown marks. I wonder when my chin will stop breaking out, since it's been breaking out like crazy non-stop since April.

But I guess it's partly hormonal too. My right cheek has no more active zits, and the red marks dotted all over the area seem to be fading really slowly but steadily (it was the first area on my face to break out horribly). Now's my left cheek's turn to break out - there are 2 actives there, which is really weird because I had NO pimples in that area at all last year. I guess the tretinoin is bringing out all the things lurking under the surface. Guess I am going to press on with it although things are taking a downturn despite the seeming improvements i.e. certain portions of my face that are healing.

Although my skin looks terrible all over - I am learning to be thankful for this situation, and acne is really teaching me many personal lessons - patience and humility.

Current regime:
AM
Cleanse with clinique liquid face wash mild
Moisturise with my derm's moisturiser

PM
Cleanse
Moisturise + Wait 30 mins
Small pea of tretinoin 0.05%
Isotrexin sparingly over active spots

Going to my derm tomorrow to get more moisturiser because I have been slathering a lot to combat the dryness.

Edited by RoseLilium, 11 June 2012 - 07:48 AM.

[RoseLilium]

My skin looks better today - radiant, glowing and fresh-looking in places which are not acned. I can see that tretinoin is slowly but surely giving me a linear upward progress, despite the bumpy downturns in between. I would say that the good has outweighed the bad in the last 38 days. The outbreaks have been unpleasant, but I am encouraged with the progress in the overall appearance of my skin. Stumbled upon this link today, and the comments really encouraged me. I am so excited to see what tretinoin can do for me. I hope that the comments will encourage you too, if you're going through the same initial phase that I'm in. I should have stuck on with the cream in 2009 and not threw it away after 3 months! Here's the link! Read the comments ~ http://beauty.about....op-using-it.htm

Edited by RoseLilium, 12 June 2012 - 10:36 AM.

[ariesgirl55]

YOU SOUND JUST LIKE ME OH MY GOSH!

My skin is definitely been over aggravated by cleansers, exfloiants, toners, etc, and I'm using a gentler appraoch now too! I'm almost at the two month mark, and even though my skin isn't close to where I want it, I'm gonna continue use! April was a horrible month for me too!!! Your skin sounds just like mine, I'm mostly left with red marks and some small whiteheads. But I HATE when I break out! The pimples I get are not too intense though and they use go away in a few days. But I need this retinoid to clear away all the scarred discoloration and left over bumpiness.

[RoseLilium]

Hi ariesgirl,

Thanks for your encouraging comment! I am so glad that we are not alone in our situation of using retinoid medications. You are absolutely right - cleansers which are too harsh strip the skin of moisture, irritating the skin further and causing more breakouts. Exfoliants, toners, masks and facials are also a BIG no no, especially when we're on these medications. Our skin is just to fragile to handle the constant scrubbing, squeezing, touching, poking and extractions. All these things will cause further irritation.

It takes so much self-control to not scratch my face these past few weeks due to the itching (one of the side effects of tretinoin). But I am so glad that I refrained myself.

Ariesgirl, do not worry too much about the pih marks left behind on your skin, I am sure that they will fade over time! I was on Differin last June til Feb this year. Personally, it is an amazing retinoid, it gave me clear skin for many months. It's just that I got a horrid breakout, probably related to stress and late nights - this Feb. That was when I stopped using Differin and other retinoids for about a month.

Before I switched from Differin to tretinoin, I used Differin for about 11 weeks, but was looking for something stronger to totally get rid of everything at a faster pace. My derm recommended tretinoin (which is also known as Retin-A, Renova). Now I am on tretinoin cream 0.05% (Retacnyl) because it is stronger than Differin. It has a greater peeling effect and really brought out all the underlying spots to the surface, and is a wonderful retinoid. The peak of the initial breakout was an emotionally traumatic period of time for me (the first few weeks). But I know that that's just the tretinoic acid doing its job

All the best for your Differin journey!

Rose

[RoseLilium]

Another encouraging article about what dermatologists think about tretinoin: http://www.nytimes.c...?pagewanted=all

[ariesgirl55]

Thank you Rose! Everyone just keeps telling me to be patient with the PIH so it's just something I'll have to do! I'm fair skinned but I hate having red spots across my face because it makes my acne look way worse than it is

Do you happen to wear a sunblock? My makeup has SPF in it, but I was told that wasn't enough and that I'd need to wear a sunblock to ensure my spots don't get any darker. I'm just not too interested with putting sunblock on my face cause it feels gross

And that was a great article! I'm excited to see what the next couple weeks/months will do for my skin!

[RoseLilium]

Day 41.

Good news - My chin is doing better today. The 3 spots on my chin have died down and flattened out over the last few days, leaving behind their usual dark marks. The 2 previously active ones on my left cheek have also dried out. However, one of them hasn't purged yet.

Bad news - One new whitehead on my forehead which is currently purging its contents. One new underground bump on my right cheek, beside my nose. One fleshy coloured bump on my right cheekbone which has been there since February and looks like it's going to purge soon.

Overall - Still breaking out, but not as badly as before.

[RoseLilium]

Hi Ariesgirl,

I don't use sunblock at all and try to keep out of the sun during the hottest hours of the day. I usually go out in the early morning or evening when it's not too hot, without any sunblock. I don't use makeup at all during weekdays. Only use 1-2 drops of foundations to cover-up the marks/zits on weekends. I hate wearing makeup, and sunblock is too greasy for my pores. Being on this treatment, I think that less products on the face would definitely help the healing process.

Hope your college orientation will turn out well! Don't worry too much about how your skin looks and just enjoy yourself to the fullest in this new season of life. I have graduation night and commencement in the last week of July and though I do hope that my skin will make a turnaround for the better, I will not let all these insecurities get me down. Continue to stick it out with your treatment for at least 3 months and don't give up to soon!

Rose

[ariesgirl55]

Thanks Rose! Best of luck with your treatments as well! I'm sure everything will pull through for us in the end

[RoseLilium]

Day 42.

A little annoyed that I have 3 new irritating red zits which decided to pop up, the moment the ones on my chin and left cheek died down. And why must my forehead start breaking out when it's usually clear? Why must these things come up at the worst moments? Argh. Why on a Friday night, wrecking my weekend. Not only that, there are dark red/brown marks (however, this is not so bad because I can see that it's fading away fast).

Consulted my derm yesterday via email and told her that I was still breaking out quite badly and asked her if I should get a stronger 0.1% for my tretinoin cream. She suggested that I continue to use Differin during the daytime and the 0.05% tretinoin at night. Which really makes me sad and frustrated because I am supposed to go out and play sports this afternoon with my friends, and I can't go out in the sun and sweat with Differin on my face. The side effects would be awful. I live in a tropical climate, where it is as hot as fire in the afternoons. Plus, the 6 huge red spots on my face are so embarrassing. I can't believe that I'm going through this phase as an adult.

Guess I have to just follow her instructions and apply Differin this morning And just skip out on the sunny activities I am so sad, and I am really tired of staying at home in the day because of this acne problem But oh well, I guess I have to do what my derm says because I DO want to get better quicker and I think that Differin in the daytime will shorten the IB period. I also hope that this awful 6 huge red spots will dry out and get better before next Friday because I have an important date.

I'll just douse the horrid red spots in isotrexin today and hope that they will spill and purge out their contents FASTER because I want them to heal I hate them

[RoseLilium]

Day 45.

I am amazed at how much my skin has improved over the past couple of days. Right now, I only have ONE active pimple - the underground bump on my right cheek. All the others have popped by themselves, without my even trying. The fleshy coloured bump just spewed out its contents and when I peeled it away gently after cleansing, it came out neatly, leaving behind a clean pore. It is amazing how this thing works!!! The rest of my face looks quite amazing (in my eyes), I recall that one month ago when my right cheek was covered with 9-10 red inflamed bumps and pastules.

I can sense the IB coming to an end. During IB, my right cheek was the first area to break out horribly. Then it was my chin's turn - there was like 10 pimples on it during the peak of the breakout, and man, did it break out crazily. No amount of foundation could cover the peely zits up. Now my chin is miraculously smooth!!! Then it was my left cheek's turn. Then my forehead. Now all of them have died down, leaving behind red marks which I know will fade rapidly.

My only problem now is the red marks - and I know that it is a minor problem Seriously, that tretinoin cream is soooooo potent, it brought up allll the underlying gunk! I wanted to cry during the IB. But really, after toughing it through for the past 45 days is really worth it coz my face is so smoooooth now It has been a rough ride thus far, since the end of March.

I would say that my IB on Differin and the tretinoin cream lasted for about 83 days! That is about 3 months. One crazy ride...... It has not been easy though. The fall was terrible, and I remembered cringing everytime I looked into the mirror.

For the past couple of days, I think what speeded up the process was my additional usage of Differin during the day. I will continue to do that, since my skin has acclimatised quite nicely for the past 83 days. Wow I can't believe that it has been 83 days.

Just a few days ago, a stranger (a teenage boy) at the bus stop and I were just chatting. When I told him that I am 22, he was shocked. He thought that I was still 16 or 17. I guess I must thank Differin and Retacnyl, and thank God

[RoseLilium]

Suddenly feeling really depressed. . . What's the use of having skin which feels smooth to the touch, but looks awful? I am far from clear. The red and brown marks make me look as though I have many pimples. The bathroom mirror was flattering this morning but when I got out of the house and looked into public mirrors, I looked awful - my skin is far from what it used to be. I came to a realisation that I have many, many, many marks all over my face and I look very ugly. I have not been using make up at all for the past weeks but on a day like this, I feel like caving in and using some to cover up the marks. I hate make up. Now I'm back home, typing this. I feel like crying. Lord, I miss my old skin.

[fadedjay]

hey rose,

I think being on any acne treatment we feel the ups and downs of it.

Easier said that done is to try not look into the mirror as much maybe reduce it. I find that some mirrors make us look great others show every flaw whether it be acne, red marks, dry skin etc.

Your not far from the 2 month mark and things should hopefully start getting better.

Sometimes crying helps to release all the tension and emotions caught up inside you.

If you can you should try take pictures and keep a log of them so over a certain period of time you can see if there is improvement or things may need tweaking. Also this helps when you have a not so good skin day you can look back and see the progress you have made

Keep your head up

[RoseLilium]

Thanks for the encouragement Jay! I plan to use this tretinoin cream everyday long-term (at least a year) because I have faith in it. My derm has always insisted I use it for the past 3 years but I have not listened to her advice. Now I will, for good. It's just that the beginning weeks have been so difficult and rough, it's hard to imagine that one day I will have flawless porcelain skin. But I sense and know that things will get better after the IB. I am keeping a picture log now and will post the pictures up one day

Day 48.

I just realised that the worst part of the IB involves many many cysts - red, huge, deep pimples that eventually turn into pus-filled things that peel off or burst by themselves. I have none of those things anymore, thank God. The last cyst, the one on my right cheek, has exploded by itself, leaving behind a horrible red markwhich still looks like a zit. But it has purged. Now I notice many blackheads and tiny little zits coming up - not the huge red cystic kinds which made me cry, but little ones. Those I can deal with. Guess its the dwindling down effects of the IB. Overall, things are better but my face still looks a mess with all the pih marks. I hope that tretinoin will fade the marks over time.

Oh yes, I will try to use sunscreen today when I go out because it is blazing hot outside. I am using the heliocare gel SPF 50.

[RoseLilium]

http://prettybunni.tumblr.com/

Edited by RoseLilium, 22 June 2012 - 02:30 AM.

[RoseLilium]

Day 50.

My skin is doing loads better, I am no longer breaking out in terrible pus-filled zits (only tiny little blackheady things which are barely noticeable). My skin feels very smooth, I no longer feel the horrible bumps under the surface. Dark marks fading. Things are improving, IB is coming to an end (or has ended already). I pray that things will stay this way as the past few months have been a battle for me - I have seen and gone through the worst purging of my life. I have never, ever had such horrible skin, and now I'm just so conscious and vain because I know how bad things can be.

Nonetheless, my battle against acne continues. Although my skin has cleared up dramatically from the awful red spots, I still have nightmares about my skin returning back to its IB state. The IB is something that has hurt me emotionally, not only physically. Lord, please continue to heal all the scars and marks left behind by the cysts. I have never had such an awful breakout before in my life. Even through this battle, I pray that I will emerge from this a stronger person, knowing that I am loved and accepted by Him unconditionally no matter what happens. No matter how ugly I can look and the depths of spottiness my skin can spiral downwards into, I am loved.

[RoseLilium]

Comparing the pictures of my cheeks and chin side by side for weeks 6 & 7

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Edited by RoseLilium, 26 June 2012 - 09:28 AM.