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Epiduo: Does It Work? The Journal Of A Long-Term Acne Sufferer

epiduo tetralysal acne scarring long-term does it work? burning itching red mark make-up

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#1 Jollyhohnson

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Posted 30 June 2012 - 06:20 AM

Hi, I've just joined acne.org after reading tons of Epiduo related posts. I’ve found that they’ve been really useful for information and reassurance and so I’ve decided to write my own journal in hope that it may be useful for someone else some day.


My History:

I started having acne when I was 13. It started mild but got worse. At 15/6 it had become very visible and so I saw my doctor and he prescribed a Clindamycin topical lotion. This slowly began to clear my skin but the spots never disappeared completely. Between 18 and 20 I stopped using Clindamycin as it no longer seemed to be improving my skin. After stopping my skin stayed the same – not worse, not better. I thought it would get better as I got older (as people continually tell you!)
However, this year my acne flared up and is the worst it has ever been. I’ve got acne all over my face and as my doctor pointed out I have the full zoo of different spot types, though the worst are the nodules/cysts along my jaw line and the whiteheads. I constantly have red markings over my cheeks and chin, I also have those tiny little bumps under the skin that don’t seem to want to surface and they’ve been there perhaps a year now. As a 21 year old woman I’m just fed up of people telling me I'll grow out of it and so I went and saw my doctor.


The Treatment:

My Doctor has prescribed me Epiduo and Tetralysal. I take the Tetralysal in the morning and I apply the Epiduo (a raisin size amount for the entire face) in the evening. The treatment lasts two months.


Two Weeks Later:

The first time I used this I used too much, and I regretted it. My face burned and was incredibly red and sore and the area around my eyes was even a little swollen. A raisin sized amount is all you need – you have to try and make it spread. I was slightly worried I’d had an allergic reaction but this was the only time I had any swelling so I think not.

Even with less, my face (but not my forehead) still burned and itched like hell when I applied the Epiduo. During the first week this burning could last anything up to two hours and I had great difficulty even sleeping. I talked to my doctor and he recommended using it every other night until I became more used it to. This helped a bit.

Towards the end of the first week my spots began to get worse. I’ve been reading around and I think this is what’s called the Initial Breakout?? Anyway, I had a chin like a witch, lots of giant whiteheads, and yet despite that I've been abiding the no picking rule, even though I've had to go to work. My cheeks did look ever so slightly better at first, but it seems they want to join the party. The only good point is that the Epiduo seems to speed up the spot process, so that whiteheads will appear in less than a day, but after 2 days they’ve dried up and gone yellowish (which is only slightly preferable to luminous white) and in 4-5 days the skin will have mostly healed up and the scab will drop off.

After week two my face is still burning, but not after I apply the Epiduo, after I apply my moisturiser. The burning doesn’t last as long now – perhaps 45 minutes, although certain areas will sting for longer sometimes. I’m putting it down to my skin being über-sensitive. I now put the Epiduo on an hour before I want to sleep so that it’s calmed down by the time I go to bed. My skin is still getting worse, plenty of whiteheads and large red spots, very dry and sensitive. Those little bumps under the skin seem to be coming to the surface and forming tiny whiteheads, but at least that means I’ll be rid of them. I tried wearing make-up but my skin is uneven so it didn’t go on well, it stung when I first put it on, and when I put Epiduo on that night it hurt more than usual.

The so called Initial Breakout is still going after the end of two weeks and my face is a mess. I have to go to work five days a week so I’m trying to be brave but does get rather overwhelming sometimes. At least before Epiduo I could cover most of it up with make-up but my skin is so sensitive now that it’s pretty much impossible, especially when my skin is all peely. However, it has only been two weeks and I’m not giving up yet.

From what I’ve read about Epiduo it seems things are meant to get worse before getting better – apparently all the bad, spot-causing material has to leave the face before it can get better. Considering I’ve had acne for 8 years this could take a while ...

My Routine

In case anybody wanted to know, here’s a summary of my routine:


MORNING:

- Brush teeth before washing face. Wash face with La Roche-Posay’s Effaclar – a face wash for oily but sensitive skin that is prone to acne. A very gentle face wash and I would recommend it as although it seems expensive, the bottle is huge and you only need a small amount as it lathers really well. Pat the face dry, don’t rub.

- Give it five to ten minutes and then apply Effaclar M which is a moisturiser of the same range, the M stands for Mattifying. I actually find it works well; my face is definitely less greasy.

- If sunny (and when I say sunny I mean even the slightest trace of sunshine), apply BodyShop Seaweed Mattifying Moisturiser with SPF 15. If very sunny apply SPF 30 face sun lotion.



EVENING:

- Again, brush teeth before washing face. Wash with La Roche-Posay’s Effaclar.

- Wait for around thirty minutes before applying Epiduo. Make sure you’ve changed into your PJ’s first as I’ve heard Epiduo can stain clothes. Apply a small raisin sized amount evenly to the whole face, except for nose and eye area.

- Wait another twenty to thirty minutes before applying moisturiser. This time I use Effaclar H, the H stands for Hydrating. I apply a decent amount, more or less depending on where it’s needed. Be really gentle when applying moisturiser, try not to rub too hard as it irritates the skin.



As you can even, it’s pretty simple. I used to have a much longer routine but I can’t use most of these products on my face anymore.

In addition to this I make sure I eat well. I’m not on any sort of special diet, however I do avoid greasy foods, crisps, sweets, etc, and only eat them occasionally. I drink lots of water and eat plenty of fruit and nuts as well as sticking to whole grain rather than white bread. I’m wasn't too keen on vegetables before, but now I eat a decent selection, such as tomatos, carrots, green beans, peas, courgette, cucumber. I eat raisins and grapes as they’re meant to contain anti-oxidants which are good for the skin – also blueberries and cranberries, but I normally drink these in smoothie form. Also, I try and do regular exercise.

At the end of Week Three:

For the first time things are looking up. My face is still in a worse condition than before I started Epiduo, and my chin is still constantly breaking out with multiple whiteheads, but I am noticing a slight improvement on my cheeks and forehead. The red marks (I think it’s called hyper-pigmentation??) that spots leave behind are beginning to fade. I mean, they were fading before, but now they’re fading faster. I’ve also had less spots on my cheeks, meaning less new red marks. My forehead is the same. Unfortunately spots are still coming up, mainly where I have those tiny little bumps lying under the skin. I’m hoping it’s these that are growing into spots because it means once they’ve gone the spots will stop. So a glimmer of hope – and it is only week three to be fair.

My chin is still horrible, and although it’s slightly better today I doubt it will last. Those tiny bumps have been getting bigger, though I do think I have less of them now.

Another up point is that applying the Epiduo is no longer stinging and burning my skin. I have been trying to use less and I’ve also been waiting a full thirty minutes after washing my face to apply the stuff, something I didn’t do before as I was a bit impatient. So either that’s made a difference or my face is getting used to it – so yay! Can still tingle and itch, but not for too long, and sometimes my chin does burn a little bit, but as I said, it’s a mess and that’s probably why. My skin is still a bit peely, but only if I try and apply foundation. This still stings, but I guess it’s because it’s rubbing and irritating the skin.

Edited by Jollyhohnson, 08 July 2012 - 02:10 PM.


#2 Ivy.

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Posted 30 June 2012 - 07:29 AM

I have tried both of the LRP products you ahve mentioned, but I found the face wash very drying, and the moisturizer had a perfume smell / made my skin just an oily mess.

If it's working for you, thats great, but CeraVe moisturizer is alot cheaper and doesn't contain perfume and has alot of beneficial skin ingredients in it.Also the CeraVe hydrating cleanser can also be helpful, as it is not irritating and VERY gentle, BUT it won't remove your makeup.

Those two products may be able to help with any dryness.

Currently I have a perscription I recieved in december for Tactuo, which is the candian version for Epiduo, but I have not used it yet. I have been considering starting it up the last few days, and I hope the perscription is still "good" and can work even though the bottle was opened 6 months ago.

Unfortunately I am afraid to use it because the chin area, for many people, is very congested and highly prone to breakouts when starting acne treatments...and my skin is so pale and prone to hyperpigmentation, I don't think I can bare to face the initial breakout.

edit: ALSO wait times are VERY important when applying products to the skin.

The irritation you were experiencing is due to the fact that the PH of your cleanser is probably not ideal (5.5). You alter the PH of your skin with the cleanser, and then when you immediately apply the epiduo, you are causing irritation do to the skin being more sensitive after washing the skin, AND the PH being altered. The PH of your skin returns to normal, within a half hour or so....but this is why it is important to wait in between applying all products. (ie when I apply my DIY vitamin C serum, I wait about a half hour because it can be very irritating to wet skin).

Edited by Ivy., 30 June 2012 - 07:32 AM.


#3 Jollyhohnson

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Posted 01 July 2012 - 08:26 AM

I have tried both of the LRP products you ahve mentioned, but I found the face wash very drying, and the moisturizer had a perfume smell / made my skin just an oily mess.

If it's working for you, thats great, but CeraVe moisturizer is alot cheaper and doesn't contain perfume and has alot of beneficial skin ingredients in it.Also the CeraVe hydrating cleanser can also be helpful, as it is not irritating and VERY gentle, BUT it won't remove your makeup.

Those two products may be able to help with any dryness.


Thanks, I will have to look into that. I'm currently in France and it's a bit awkward trying to get hold of certain products. I've been told Cetaphil is also very good. Make-up isn't too much of a problem at the moment so it could be a product to try. I didn't consider the fact that the face wash could be the thing drying out my skin. The moisturiser however does work well for me, especially the Effaclar M. Though I might try the Cetaphil moisturiser when I go back to England as I've heard good things about it.

I'm not sure about your Epiduo - if the bottle was opened over 6 months ago it may not work.

I was actually unaware of the Initial Breakout stage until it hit me! I was devastated, but it's too late now and I'm just trying to ride it through. One thing about Epiduo though is that the red marking seems to fade faster.

Edited by Jollyhohnson, 01 July 2012 - 01:51 PM.


#4 justsomeguy44

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Posted 12 July 2012 - 02:08 PM

I just started Epiduo last week!

Since yesterday my initial breakout has started. Not fun! I'll be following your log, so keep updating!

#5 AcneIsACurse

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Posted 16 July 2012 - 07:28 AM

I used Epiduo for 2 years along with Aczone and I stopped a few months ago. For the first year and a half or so it worked pretty well, it got rid of most of my acne. HOWEVER, after that I noticed the acne started getting worse and worse, and I feel like it just stopped working. My breakouts got worse and worse and I was still putting the cream on and after I had read about the bad things about benzoyl peroxide I decided to quit. I didn't really have any initial breakout because it seemed like the cream lost most of its effectiveness anyways. Now I'm trying to manage my skin with diet and nutrition, and other things.

Btw when I started Epiduo it didn't do anything for a month and THEN it started working.

#6 dsumo402

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Posted 24 July 2012 - 11:57 PM

How is your skin doing now while you're using the Epiduo?

#7 Jollyhohnson

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Posted 12 August 2012 - 06:13 AM

I’m ever so sorry that I haven’t posted in such a long time. I’ve been incredibly busy with work and travel and all sorts. It’s now week 10 on Epiduo and I have so much to tell you guys! I’m finally back in England now as well so hopefully I’ll get more time to update. I’ll go over the weeks briefly and then fill you in on what I’m doing at the moment ...


Week four, five and six:
The initial breakout continues. The spots cover the majority of my face and I have pustules, nodules and the occasional little cyst. My acne has become more painful and I think this is due to the Adapalene thinning the skin. Epiduo doesn’t normally burn on application, although some days it just seems to react. I take Ibuprofen to reduce the swelling and a Vitamin E supplement to aid the skin in repairing itself. I’m also eating a diet high in fresh fruit and veg and eating a mixed variety of nuts and seeds. I drink a lot of water, just over two litres a day. Towards the end of week six however the spots were starting to reduce in number and the initial seems to be dying down.


Week seven and eight:
Although I continue to breakout I saw progress during these two weeks. There are most definitely less spots appearing. However, my face is covered in red marking which is the fault of the Benzoyl Peroxide, but it’s temporary so it will go eventually. The Epiduo has started to sting again so I now apply every other day and so far this seems to work fine.


Week nine and ten:
At the end of week eight I returned to England and in the last week and a half the progress of my skin is just fantastic. Strange however that my acne should have started to worsen when I arrived in France and has improved twice as quickly now I’ve left – something different in the water perhaps?
I had an appointment with my doctor the day after I got back and he said immediately that he wasn’t happy with the progress my skin was making, which surprised me. He seemed to know nothing about the IB, and didn’t really have a proper look at my skin. Then he wanted to put me on Accutane. I told him I didn’t want to do that and surely the Epiduo needed more than two months to work? I asked him about side effects and he said there were none and the things people say on this site are invalid and nonsense. So I didn’t like him much after that, but luckily I’ve just moved house and so a week later I saw my new doctor. She also recommended Accutane but she agreed that the Epiduo ought to be given another month.
Today, after nine and a half weeks on Epiduo and Tetralysal (antibiotic) my acne looks so much better. I’m also on Yasmin (pill) which has probably helped. I’ve cut milk from my diet and now drink almond milk with my breakfast and I continue to eat lots of fruit and veg. I also drink two mugs of green tea a day and take a Vitamin E and C supplement. I avoid sunlight, but when I do go out I put on an SPF 30 sunscreen.
I now apply Epiduo for two nights, and then have a night off. On this night off I apply an Aloe Vera Gel instead, which I love as I really feel is helps calm my skin and help the red marks to fade. I do have scarring from the IB but that is something that will have to wait until the acne is completely gone. My forehead is the worst, which is weird considering I had very little acne there. It’s covered in ice pick scars and looks like the surface of the moon. Luckily I have a fringe, lol. But seriously, I’m going to look into scar treatments to solve that. Once upon a time I would have been in tears about it, but after the two months of IB I went through it will take a bit more than that.


@AcneIsACurse: The skin can never become resistant to Benzoyl Peroxide. It oxygenises the skin, which kills the spot causing bacteria. It’s not something the skin can become immune to. It may just be that it’s not strong enough to treat your acne. Looking at diet is probably one of the best things you can do. I don’t agree with some people that you have to change your diet completely, but there are certainly things you can do which will help.


Oo, forgot to mention. I use The Body Shop’s Tea Tree face wash because it’s gentle and anti-bacterial and I use Cetaphil moisturiser. On pustules that have burst or on broken skin I use Savlon anti-septic cream.

#8 billz7

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Posted 17 August 2012 - 03:30 AM

Epiduo does not clear skin , it sits on spots and brings them out more but does not clear them. Its not a cure

#9 Jollyhohnson

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Posted 23 August 2012 - 03:36 AM

Epiduo does not clear skin , it sits on spots and brings them out more but does not clear them. Its not a cure


You might say that but at the moment it's working pretty well for me - the only problem is that you have to be patient and give it time to work. Anyway, there is no 'cure' for acne - Epiduo is a treatment.

It's now eleven weeks since I started using Epiduo and Tetralysal. I currently have NO giant spots on my face, just a couple of small ones, and none of them are whiteheads. The marking on my face is still pretty bad but everyone I know tells me it looks better everyday. I don't know about that, but it definitely has improved since two weeks ago - and they do say that red marks like this can take six months to fade. I will keep you updated.

#10 Jollyhohnson

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Posted 03 September 2012 - 03:00 AM

It's another week later and my skin just keeps getting better. That's not to say that it's perfect though, I'm expecting it to take several months for the red marks to fade and I know I'm going to have scars - strangely the most scarred part of my face is my forehead, where I had the least amount of spots. How odd. I still have some spots, but they're small.

I recently started wearing make-up again, five months without it! I'm not wearing it everyday, perhaps once a week, just when I need to feel more confident. I find that I can cover the majority of it up, and I'm not even using thick make-up. I'm using mineral make-up, known to be good for those with sensitive and acne-prone skin, and it doesn't make my skin break out at all and doesn't itch or irritate.

I now use Epiduo every other night, alternating it with an Aloe Vera Gel infused with Witch Hazel - I'm hoping this will help fade marks and heal scars. I'm using Cetaphil moisturiser at night after Epiduo and I use Olay Complete Care Day Fluid with SPF15 during the day. I'm currently using a Simple facewash after my Body Shop Tea Tree one ran out.

I have heard that using BP means you're more likely to be left with red post-blemish marks and that the skin can become reliant on it. Not sure how true this is but I'm trying to use it less often, every other day at the moment, and hopefully eventually I'll be able to stop using it completely.