Some background: I'm 30 and have very oily skin. Since I was 15, I've had big cysts that scab and leave permanent depressed scars. I've usually only had one big cyst at a time, though, and they usually happen a few months apart. I don't get a whole lot of inflammatory acne besides that. I get the occasional pustule and papule, but they're not terrible. I dunno if this makes me an outlier -- big standalone half-inch long-lasting scabby cysts, but not much other acne? Is that weird? I haven't seen many others on here like me.
What I've tried: I started using 2.5% BP about ten years ago, but I haven't been religious about it, and it hasn't been amazing. Whenever I've been prescribed an oral antibiotic for random non-acne things (throat infection, dental surgery, etc), it would make my acne go away for 4-6 months, but, inevitably, it'd return. About two years back, I did tons of research on acne, read about diet's effects on it, and started myself on the paleo diet. This actually seemed to help a lot. I still got some cysts, but they were much farther apart time-wise. (Although I DID do two courses of antibiotics a couple months apart around the time I started the diet, so maybe those are more responsible for the clearup? Dunno.)
Anyway, onto the point of this post: I'd been completely tired of the diet for a while and started cheating, and my skin slowly started getting worse, so I finally went to a derm for the very first time back in the middle of October, and she put me on Tazorac 0.1% gel. Started off every three days, and went up to every other day in November. Tazorac nights went like this: 1) Cleanser > 2) Moisturizer > 3) (an hour later) Tazorac. My skin wasn't irritated by it, AFAIK. (Maybe it's used to the irritation from the BP.) I did notice that the Taz made my skin WAY greasier. I guess that makes sense, since it's a strong retinoid that combats hyperkeritinization. Also, I didn't really have the initial breakout that others have. I had two ~5mm pustules in that first month. When I put Taz on one of them, the very next day the pus had already been expelled and hardened, and the inflammation had gone down. I was like, whoa, miracle drug. But, on the other pustule a few weeks later, it hardly did a thing. Anyway, I kept using it for a while after that. I'd get the occasional papule, which the Taz didn't really help with--they'd stick around for about a week and fade, which is normal for me. From what I could tell, Taz wasn't doing much that my diet wasn't already doing on its own, aside from making my skin way greasier. Then, all of a sudden, a few weeks ago (mid-December), after two months on Taz, a couple cysts started growing, and I'd slather a little extra Taz on them, but as far as I could tell, it was doing jack all. One cyst grew over the course of a week and a half into one of the BIGGEST I've ever had in my life, and at this moment it's a giant ugly scab (yay, new scar). The other just kinda sat around for a month, but never came to a head. Around the time these two cysts were growing, a bunch of other smaller cysts started appearing nearby. Taz did nothing while they grew. They're still here. This is the worst my skin has looked in my life.
Is it possible that THIS is the initial breakout that's supposed to happen? I was 10-11 weeks into using Taz, though. That seems way too long for the IB.
My derm's office was closed for the holidays so I couldn't get in. I thought to myself that, at best, the Taz was doing nothing, and at worst, it was causing this bizarre breakout, so I decided to stop using it a few days ago, and went back to Dan's BP. (My derm had me doing a BP wash while on Taz, so I wasn't completely BP-less.)
I'm not sure what the deal is. I did start taking some Niacinamide 500mg tablets a little bit after the the breakout started, but those couldn't have made it worse, could it? I stopped taking them after only a few days just to reduce the number of variables in this mess.
One thing that I keep coming back to: the Taz tube says to store at 77 degrees F. That's awfully specific. I've been storing it at maybe 70. I'm not heating up my entire house to 77 just for a stupid tube of cream. But, also, about 3 or 4 times I forgot the tube in the bathroom during a shower. The tube says excursions are permitted to 59 degrees - 86 degrees. Is it possible I accidentally screwed up the med? It can't be THAT sensitive, can it? Besides, it was making me greasy and stinging my face just a little all the way up until I stopped using it, so at least parts of it were still working.
Any ideas? I'm seeing my derm soon. I can't help but wonder what went wrong.
Edited by baloo, 03 January 2014 - 03:31 AM.