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I would use the retin - a micro gel, which is the least irritating if you are going to try it. I think an initial outbreak is pretty universal, so be prepared for that. If you have moderate to severe acne, I would recommend getting on antibiotics first, otherwise tretinoin will just make your break out unbearable. Ultimately, retin-a is an irritant, that peels away the top layers of skin. It will irritate any existing acne and bring it to the surface. I think this is way most people with moderate to severe acne find this form of treatment, to be well, basically hell. Read the tips on using retin-a, pinned to this forum.