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Hi Guys, this is my first post here, and I am really just looking for help on what to do. Don't know where to start, so here are thepicsfirst. Have been battling acne for about 9 years now. Since I was 11. First experience with severe cystic acne was at 17, should've went to the Dermatologist by then, but I was too embarrassed and didn't. It subsided to pretty moderate acne but three years later, at 20, I Broke out again, this June. Went to a General Practitioner first, in July. She prescribed me 100 Mg Doxycycline hyclate 2x a day, and Epiduo. Used this in combination with Cetaphil Skin Cleanser, and Cerave Moisturizer to pretty good results. By Mid August, most of my cystic acne had gone. Had relatively less acne (by my standards). Visited a Dermatologist (Finally!) two weeks ago. She prescribed me Epiduo forte (0.3% Adapalene), and gave me Tazorac (.05% Tazarotene) too. Instructed me to use Epiduo forte in the daytime, Tazorac at night. I've been applying both daily, religiously, and haven't suffered from any dryness, luckily. My cystic acne has gone (as you can see in the pics) and I only have a few active pimples on my temple area, which I expect to go away in a week or two. The problem, though, is that I am now covered in severe hyperpigmentation. And though i'm happy about the active acne going away, this redness left over still does no good, and isn't much better. I wonder if you guys have any reccommendations, tips, on how I can reduce my redness. I know retinoids which I am already using should be good for this right? But is there anything else I can do to speed up the process? I visit the dermatologist again in two weeks, and I remember her telling me peels are something we can look at, so I am eager for that. But is there anything else I can add to my current regimen that can reduce my redness, without affecting the effectiveness of what I am already using?
Current Regimen: Morning: Cetaphil Gentle Skin Cleanser, Epiduo Forte (2.5% BP, .3% Adapalene), Cerave Moisturizing Lotion, Doxycycline Hyclate 100mg, Neutrogena Clear Face Sunscreen Broad Spectrum SPF 30
Night: Cetaphil Gentle Skin Cleanser, Cerave Moisturizing Lotion, Tazorac (.05% Tazarotene), Doxycycline Hyclate 100 mg
I also wanted to ask if anybody has used this combination before? That is, both Epiduo and Tazorac at the same time. Because I know theyre both retinoids, used generally at night right? So its a pretty awkward combination. But I havent experienced any irritation or dryness so far, and my skin feels pretty good right now in my cheeks, and I saw tazorac was one of the strongest retinoids, so Im pretty eager to see the results.
Also, do you guys have any recommendations for sunscreen? My derm gave me Neutrogena SPF 60+ sunscreen, but I have brown, asian skin, so it leaves a really white cast, and I've opted for a weaker sunscreen that doesn't leave a mark. Is there a sunscreen I can buy that is strong, but won't leave such a noticeable white cast for brown skin?
Thank you in advance everyone for the help!!
I'm really surprised that your derm didn't put you on Accutane. Whenever you see acne scars like this, I've heard that you need to go straight for Accutane. I think you've reached that point that you need to consider it. Also, I don't understand why they're telling you to use 2 retinoids? The Adapalene I haven't tried, but I heard it's the most gentle retinoid, but you're using the one with BP so it won't be so gentle. Adapalene (brand name Differin) prescription strength will soon be available at drugstores over the counter. I've tried generic Retin-A (tretinoin), which was the worst mistake of my life, it gave me cystic acne all over my face, which I never had before and now my skin is forever changed for the worse, have scars and still breaking out with cystic acne. My face on tretinoin looked as horrible as it does when you take Accutane, it was that bad. Anyways, tazorac I love, I've used it before tretinoin and after it, it's supposedly the most harsh retinoid, but I didn't feel that it was, but of course I moisturized really well. Each time I used it I wished I never stopped because each time you restart you have to go through the horrible purge again. You have to keep on using it even after 3-4 months when you get the full results, because it's a preventative treatment. For some reason, it didn't make me purge like tretinoin and the more important difference is it didn't give me cystic acne or scarring. I don't know why, I think it works on different skin receptors on a cellular/molecular level. Personally I would try a different stronger antibiotic such as Bactrim (if you don't have an allergy to Sulfa drugs). I feel like you're doing too much, BP is very harsh on the skin and then also 2 retinoids. I would do 1 retinoid, the tazorac, and then in the morning instead of BP, I would try azelaic acid (Finacea, Azelex). It works like a topical antibiotic and it's also anti-inflammatory so that would help with the redness too. I haven't tried it long enough to see the full results, it supposedly takes ~6 months to work, but I've seen amazing results on Youtube. I would use it now, but I'm gonna first try Spironolactone.