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My derm put me on tretinoin 0.05% (Acid A Vit) last week. I asked him about azelaic acid (in Holland there is only a generic brand, no Finacea, Skinoren, Azelex...) but he said all this cream does is bleach your skin. He thinks it's too harsh for me. I have been using Differin for 3 months. It did help a little but not satisfactory according to my derm. That's why he put me on tretinoin. I hope I won't get an other initial breakout... I'm trying it out on my forehead at the moment before I will put it on my cheeks (problem area).
How is you face doing? Do you have pictures of that too?
not meaning to sounds like an ass but your derm sounds a little ... uneducated about azelaic acid.
Dermatologists should make an effort to read the research website "PUBMED" to make sure they are aware of the latest reccomendations regarding acne treatment and should ensure that all the information they give out is accurate.
Like Benzoyl peroxide it kills bacteria and also supports the skin shedding to prevent pores from blocking (a big part of acne is the skin cells accumulating inside the follicule). Azelaic acid is (like BP) also shown to lighten darker skin... more often seen in ethnically dark skin.
http://www.ncbi.nlm.nih.gov/pubmed/18246693 here is an abstract from research on azelaic acids effect on acne in the past few years. Print it out and show to your derm if you do decide you want to try it.
http://www.ncbi.nlm.nih.gov/pubmed/16281587 here is another, possibly easier to understand.
I alos read a study which said that azelaic acid is just as effective as retin-A statistically but I can't find the link so sorry about that.
I have attached two photos for your approval.
I'd advice anyone to do their own research into effective acne treatments and never assume a dermatologist knows the latest research.
xx
i find the nhs useful here http://www.nhs.uk/Conditions/Acne/Pages/Treatment.aspx
click on map of medicine to make sure your derm is treating you correctly
to clarify the pic on the left is early on in treatment and the one on the right is 2 days ago.
Wow, that is a really great improvement on your back!
How do you plan to maintain the improvement, will you scale the Finacea back to every second day, or do you need to keep going with it every day indefinitely?
I am going to carry on with once a day as the original reccomendation was twice a day and I ... ignored this as I read pubmed research saying once a day was enough. My skin is not totally clear either so I will keep going as I am for a while... depends on whether my derm comes up with any good ideas.
Using tea tree in jojoba on outbreaks at night really seems to help me (alot and by morning... redices inflamation) around the face recently (doesnt prevent but treats acne which DOES come up) so I may expend this to anywhere where my acne develops.
My derm may decide to add something to my existing routine as its proven so sucessful so far.
Thanks for the comment 
Wow, your face also looks really good! And thanks for the links.
I think my derm put me on tretinoin mostly to fade the scars (little indents 
and red marks). The situation is a little complicated as I work in the same hospital, so he is my colleague... I don't want to act pedantic.
Wow, your face also looks really good! And thanks for the links.I think my derm put me on tretinoin mostly to fade the scars (little indents
cheers for the face compliment 
shame about the complicated work situation, hope the tretinoin works well, I would assume its better for scars than finacea is. Finacea is better for prevention rather than cure
Don't you hate how quick you run out of Finacea? I have been on it for 2 weeks, and used most of my 60g tube!
Whhooa that is a whole boat load of finacea! I have a 3g sample that I have been applying morning and evening for the past week and still have enough for 1-2 more days. A pea size is all that is needed!
Don't you hate how quick you run out of Finacea? I have been on it for 2 weeks, and used most of my 60g tube!
Whhooa that is a whole boat load of finacea! I have a 3g sample that I have been applying morning and evening for the past week and still have enough for 1-2 more days. A pea size is all that is needed!
where are you applying it? I am applying it to my face, neck, chest and the whole of my back top to bottom. For that reason it runs out pretty fast.
haha ohhh that makes sense! I was really surprised when I read how quickly you were running out of it and I was a bit concerned as well. I am applying it to just my face. A pea size is all that is needed for the face 
Has anyone found finacea to help with tiny pitted scars? I imagine no because it doesn't help in collagen production the same way a retinoid would
haha ohhh that makes sense! I was really surprised when I read how quickly you were running out of it and I was a bit concerned as well. I am applying it to just my face. A pea size is all that is needed for the face
Has anyone found finacea to help with tiny pitted scars? I imagine no because it doesn't help in collagen production the same way a retinoid would
Yeah I am jealous of Retin A users for that reason. Maybe I'll switch when I start getting wrinkles!
right, preparing to go to the derm tomorrow. My skin is very clear... for me.... so I am worried they will shout at me :S
but I would like to be clearer really. Don't know if I should just stick to this treatment for longer as its improving with time... or let them prescribe me something else.
I'll be talking to them about this tomorrow.
nervous!!
derm was a waste of time, I think I pissed her off when she asked to look at my skin and went to touch my face. I said "i'm sorry, I don't want to seem rude but I read on pubmed that antibiotic resistant acne bacteria are often spread by dermatologists so if you touch my skin could you put some gloves on please" 
she looked totally put out..... bitch! its my skin for f***s sake and i would have to deal with the LIFELONG consequences of her inability/refusal to read the research which directly relates to her job. 
here is the link: http://www.ncbi.nlm.nih.gov/pubmed/12653738
"Of the dermatologists, 25 of 39 were colonized with resistant propionibacteria, including all those who specialized in treating acne. None of 27 physicians working in other outpatient departments harboured resistant propionibacteria."
"..dermatologists should use stricter cross-infection control measures when assessing acne in the clinic."
anyway, due to my famialies history of mental illness she (like me) was not keen to try accutane in case I offed myself or something. 
she was very keen to get me on an antibiotic pill... which i made clear I was not interested in as I have IBS and easily get sick 
as well as being conserned about developing resistance. I also said I don't want to be on an antibiotic long term and she said i may not have to be... how does that work? I have never met someone with acne prone skin who took antibiotics for a while then had the acne never come back.... the only thing which produces those kinds of results is accutane. 
I know one person who claimed this happaned but they were in their late 20's when they came off of the antibiotic and admit themselves that they, most likely, just finished puberty.
anyway after making it clear I was not keen on antibiotics she went through topicals but most of the ones she suggested have an antibiotic in them so she seemed stumped. 
After an akward silence I thought, I know there are more options than just antibiotics and accutane so I asked about RetinA to get the convo flowing again (why did I have to do this?) specifically (repeating) that I was after a topical to try alongside my current, very sucessful so far, azelaic acid treatments. 
she didnt bother to explore any further than topical retanoids and just said that I could try that and drew me up a script for differin gel, clearly keen for me to leave. 
I asked about nicatinamide gel, she waved the idea away and said that was not as good as differin. 
It is a totally different treatment and I would have liked to discuss it but no...... I asked if I would use any topoical alongside my finacea she said I couldn't do that. I would have to stop finacea to use another topical.
I am pretty sure people on here have said they have used a topical retanoid with finacea before and I know other people ahve been given things to use alongside finacea... my jawline is the main problem. I asked about initial outbreak and she said yes I would probably have one. I could try this for 6 weeks to see if it worked (I am pretty sure this is just enough time for me to have an initial outbreak, not enough time to see if its actually better than finacea)
basically, I think she was terrible at her job and undedicated. I don't feel like she listened to me or what I wanted from a treatment and because I would not simply do as I was told she wanted me to leave. 
whose skin is this?
I have been "discharged" back to my GP, I think its better this way as I will research the products myself and ask for them through the GP rather than be told what to do by an overpaid pill dispenser. 
I came to discuss treatment options, I got told what to do, then dismissed.
and that was my NHS dermatology experience
rating:
update: she only prescribed me 45g of differin, does she think I am made of money? I told her my acne covers my face, chest, neck, back and tops of my arms. if she wants me to replace azelaic acid i'll need a lot more than 45g......
i give up with this one, this one clearly took dermatology cause she couldn't get into her first choice speciality... maybe one day I will see another derm who is not poop
Wow your derm sounds like a major bitch! sorry that it is such an unpleasant experience going to her. Is there any way you can get a different one? To answer your question about Differin and Finacea together I was prescribed .1% Differin(at night) and 15% Finacea(morning and night and eventually just am). So far its been 13 days of Finacea and on Sunday it will be two weeks of differin. I am still not too dry and no major IB yet. I did have a skin pick set back this weekend so the improvement in my skin has regressed but it is back on track as I haven't picked in a few days.
In my reading the benefit of the two together is that Differin draws the the stuff out of the clogged pores and finacea zap the breakout because of its antibacterial properties and helps with redness.
Wow your derm sounds like a major bitch! sorry that it is such an unpleasant experience going to her. Is there any way you can get a different one? To answer your question about Differin and Finacea together I was prescribed .1% Differin(at night) and 15% Finacea(morning and night and eventually just am). So far its been 13 days of Finacea and on Sunday it will be two weeks of differin. I am still not too dry and no major IB yet. I did have a skin pick set back this weekend so the improvement in my skin has regressed but it is back on track as I haven't picked in a few days.
In my reading the benefit of the two together is that Differin draws the the stuff out of the clogged pores and finacea zap the breakout because of its antibacterial properties and helps with redness.
maybe I will get my script and just use it on my jawline if I see no further improvement in the next few months in that area. Glad to see someone has been given the exact opposite advice and support from a dermatologist. Thankyou for letting me know
Oh no, she sounds totally sh1t 
Honestly, I really don't know what some of these doctors/derms are up to...I mean to say, your own GP could have prescribed you Retin A or an antibiotic. The only useful thing about dermatologists as far as I can see is that they are the only doctors who are allowed to prescribe Accutane!
And fancy touching your face without gloves, oh thanks for the heads-up as if/when I ever get my derm appt. I shall watch out for that!
Don't these people know that they have to wash their hands as well?? (Evidently not, which is why so many patients die of MRSA in hospitals!)
I somehow think when you see a derm or any specialist on the NHS they act like they are doing you a favour, because you (or an insurer) are not paying them directly...never mind that we've paid taxes and National Insurance for years on end which pays their salaries.
I only ever saw one derm for my acne (on NHS) and he was OK but of course just gave me a different antibiotic (which I developed resistance to eventually) plus topical Isotretinoin gel.
He refused point blank to try Accutane, b/c of my history of depression but anyway, I suspect the real reason UK derms are so reluctant to give acne sufferers accutane is the COST. Every NHS dept. has a 'budget' , so if they go around giving every moderate case of acne accutane, they will be over-budget (I gather it is an expensive drug).
Why can't they at least do something useful like offer laser therapy, I don't know.
So are you going to try the retinoid?
I'm going to give my acne more time on the finacea and use salicylic acid products and tea tree, seems my skin has improved LOADS this past 2 months so I want to see where it will plateau.
if i'm still not happy with it then i'll try the retanoid on my jawline alone to see how effective it will be. I will continue to take photos to document my sucess (or lack thereof) and hopefully I will find the perfect combination for me.
ok so new photos for the log today. I washes my makeup off not too long before taking these so I have a bit of redness which has nothing to do with acne at all and everything to do with cheap cotton pads scrubbing my skin a little to roughly.
anyway, I hope you approve. My back looks AMAZING. ITS SO CLEAR... i get so emotional every time I think about it. I can go swimming1 I can go to a spa. I can wear low cut tops and low backed dresses again... thankyou finacea!
GOD I love science!
These are both todays picture. I really could kiss the researcher who decided to investigate azelaics effect on acne.....
Yep, your back looks goooood. Anyway, my suggestions also is to research on fatty oils. Linoleic acid helps reducing redness and inflammation so taking some grape seed oil or omega 3 (for instance, three times a week) it might help your skin. Why? because the sebum composition is different.
Great your doing good.
Fantastic result! How many months have you been using Finacea again? It does seem your results have been quite gradual, so it's very encouraging to me to keep going with this topical.
I'm so pleased for you!
Did you ever try the Differin or not bother with it?
have not bothered with the differin, as yuou say my improvement has been gradual so I want to see how far I can push this before adding additional products. My skins even better than it was when these photos were taken hope your getting on with it well.
me getting my back/skin out for the blue lagoon. it was amazing. you have to shower nude before getting in as the pool needs to be kept hygenic. This, when my skin was bad, would have been a mortifying situation. Face, neck, back, chest, no clothes, no makeup! It was amazing as I stripped off and I realised that I felt confident about myself. People saw my skin completely un covered and I did not feel at all self consious.
yay!!
My skin isn't 100% clear (jawline skill has breakouts) but its so my better than it ever has been and it keeps getting better.
on a side note, icelandic water is great for your skin. even the shower water in the hotel. It comes from boreholes and due to the volcanos its got sulphur in it. My skin was so soft after 2 weeks.
Im thinking of a sulphur product for my jawline, i had wondered about it before and this shows it could be effective.
yay... again
Reading through your log has given me extra hope in my azelaic acid working, Ive only been on it for a couple of weeks but sometimes I think its working an then others I'l break out (like now) I do see my skin condition getting gradually clearer though!
Btw your skin looks amazing .
Reading through your log has given me extra hope in my azelaic acid working, Ive only been on it for a couple of weeks but sometimes I think its working an then others I'l break out (like now) I do see my skin condition getting gradually clearer though!
Btw your skin looks amazing
Im glad it brings you hope. I wish I had a log to read through when I first started using finacea cause the progress is so gradual. I remember being so angry with my acne I would cry in the shower and be so angry whenever I had to choose an outfit in the summer. I only knew about azelaic acid cause I researched acne treatments obsessively. My doctor was ready to send me straight to a derm before I tried it.
I wish my skin was 100% clear, its not. Saying that my ONLY spots at present are around my jawline and they are genuinely barely noticable when I catch myself in the mirror... now when I catch a glimpse of myself I smile but I don't obsessively look anymore which is awesome.
good luck with azelaic acid. Keep photos though, once a fortnight or once a menstral month cause the progress is gradual and it helps to keep track that way rather than obsess over it daily. obviously you will obsess, I did, but making an acne photo date with yourself makes it easier to know its the treatment is effective. Doing it the same menstral day is a really good idea though if your female cause our breakouts fluctuate so much throughout the month.
I can genuinely say finacea has changed my life