You should get your Epiduo Forte and Aczone filled and ditch pretty much everything else in your regimine. Using those two (Epiduo Forte at night Aczone in the morning) with a gentle cleanser, CeraVe moisturizer, and sunscreen will be enough to see results. Don't second guess what the dermatologist is telling you they have a lot of experience with treating acne and are prescribing you the best products.

@acneguruThanks for the input. As you can see, I've just redesigned my regimen, in a way that meets many of your points.

Upon the advice of members of this forum, my dermatologist, and my own conscience, I simplified my regimen considerably a few months ago. It's listed, in its present form, below.

REGIMEN:

• Morning:
  1. If MWF, shave with Proraso New Formulation Shaving Cream and Merkur safety razor.
  2. Wash my face with Dermalogica Essential Cleansing Solution
  3. Apply Aczone
  4. Apply Elta MD UV Clear Sunscreen(or sometimes CeraVe, if I'm worried Elta will make my skin too shiny)
• Evening:
  1. Wash my face with Dermalogica Essential Cleansing Solution
  2. Use deep cleaning salicylic and glycolic acid wipe
  3. Apply Epiduo
  4. Apply CeraVe Moisturizing Lotion
• Change my pillowcase every night
• Don't talk with my phone on my face
• Spot-treat with Clean & Clear Advantage Acne Spot Treatment

RESULTS:

• Summer:
  • Over the summer my skin wasgreat. In all, I think I had two blemishes over 3 monthsthe best my skin has been in years.
  • I did have some problems with dryness and sunburn from being outside (despite repeated application of sunscreen), but they were pretty minor.
  • My skin also looked somewhat shiny during the summer. Maybe a combination of sweat, sunscreen-shine, that "healthy glow," and a bit of oilinessperhaps as a reaction to dryness?
  • The only real problem I had was blackheads in my nose. My skin is pretty dry, especially around my nostrils and in the crevices where my nose meets my face, which makes it really difficult to get these blackheads out. I've tried gritty exfoliators, pore strips, and some masks, but nothing really seems to help.
• Now:
  • In the past month since returning to school, my skin has gotten worse. My forehead and chin remain remarkably clear, but my cheeks have suffered. In the middle of each cheekroughly along a line from my ear lobe to the corner of my mouthI've gotten multiple blemishes.
  • Some of the blemishes in my cheeks are superficial whiteheads, the kind that can be easily extracted without damaging my skin.
  • Others are deeper, larger pimples that don't have a head, at least immediately, and are sometimes painful. These are the worst.
  • The most common kind of blemish on my cheeks, however, continues to be along the outsides of my cheeks: small, slightly raised or flush, red marks that some to be ingrown hairs or at least related to shaving in some way.
  • Blackheads in my nose continue to be an issue, slightly worse than over the summer. I know also now find tiny whiteheads along my nose.

I can think of a few things related to returning to school that could haveled to the recent uptick in my acne:

• Increased stress
  • Could exercise be helpful in combatting this?
• Drinking less water or eating less regularly
  • I've noticed that when I'm at school without the opportunity to have lunchas often happensmy skin can get tough, or oily, or uncomfortable.
• Picking (because of increased stress)
  • As much as I'd like to stop, I haven't been able to quit picking my skin. I've definitely begun to pick my skin more recently; I'd like to think that this is because my skin has gotten worse, but itcould be because I'm simply more stressed (and my picking has had a negative impact on my skin).

Here are the things I'm considering to improve my skin (pending the advice of my dermatologist):

• Going on Doxycycline again
• Switch from Epiduo to Epiduo Forte
• Drinking more water, or trying to eat more regularly
• Exercising
• Finding a lasting way to quit picking
• Sleeping more

I'll update this as soon as I decide what I decide to change, and soon thereafter with results.

So, I saw my dermatologist, which has resulted in three changes to my routine beginning today:

1. I'll be using Epiduo Forte, instead of Epiduo, from now on. Hopefully, it won't be too drying.
2. I'll start taking 2 50mg Doxycycline pills daily.
3. I will no longer pick my skin. (Er...)

Hm. So, it turns out Epiduo Forte is on backorder; for now I'll keep using the regular-strength version.

In the last less-than-a-week, there have been a few developments:

• I got a patch of incredibly dry, red, rough itchy skin on the side of my neck. It was pretty uncomfortable, and when I touched it, it was incredibly raw/drytiny flakes of skin were coming off. I tried moisturizing, but that stung incredibly. It seems to have gone away, but I'm not sure what caused itsunburn? excessively hot or long showers?
• The dark marks on the side of my left cheek, near my sideburn, are fading well.
• I now have not one, buttwolarge, painful, hard, round lumps (cysts?) on my forehead, which has been clear for months. I've done my best to keep my hands away from them, but I couldn't restrain myself from picking/prodding one of them into a painful-er red mess. Reading posts here, it seems like the best thing to do is apply Benzoyl peroxide, ice, cortisone, and not touch them.

Wish me luck.

So! All the problems I described last week (rough skin on my neck, dark marks, and maybe-cysts on my forehead) are gone!

But, my skin is not doing better. I had multiple deep whiteheads on my right cheekbone. More dispiritingly, I have 1 large, red, painful lump of considerable size in the middle of my left cheek. I've noticed a pattern with these kinds of blemishes, which don't seem to be like anything else I get:

• They start as a flat, slightly raised patch of skin with a different texture.
• Gradually, they grow and begin to protrude from the surface of my cheek.
• Eventually, they're a full-on throbbing, tingling, painful, inflamed, somewhat dry monstrosity.

I seem to get them when I'm more stressed. I've also noted that hot compresses don't help, and picking them has never ended wellit's seems like there's inflammatory tissue, not pus, inside anyway.

Cortisone and a bandaid are really the only things that make a difference. I've also updated my regimen (the one posted on 9/25) to reflect some slight changes:

• I now shave three times a week (MWF).
• After washing my face at night but before applying Epiduo, I use a "deep cleaning" salicylic and glycolic acid wipe.

I've realized I pick so much that I don't even know what my skin is actually likewhether I'm making it better or (probably) worse.

So, the picking stops now. Today.

For the next 30 days, at least, I won't touch my face.

Saw my dermatologist againshe agreed my skin was worse than it had been. (Not worse since my last two posts, though).

Some routine changes:

• I'll be taking350mg doxycycline pills (1 in the morning; 2 at night). Doxycycline really helped my skin get (and stay) better fast before; I'm hoping it will work again.
• I'm using some new version of AcZone that's supposed to be stronger and all-around better.
• I'm using Epiduo Forte (this isn't newit started a while agobut I forgot to update once I got it off backorder).