its hard to say without a photo but "severe" is all in an opinion. Did you post one? We cant see it.

Good luck with the derm, dont let them talk you into accutane.

auguries is right. Some people consider 3-4 big pimples as severe (not saying you do not). But if you do really have zits that are like mountains, it is probably moderately severe to severe. Photos would do justice

Hey berserkaf, that's great that you're all set up for a dermatology appointment. If you are developing scars, then yes you're probably dealing with "severe acne". Fortunately, your dermatologist can give you access to much stronger medications that Retin-A. You said that Retin-A didn't work very well in the past; this is because tretinoin, the active ingredient in Retin-A, is really only effective in treating the comedones.

Since your acne has gotten a bit more severe, your dermatologist will probably give you another topical retinoid (like Retin-A or Differin) and then he will add an antimicrobial (like benzoyl peroxide, topical antibiotics, or oral antibiotics). A combination of topical retinoids and antibiotics is a really effective treatment. The topical retinoids will clear away those clogged pores, and then the antibiotics can get right into your pores to kill the acne-causing bacteria. Additionally, the antibiotics will help reduce the inflammation around your acne lesions. (Here is a great resource to learn more about these Acne Treatments [Removed])

Make sure you tell your dermatologist about the treatments you've used in the past and how effective or ineffective they were. I'm sure your derm will be able to set you up with a very effective treatment. Best of luck, and let us know how your appointment goes.

On 5/3/2013 at 6:30 AM, Ryan Hambley said:

Hey berserkaf, that's great that you're all set up for a dermatology appointment. If you are developing scars, then yes you're probably dealing with "severe acne". Fortunately, your dermatologist can give you access to much stronger medications that Retin-A. You said that Retin-A didn't work very well in the past; this is because tretinoin, the active ingredient in Retin-A, is really only effective in treating the comedones.

Since your acne has gotten a bit more severe, your dermatologist will probably give you another topical retinoid (like Retin-A or Differin) and then he will add an antimicrobial (like benzoyl peroxide, topical antibiotics, or oral antibiotics). A combination of topical retinoids and antibiotics is a really effective treatment. The topical retinoids will clear away those clogged pores, and then the antibiotics can get right into your pores to kill the acne-causing bacteria. Additionally, the antibiotics will help reduce the inflammation around your acne lesions. (Here is a great resource to learn more about these[Removed])

Make sure you tell your dermatologist about the treatments you've used in the past and how effective or ineffective they were. I'm sure your derm will be able to set you up with a very effective treatment. Best of luck, and let us know how your appointment goes.

I started a new topic with photos

I used Proactiv for the past 2 years without it doing anything, so I don't think benzoyl peroxide will work well? since it's like the main ingredient in proactiv it seems.

I stopped proactiv in December and I've just been using baby shampoo because someone told me that it would help the sensitivity I inherited from proactiv, which it did but it doesn't help with acne but at least it's a sort of cleaner, right?

I've used neutrogena, clearasil, proactiv and oxy. none worked.

On 5/4/2013 at 5:44 AM, berserkaf said:

On 5/3/2013 at 6:30 AM, Ryan Hambley said:

Hey berserkaf, that's great that you're all set up for a dermatology appointment. If you are developing scars, then yes you're probably dealing with "severe acne". Fortunately, your dermatologist can give you access to much stronger medications that Retin-A. You said that Retin-A didn't work very well in the past; this is because tretinoin, the active ingredient in Retin-A, is really only effective in treating the comedones.

Since your acne has gotten a bit more severe, your dermatologist will probably give you another topical retinoid (like Retin-A or Differin) and then he will add an antimicrobial (like benzoyl peroxide, topical antibiotics, or oral antibiotics). A combination of topical retinoids and antibiotics is a really effective treatment. The topical retinoids will clear away those clogged pores, and then the antibiotics can get right into your pores to kill the acne-causing bacteria. Additionally, the antibiotics will help reduce the inflammation around your acne lesions. (Here is a great resource to learn more about these[Removed])

Make sure you tell your dermatologist about the treatments you've used in the past and how effective or ineffective they were. I'm sure your derm will be able to set you up with a very effective treatment. Best of luck, and let us know how your appointment goes.

I started a new topic with photos

I used Proactiv for the past 2 years without it doing anything, so I don't think benzoyl peroxide will work well? since it's like the main ingredient in proactiv it seems.

I stopped proactiv in December and I've just been using baby shampoo because someone told me that it would help the sensitivity I inherited from proactiv, which it did but it doesn't help with acne but at least it's a sort of cleaner, right?

I've used neutrogena, clearasil, proactiv and oxy. none worked.

Hey, thanks for adding the photos and including more of the medications that you have used.

I started a new topic with photos

As far as I could tell from the photo's, you have some comedones (blocked pores), papules (red inflammation around your acne lesions), and some pustules (the inflamed pimples that also have some pus inside). At a minimum, this is moderate acne but it is starting to look pretty severe. Do you have any deep and painful pimples or do they feel like they are just sitting on the top of your skin? The deep and painful ones are called nodules or cysts, and they are indicative of severe acne. Don't worry though; virtually all acne can be treated and I'm sure your dermatologist will get you set up with the right treatment plan.

I used Proactiv for the past 2 years without it doing anything, so I don't think benzoyl peroxide will work well? since it's like the main ingredient in proactiv it seems.

You're correct that benzoyl peroxide (BP) is the main ingredient in Proactiv, and alone, it makes sense that it wouldnt work very well for your acne. Alone, BP isn't very effective, but if you combine it with a topical retinoid then it becomes an extremely more effective treatment. Benzoyl peroxide has similar effects as an antibiotic. Both BP and antibiotics work by killing acne-causing bacteria (P. acnes), but without using a topical retinoid at the same time, the BP can't get into your pores where the bacteria is building up. You might be correct in assuming that BP isn't the right medication for you though. Antibiotics are a bit stronger and they are also more effective in getting rid of the inflammation. But weather you use BP or an antibiotic, it is really important that you use a topical retinoid at the same time.

I stopped proactiv in December and I've just been using baby shampoo because someone told me that it would help the sensitivity I inherited from proactiv, which it did but it doesn't help with acne but at least it's a sort of cleaner, right?

Moisturizer, moisturizer, moisturizer! If your skin get's irritated by your acne medications, make sure you use a bunch of moisturizer right after applying your acne meds. If it's still getting irritated, try mixing your acne meds into a moisturizer and then apply that to your skin. You may just have a bad reaction to Proactiv, but I have had really red, flakey, painful reactions to my prescription benzoyl peroxide and topical retinoids before -- it completely went away when I began mixing my meds with a bunch of moisturizer.

I've used neutrogena, clearasil, proactiv and oxy. none worked.

Yea, these are only going to work for mild acne. They can be helpful to keep using along with your prescription medications but they won't do a whole lot if this is the only thing you are using.

I hope this was helpful and please update me after you see the dermatologist, I am really curious to find out what he thinks is best for you. Good luck berserkaf, your definately going to beat this one.

On 5/5/2013 at 1:31 AM, Ryan Hambley said:

On 5/4/2013 at 5:44 AM, berserkaf said:

On 5/3/2013 at 6:30 AM, Ryan Hambley said:

Hey berserkaf, that's great that you're all set up for a dermatology appointment. If you are developing scars, then yes you're probably dealing with "severe acne". Fortunately, your dermatologist can give you access to much stronger medications that Retin-A. You said that Retin-A didn't work very well in the past; this is because tretinoin, the active ingredient in Retin-A, is really only effective in treating the comedones.

Since your acne has gotten a bit more severe, your dermatologist will probably give you another topical retinoid (like Retin-A or Differin) and then he will add an antimicrobial (like benzoyl peroxide, topical antibiotics, or oral antibiotics). A combination of topical retinoids and antibiotics is a really effective treatment. The topical retinoids will clear away those clogged pores, and then the antibiotics can get right into your pores to kill the acne-causing bacteria. Additionally, the antibiotics will help reduce the inflammation around your acne lesions. (Here is a great resource to learn more about these[Removed])

Make sure you tell your dermatologist about the treatments you've used in the past and how effective or ineffective they were. I'm sure your derm will be able to set you up with a very effective treatment. Best of luck, and let us know how your appointment goes.

I started a new topic with photos

I used Proactiv for the past 2 years without it doing anything, so I don't think benzoyl peroxide will work well? since it's like the main ingredient in proactiv it seems.

I stopped proactiv in December and I've just been using baby shampoo because someone told me that it would help the sensitivity I inherited from proactiv, which it did but it doesn't help with acne but at least it's a sort of cleaner, right?

I've used neutrogena, clearasil, proactiv and oxy. none worked.

Hey, thanks for adding the photos and including more of the medications that you have used.

I started a new topic with photos

As far as I could tell from the photo's, you have some comedones (blocked pores), papules (red inflammation around your acne lesions), and some pustules (the inflamed pimples that also have some pus inside). At a minimum, this is moderate acne but it is starting to look pretty severe. Do you have any deep and painful pimples or do they feel like they are just sitting on the top of your skin? The deep and painful ones are called nodules or cysts, and they are indicative of severe acne. Don't worry though; virtually all acne can be treated and I'm sure your dermatologist will get you set up with the right treatment plan.

I used Proactiv for the past 2 years without it doing anything, so I don't think benzoyl peroxide will work well? since it's like the main ingredient in proactiv it seems.

You're correct that benzoyl peroxide (BP) is the main ingredient in Proactiv, and alone, it makes sense that it wouldnt work very well for your acne. Alone, BP isn't very effective, but if you combine it with a topical retinoid then it becomes an extremely more effective treatment. Benzoyl peroxide has similar effects as an antibiotic. Both BP and antibiotics work by killing acne-causing bacteria (P. acnes), but without using a topical retinoid at the same time, the BP can't get into your pores where the bacteria is building up. You might be correct in assuming that BP isn't the right medication for you though. Antibiotics are a bit stronger and they are also more effective in getting rid of the inflammation. But weather you use BP or an antibiotic, it is really important that you use a topical retinoid at the same time.

I stopped proactiv in December and I've just been using baby shampoo because someone told me that it would help the sensitivity I inherited from proactiv, which it did but it doesn't help with acne but at least it's a sort of cleaner, right?

Moisturizer, moisturizer, moisturizer! If your skin get's irritated by your acne medications, make sure you use a bunch of moisturizer right after applying your acne meds. If it's still getting irritated, try mixing your acne meds into a moisturizer and then apply that to your skin. You may just have a bad reaction to Proactiv, but I have had really red, flakey, painful reactions to my prescription benzoyl peroxide and topical retinoids before -- it completely went away when I began mixing my meds with a bunch of moisturizer.

I've used neutrogena, clearasil, proactiv and oxy. none worked.

Yea, these are only going to work for mild acne. They can be helpful to keep using along with your prescription medications but they won't do a whole lot if this is the only thing you are using.

I hope this was helpful and please update me after you see the dermatologist, I am really curious to find out what he thinks is best for you. Good luck berserkaf, your definately going to beat this one.

Ok, I think I do have nodules

I think I might just ask for epiduo and try it out over the summer

Thanks, Ryan