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little labbit

searching for info/advice @ purging on retin-a

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hi-

i am hoping that anyone here knows of any helpful links? (besides the obvious!)

i have already seen/read to "retin-a micro-what to expect/healthboards/webMD/drugtalk/askdocweb...

.....etc. i have to say that acne.org is by far THE BEST ONE!

however-

i really haven't found enough about people who have experienced a PROLONGED/EXCESSIVE PURGING while using retin-a or retin-a micro. i am still purging excessively (after 2+ months of nightly use. *been taking tetracycline and yaz for 3+ weeks to help combat this purging)-however, my pores clog up to the point of bursting about twice a day, every day. they are all along the sides of my face and cheeks. (the chronic stubborn blackheads on my nose have cleared up considerably so i know RAM is working-i have faith!)

so-

i'm just in search for info/advice about EXCESSIVE PURGING.

thanks friends...

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perhaps the drug is expired and no longer effective.

also depending on how bad your acne is, it could take a long time to work.

your diet could also be influencing your breakouts, cut back on sugar and simple carbs like bread, cut out dairy completly and take a fish oil supplement(very effective) and balance your omega6/omega3 ratio to 1:1 using fish oil. cut out any foods with excessive omega 6s like all nuts, walnuts are sometimes ok like once every two weeks or so, anything with alot of saturated fat and stuff like corn chips.

go to nutrition data.com to look up the omega 3 and 6 content of your foods to see what your current ratio is.

check out the fish oil threads in diet/holistic section

hope this leads you in the right direction.

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Not sure if I'll be of any help. But I tried retin-A micro (I had mild stubborn acne on forehead and once in a blue moon on my cheeks).Started to use retin-A micro several months ago and only used it 2 times a week (which may have been my problem) because my skin is sooo sensitive and that's what my derm recommended. Anyhow, I put a very thin layer on forehead, sides of face and cheeks. I started breaking out like crazy, big cysts, places I never even broke out before. I had to stop using it. Maybe I quit too soon. I am now on a very natural regimine (the goats milk regimine- see forum for over-the counter acne products). I only use canus goats milk and complex 15 lotion. I have given up all topicals. My skin is definitely improving, I still have small breakouts (but usually very small and go away in a few days by themself). Again, we may have very different skin types but just thought I'd share becuase your story sounded awfully familiar (cetaphil soap and retin-A micro). Good luck!

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I heard once that purging isn't true. That it isn't necessary, that it is just an excuse for irritation and such. Is that true?

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retin A is keratolytic and comedolytic, and may improve the appearance of hyperpigmented skin. Side-effects, which tend to diminish over time, include peeling, dryness, irritation and a flare in acne over the first few weeks of therapy.

A product/ingredient is keratolytic if it encourages the shedding of corneocytes (dry outer skin cells) from the stratum corneum or outermost ‘horny layer’ of skin by dissolving the intracellular cement of lipids, ceramides, etc; and otherwise softening the horny layer.

A comedone is a clogged pore (from sebum [oil], dead skin cells). A product/ingredient is comedolytic if it unclogs comedones and helps prevent their future formation. Comedolytic agents often increase cell turnover and increase desquamation (shedding of outermost skin cells, ie: corneocytes).

So the Retin A is increasing your cell turnover and shedding your outer skin.

So increased cell turnover may = increased acne. If you don't wash your face proberly then the shedded skin will deposit in your pores and block them = increased acne.

If you have pussy pimples and not just comedones then you need to use an antibiotic or BP to get rid of the bacteria that cause them. A lot of people find antibiotics useless and so use BP. In addition an antiinflammatory could be used. Some people use ice to get the inflamation down.

You must wash your face inbetween retin A and BP.

A good wash, which is also comedolytic is one containing salicyclic acid 2% at a ph of around 4. This'll wash away those dead skin cells clogging your skin.

If you are getting cysts then Retin A doesn't do anything to help them, so depending on how bad, you could consider hormones such as diane35ed or spironolactone (or accutane) for those. Otherwise you may have to just ride them out.

It took me at least 6 months with Retin A to see any effects, which is more the usual than the exception. I also had microdermabrasion on top of Retin A, because the retinA wasn't strong enough to expel my comedones. I also used nose-off (or nose-on) strips to expel the comedones from my nose and chin after using retin a for awhile.

Good Luck

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There is nothing wrong with going to your derm at the 12-week (3 month) mark and saying... this isn't working for me. I did it with Differin, and we came up with a new course of action. The thing with acne is you can't settle if your not happy. If you keep pushing your derm, that is how you get results!

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wow guys!

thank you soooo much for the helpful advice!

i was initially using benzaclin in addition to the RAM-however, when my derm. put me on tetracyclin and yaz she told me i wouldn't need the benzaclin anymore, that tetracyclin would do the trick.

in over a month tetracyclin has not done anything. last week i discontinued tetracyclin and today i applied a small amonunt of benzaclin for 45 minutes as it is super drying to my skin.

last month when i initially complained about the excessive purging-derm. told me to use RAM every night-and if possible 2X a day! using RAM every night for a month actually increased the purging, but i figured my derm. knew what she was doing.

this week i cut down use of RAM to 3X a week-my skin is NOT PURGING NEARLY AS MUCH!

i have an appointment next week to see derm. again to figure this out. it's been 3 months and the excessive purging is really taking a toll on the sides of my face!!!!

YOU ALL HAVE REALLY OFFERED SOME BRILLIANT ADVICE, AND I APPRECIATE EVERYONE WHO TOOK THE TIME TO RESPOND!

acne.org has been a life saver!

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wow guys!

thank you soooo much for the helpful advice!

i was initially using benzaclin in addition to the RAM-however, when my derm. put me on tetracyclin and yaz she told me i wouldn't need the benzaclin anymore, that tetracyclin would do the trick.

in over a month tetracyclin has not done anything. last week i discontinued tetracyclin and today i applied a small amonunt of benzaclin for 45 minutes as it is super drying to my skin.

last month when i initially complained about the excessive purging-derm. told me to use RAM every night-and if possible 2X a day! using RAM every night for a month actually increased the purging, but i figured my derm. knew what she was doing.

this week i cut down use of RAM to 3X a week-my skin is NOT PURGING NEARLY AS MUCH!

i have an appointment next week to see derm. again to figure this out. it's been 3 months and the excessive purging is really taking a toll on the sides of my face!!!!

YOU ALL HAVE REALLY OFFERED SOME BRILLIANT ADVICE, AND I APPRECIATE EVERYONE WHO TOOK THE TIME TO RESPOND!

acne.org has been a life saver!

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Slightly off topic, but someone above mentioned washing their face to get rid of dead skin etc... When i wash my face, i don't use anything apart from water. I splash it on for about 40seconds and rub my face with my hands whilst spashing the water on.

Is this adequate, or do i need a proper face wash?

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Slightly off topic, but someone above mentioned washing their face to get rid of dead skin etc... When i wash my face, i don't use anything apart from water. I splash it on for about 40seconds and rub my face with my hands whilst spashing the water on.

Is this adequate, or do i need a proper face wash?

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Slightly off topic, but someone above mentioned washing their face to get rid of dead skin etc... When i wash my face, i don't use anything apart from water. I splash it on for about 40seconds and rub my face with my hands whilst spashing the water on.

Is this adequate, or do i need a proper face wash?

That is often debated on these boards - I tend to use face wash at night, but not in the morning... but to each his own

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If you are using water based products then a water wash will wash the product off and if you use a cloth it will also get rid of the dead skin cells. Water will also wash away dead skin to a degree.

If water is not enough and you want the wash to positively get rid of the dead skin cells, grime and comedones within your pores then salicyclic acid washes are a good option.

Some people can be irritated by using too much exfoliation/acid and so stick with water. Some people find they break out with water.

Do a check. If you wash with water at night and the next morning check with a magnifying glass how many blocked pores you have (do this a few times). Then use a wash and check the next morning how many blocked pores you have (do this a few times). The wash should esentially prevent or reduce the number of blocked pores you normally have, so if it's not doing that then use another wash.

Also I looked again at the regimin you have.

AM-

La Roche Posay-effaclar purifying gel cleanser

DDF ultra lite oil free moisturizing dew

Dr. Hauschka normalizing day oil-2 drops

Reviva vit. e stick-under eyes+lips

PM-

Organic jojoba oil+cotton ball-remove make-up

Kose white powder wash-as needed

Moisturize as above-Dr. Hauschka/DDF

Reviva vit. e stick-under eyes+lips

Neosporin-treat scabs+peeling

retin-A micro-3X/week

benzaclin-as needed

acidophilus-2 a day

yaz

no dairy

increase water consumption

I don't know what half the stuff you are using is, but when my derm put me on retin A, he said i had to use absolutely no make-up, no suncreens (use a hat), no moisturizers or anything oily on my skin otherwise I would be adversly affecting the treatment. I even had to stop using oxy10 because it was a moisturizing bp.

For example some moisturizers work by sticking dead skin cells onto your skin and making them look alive and making your skin somewhat thicker, which is the opposite of what retin A does, which is shedding those dead skin cells and making it thinner. Other mositurizers soak into the skin, have minerals etc that may provide your skin with some food and are absorbed by your body. Some do both.

However if you soften your skin with these oils/moisturizers, such as jojoba, some people have reported that their dead skin comes more easily off when you wash it, so they are using these to increase shedding of dead skin cells by softening the outer layer of skin and then washing the dead skin off.

I would say if you are following the regimen above then you need to go through each item, determine why you are using it and what it does to your skin and comedones and pussy acne, and then eliminate some items or add some items to ensure that what you are using is working the way you want.

My advice is as a start use current proven techniques and try to ignore popular advice such as "drink more water" because there is no proof that e.g. "drinking more water" improves your acne at this point in time. Ignore nearly everything you read on commercial products, they promise the earth yet deliver zip. You can get good info from Paula's Choice Books, some books on acne e.g. Acne RX, Dr Terry Dubrow's, Dermotologist web sites etc. MakeupAlley has a good reference section, which is where I got some of the above info from. Once you can control your acne with proven techniques, likes dans regimen, retin A micro, hormone treatments etc then you can maybe add e.g. jojoba oil, omega 3, sunscreen, make-up, drinking more water etc to your regimen and see if they help or worsen your condition.

Retin A works by shedding the skin and releasing the comedones and other stuff which clog your pores, and providing and environment where it is difficult for your pores to get clogged, so if you are using something else that continually clogs your pores then it won't reduce the number or clogged pores you have and thus won't reduce the acne you have. If you just touch your face then you are pushing dirt, skin etc into your pores and clogging them, so alot of people stop touching their face when they go on acne treatment.

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