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didi78

Duac and Differin for my adult acne

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I decided to move to Personal Regimen Logs to track my progress with duac and differin. Thanks for everyone who helped me figure out the best way to start duac and differin (I had a nightmare dermatologist who was not helpful).

HISTORY:

I am 29 year-old and have a history of acne, off and on, since I was 19 years old (so definitely adult acne). This time around, I started breaking out last year, possibly triggered by oral birth control. Usually, problems occur around my chin area, consisting of 1 or 2 large cysts a month that would last for weeks (due to scaring, hyperpigmentation, or they would be hard and dormant under the surface). I also would have smaller inflamed pimples on my chin and lower cheek. I tried using the regimen, which helped but didn't seem to provide long-term benefits. Also tried using alpha hydrox souffle, which helped with smaller pimples and hyperpigmentation, but not with the large cystic pimples I would get. Zeno made the large pimples get even larger!!! Finally got fed up after trying these things for a year, so I went to the dermatologist, who prescribed duac and differin gel (0.1%)

WEEK 1:

Differin every other night.

And the morning after, I put a very very thin layer of duac all over (hoping this will minimize IB caused by the differin).

And then on the nights I don't use differin, I just spot treat with duac (to minimize dryness).

I plan on decreasing my duac usage if I experience too much peeling. but i can't help but use it because i feel like it will help a lot with my inflamed white heads and cysts.

So far, my symptoms include:

1. small, red bumps on one side of my cheek, which may be an IB caused by differin.

2. 1 or two small, inflamed whiteheads.

3. an old deep cyst is finally coming out with a whitehead.

4. some dryness and peeling, but I'm moisturizing a lot with Complex 15 (about 20 minutes after I apply differin, but I will up it to 30 minutes based on your advice).

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WEEK 2:

Just wanted to give everyone a quick update. So it's my second week using differin every other day and all over or spot-treat with duac depending on how my skin feels, and so far there has been mixed results.

Improvements:

1. My little red bumps on one cheek all went away and is smooth.

2. The rough spots of my skin has gone away and is now soft.

3. My complexion seems smoother and more "glowy" than it was. Also, softer to the touch!

4. The pimples that generally turn into large cysts DON'T anymore. They are smaller and go away faster.

5. wearing slightly less concealer than I usually do.

Negatives:

1. Still getting some breakouts, especially in my problem areas. I tried to up my differin to once a day, but I noticed that that made my skin break out more, so I'm cutting back and slowly increasing the differin.

2. Skin still pretty oily.

3. Still have old, darker pigmentation scars.

4. Very mild peeling, but I think using cetaphil and complex 15 really helps. I'm thinking of adding jojoba oil into my regimen, but not sure how.

Hopefully it will slowly improve! I am pretty esctatic that my pimples are generally smaller and more tolerable than usual.

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A few more days into WEEK 2:

Major breakout on my chin. :( I think it's the dreaded breakout that occurs during week 2 to 3. I have about 5-6 small inflamed pimples on my chin, and 1 larger pimple that probably would have turned into a full-blown cyst if it weren't for differin and duac. Hopefully it will go away! Definitely a lot WORSE than what I usually get, which is 1 or 2 pimples on my chin...I never have so many at the same time, but they are milder than they can be.

My cheeks have a smoother quality to them and are relatively smooth except for 3 very small red dots. My forehead has 2 small red dots too from using differin (I normally do not break out over there), but nothing major.

Still using differin every other day, sometimes 2 days in a row so that my skin can start getting used to daily application. My skin is peeling more, especially on my chin where all the problems are. Maybe I should cut back on the duac, but I feel like I MUST use it to combat the inflamed pimples I have right now.

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Hi Zitophobe. Thanks for your continued support and kind words! :D

Week 3:

Hmmm, I'm thinking it may be more accurate if I start counting the days I've been on my regimen. I started on 1/22/08, today's 2/11/08 so it has been exactly 21 days since I've started.

My skin has a "glow" to it, but I can't tell if it's from clarity or oil. I think it's much oily and shinier than it used to be. My coworker commented today that my skin looked "sweaty", but it was in response to me telling her that I was sick and feverish. hahaha. She said, "well, your face does kinda look sweaty." Not sure if I like the glow, sometimes it seems reflective and slightly unnatural. But am I complaining about having glowy skin???

My flareup from a couple of days ago have gone done substantially. There are still two stubborn pimples remaining on my chin, right next to each other so they touch...they would have turned into a giant cyst if it weren't for the differin/duac. Now they are just little hard whiteheads that have been there for over a week. The other smaller inflamed pimples sorta became white, then hard, and then "fell off". I am also still getting smaller red pimples all over my face, but they don't become as inflamed as they used to rather they are like little red dots. There are also lots of hyperpigmentation on my skin, so I am still using makeup to cover up.

I started using differin every night since Friday (today's Monday), and so far so good. No big flareups since, but some peeling. I used Pond's microdermabrasion gently to get rid of the peeling/flaking, and it did a really good job.

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Week 3, Day 23

Other than those two stubborn whiteheads that are right next to each other and won't come out and also a tiny red dot between my eyes (barely noticeable), I actually have no new pimples!!!! I feel so excited! Hopefully that means my initial breakout is over and done with, but then again, I'm crossing my fingers about. You never know what will happen!

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YICKS! I JINXED MYSELF! Spoke too soon. I just noticed a very tender, painful spot on my chin. Looks like the beginning of a cyst. It will be interesting to see how this cyst progresses with duac and differin. I'm going to get my hands on some aleve in the meantime.

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Week 4: Day 28

I'm at a BAD place. I have 4 cysts on my face!!!! And they are not going away. I have NEVER had so many at once before, so it must be triggered by differin. I tried the Aleve, but it doesn't seem to be helping. I've had them for 5 days now and i don't think they are going anywhere anytime soon. The two whiteheads that were close together combined and became a giant cyst, and also that tender spot became a cyst. 3 on my chin. And a brand new one (the 4th) right on the bottom of my nose....it's not as noticeable due to the location. And there's a possible 5th one on the corner of my mouth, but it's not a full blown cyst yet. I think I read somewhere that differin gives people cysts! I HOPE THAT'S NOT TRUE. I hope this is just part of the initial breakout!!! :(

The rest of my face has become VERY FLAKY. My lower face is so dry that it looks very noticeable and embarassing. I was embarassed at work and felt ashamed (especially with the 4 cysts on my face). Very depressing.

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Week 4: Day 28

I'm at a BAD place. I have 4 cysts on my face!!!! And they are not going away. I have NEVER had so many at once before, so it must be triggered by differin. I tried the Aleve, but it doesn't seem to be helping. I've had them for 5 days now and i don't think they are going anywhere anytime soon. The two whiteheads that were close together combined and became a giant cyst, and also that tender spot became a cyst. 3 on my chin. And a brand new one (the 4th) right on the bottom of my nose....it's not as noticeable due to the location. And there's a possible 5th one on the corner of my mouth, but it's not a full blown cyst yet. I think I read somewhere that differin gives people cysts! I HOPE THAT'S NOT TRUE. I hope this is just part of the initial breakout!!! :(

The rest of my face has become VERY FLAKY. My lower face is so dry that it looks very noticeable and embarassing. I was embarassed at work and felt ashamed (especially with the 4 cysts on my face). Very depressing.

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Thank you Merf for your support! The weird thing is, my cystic (like 1-2 cysts a month) was triggered by me beginning birth control pills (ortho tri cyclen lo) and I was on them for about 6 months. I stopped, but my cysts did not go away. I'm not sure if it's a hormonal imbalance but I did just realize that I get my cysts 2 days before ovulation. At this point, I'm too scared to start any new birth control.

I hope you're not too depressed and I hope you're at a better place than I am. But thank you so much for your kind words! :)

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Week 4, Day 29:

My cysts are still as big and dark red as ever! It's been almost a week since I've had the ones on my chin, and they really are not subsiding, even after taking Aleve for a good 5 days. The pimple on the corner of my mouth is definitely a small cyst. And the one under my nose is pretty inflamed as well.

My skin has been flaking like crazy so I took a day off differin. Guess I shouldn't be using it every day, rather I should use it like 4-5 days a week. I also have been adding 1 tiny drop of jojoba oil to my daily moisturizer, which seems to be helping. I'm trying not to exfoliate the flakes off because my skin seems a little tender. Hopefully, my cysts will be smaller by the time weekend rolls around. I feel so embarassed and just want to isolate myself from other people. Luckily, I have an amazing fiance who loves me no matter what.

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Called my dermatologist to tell him about my cystic breakout and he prescribed Minocycline 100 mg, 2x a day, for 1 month. Not sure if I want to try it because of fear of dependence and possibly breaking out worse once I stop it. I may take it 2x a day for 1 month and then slowly wean myself off by taking it 1x a day for a week, then every other day for the 2nd week, and then every 2 days the 3rd week, etc. Not sure if i'm up to the side effects though...I tend to have GI issues already and not sure if I want to aggravate my GI tract.

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Week 5:

My cysts are still there, but much smaller in size with no inflammation. They somewhat popped "uncleanly", so that although they are less swollen and don't protrude as much, I can still feel bumps under the skin. I am also nervous about a new bump on the other side of my chin...afraid it will turn into another inflammed cyst! As soon as I felt it, I took 2 Aleve (to jump start the anti-inflammatory effect), zapped it with Zeno, and applied lots of duac on it. So far, it is still just a bump inside my skin, not yet inflammed, though I feel like I'm just delaying the inevitable. :( The rest of my skin is better. Most of the little bumps that erupted last week have disappeared. I have noticed a "reddish" tint to my complexion and wonder if it's due to the differin. I really hope that differin/duac works after a few more weeks and am impatient to see the results.

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HI Didi, I'm sorry you are getting cysts! I am also on Differin mixed with moisturizer every other night. I have 2 large cysts at the moment and various stages. I have been on Differin before and I got cysts with it but they eventually went away. Have you been taking the Mino? I have noticed that it does help me and I stopped using it after about 5 months (the mino), because, like you, I didn't want to be dependent on it. But it does help with the initial break out. I'm sure it will continue to get better for you! I think it is just a super slow process!

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Hi Cuddlebug!

In the middle of Week 5 and the "inevitable cyst" has definitely become a cyst, but less inflamed and less painful than the other ones I had from last week. Maybe it was the Zeno that did it, maybe it killed off some of the bacteria. The one under my nose from last week just popped last night, but now it is very red. I am also struggling with red/brown hyperpigmentation scars from previous pimples. Considering using lemon on it but afraid it will irritate my skin since I'm on differin.

I actually decided NOT to take the minocyclin that my dermatologist prescribed for the following reasons:

1. Gastrointestinal side effects: I already have IBS (irritable bowel syndrome) and really cannot take any more GI problems.

2. Dependency factor: I don't want to become dependent on it and have to take it forever.

3. Post-breakout factor: I don't want to break out again once I stop taking it.

HOWEVER, I have decided to take 50 mg of Zinc just to have some kind of internal treatment (be treated inside and out). I've read that it can help with hormonal acne, so hopefully it will help me control my cyst problem. I also read that Desitin (for diaper rash), which is 40 mg of zinc oxide, can help with the inflammation of a cyst, so maybe I'll try that on my cysts to see if that works.

Otherwise, I'm sticking with my regimen. Still using differin almost every evening, sometimes taking a break if my skin is feeling sensitive or is peeling (like last night). I am trying to use less of the duac as well since I don't think it's helping with my cysts and may just be causing peeling.

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Week 6:

So my cysts have died down but they have left dark red/brown marks. I found that taking zinc supplements (50 mg of chelated zinc gluconate) internally, and applying zinc oxide 40% (Desitin for diaper rash) externally on my cysts really helped them heal and shrink in size. Basically, I applied Desitin on my "inevitable cyst" that was coming out on my chin and then covered it with a small round bandaid. I did that every night for a few days and the cyst just never grew into the usual big size. It was probably 50% smaller than the other cysts that I had and it never hurt like they usually do. I can't tell if it's the Desitin or the zinc supplements that helped with the inflammation, but I think it's a combination of both. Now, that cyst is still there, but it's just a brown bump, way better than my other scary cysts.

I also read on this forum that BP can cause red marks and prevent them from healing properly. I noticed that when I look at my face, the imperfections that I see aren't active pimples/cysts, rather, they are just hyperpigmentation from old pimples/cysts during my initial breakout. So I made a decision to stop using duac, which is 5% BP. Basically, right now, the worst thing about my skin are the red/brown marks. I can't wait for them to go away so I can stop using concealer!!!

So I changed up my regimen a bit. I decided to replace duac with a more natural bacteria killing agent: tea tree oil! Though tea tree doesn't have the antibiotic component that duac has, I think I want to give my red marks a better chance to heal. Also, I think the zinc supplement is helping with inflammation, so I'm not too nervous about losing the antibiotic in duac. I am also including an AHA to help with the red marks. Previously, I wanted to re-introduce my favorite AHA product which is Alpha Hydrox Souffle; however, I think that may be too harsh with differin and would really complicate my regimen. So I'm going to start using my favorite AHA peel, which is the MyChelle Incredible Pumpkin Peel.

My new regimen:

AM

1. Wash face with origins checks and balances face wash.

2. Use a q-tip and dip into tea tree oil. Dillute the tea tree oil on the q-tip with water. Then apply to my problem areas. TINGLY!

3. Wait to dry, then apply Complex moisturizer

4. Apply shiseido sunscreen (I've been using this brand for 10 years).

Noon

1. After a full lunch, 50 mg of zinc gluconate.

PM

1. Wash face.

2. Apply MyChelle Incredible Pumpkin Peel (a few times a week) for 5 minutes.

3. Apply differin to face (I also started to put it on my neck because it looks older than my face).

4. After 20 minutes, moisturize with Complex.

I've only done this new regimen for 2 days, and so far so good. No new pimples, still the same old cyst scars, but I have noticed that the red/brown marks look a bit lighter, which I believe is due to my pumpkin peel. Wish me luck!

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Week 6:

So my cysts have died down but they have left dark red/brown marks. I found that taking zinc supplements (50 mg of chelated zinc gluconate) internally, and applying zinc oxide 40% (Desitin for diaper rash) externally on my cysts really helped them heal and shrink in size. Basically, I applied Desitin on my "inevitable cyst" that was coming out on my chin and then covered it with a small round bandaid. I did that every night for a few days and the cyst just never grew into the usual big size. It was probably 50% smaller than the other cysts that I had and it never hurt like they usually do. I can't tell if it's the Desitin or the zinc supplements that helped with the inflammation, but I think it's a combination of both. Now, that cyst is still there, but it's just a brown bump, way better than my other scary cysts.

I also read on this forum that BP can cause red marks and prevent them from healing properly. I noticed that when I look at my face, the imperfections that I see aren't active pimples/cysts, rather, they are just hyperpigmentation from old pimples/cysts during my initial breakout. So I made a decision to stop using duac, which is 5% BP. Basically, right now, the worst thing about my skin are the red/brown marks. I can't wait for them to go away so I can stop using concealer!!!

So I changed up my regimen a bit. I decided to replace duac with a more natural bacteria killing agent: tea tree oil! Though tea tree doesn't have the antibiotic component that duac has, I think I want to give my red marks a better chance to heal. Also, I think the zinc supplement is helping with inflammation, so I'm not too nervous about losing the antibiotic in duac. I am also including an AHA to help with the red marks. Previously, I wanted to re-introduce my favorite AHA product which is Alpha Hydrox Souffle; however, I think that may be too harsh with differin and would really complicate my regimen. So I'm going to start using my favorite AHA peel, which is the MyChelle Incredible Pumpkin Peel.

My new regimen:

AM

1. Wash face with origins checks and balances face wash.

2. Use a q-tip and dip into tea tree oil. Dillute the tea tree oil on the q-tip with water. Then apply to my problem areas. TINGLY!

3. Wait to dry, then apply Complex moisturizer

4. Apply shiseido sunscreen (I've been using this brand for 10 years).

Noon

1. After a full lunch, 50 mg of zinc gluconate.

PM

1. Wash face.

2. Apply MyChelle Incredible Pumpkin Peel (a few times a week) for 5 minutes.

3. Apply differin to face (I also started to put it on my neck because it looks older than my face).

4. After 20 minutes, moisturize with Complex.

I've only done this new regimen for 2 days, and so far so good. No new pimples, still the same old cyst scars, but I have noticed that the red/brown marks look a bit lighter, which I believe is due to my pumpkin peel. Wish me luck!

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MERF. Thanks for that info! I have never heard of that supplement and it definitely is something I am going to look into. For now, I'm going to continue my zinc since it is working, and I'll also look into DIM and see if I want to add that to my regimen. THANK YOU!

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Week7:

So I've been substituting tea tree oil for duac for almost a week now, and so far so good. I had a few small red bumps though, but they went away within a day or two. I don't know those bumps were caused by not using duac or if it's from the AHA that I've been introducing into my regimen. My cysts still have dark red pigmentation and you can still feel bumps underneath the skin, but definitely better than before. Also, I have two old cysts that sorta have a tiny pimple bump on the surface that looks like a whitehead, but it's not. Hopefully they'll go away.

I just took a look at pictures that I took during Week 1, and comparing my skin then to now, there really isn't noticeable difference. Guess that's disheartening. I guess my overall skin looks smoother with smaller pores, but I actually have more hyperpigmentation now than I did before I started this regimen. It's all from the IB from week 4-6. :(

Also, my ovulation week is approaching, so I'm feeling nervous about the possibility of getting most cysts. Hopefully the zinc supplement I'm taking will help with that.

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Im on Week 10 with my Differin. I was originally prescribed on Duac and Differin but my skin always seemed to be really irritated with Duac and it was making my face red all the time. I decided to drop Duac when I was on Week 8 or so and so far my face is looking better than ever. My face is no longer red and I think Differin is starting to kick in as my face is starting to noticeably clear up. I remember around Week 7 my face was also the same if not worse from when I started my regimen so keep at it! Remember, many people don't see results until Week 12. Good luck!

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Thanks Axsuul! So far I haven't experienced any bad reactions as a result of stopping duac, so I don't plan on using that anymore, at least for the short-term. Thanks for your kind and supportive words.

Week 8:

I think my tea tree oil regimen is going well because i'm not getting any big pimples, though some small ones that go away in a day or two (which is nothing). And I think I'm getting those small dots from introducing AHA/BHA into my regimen. AND NO CYSTS LAST WEEK, which is my ovulation week...the week I ALWAYS get at least one big cyst! I don't know it's my regimen kicking in, or if it's the zinc I've been taking, or if it's the aleve I took last week....but regardless of what it is, it's working! NO CYSTS!!!! WHOOOO HOOOO!

What's still bugging me though are my red/brown pigmentation from previous cysts and smaller pimples. I still can't go out without makeup, which upsets me. Last week, I tried using my pumpkin mask and also Alpha Hydroxy Souffle, but my skin stung, so I stopped using it. Then I thought to use my Paula's Choice BHA to help exfoliate and lighten hyperpigmentation. I read that you can apply BHA FIRST, then Differin afterwards, which is supposed to increase the absorption of Differin. So I tried that for a few days but found that my skin began to peel, and also I was getting a cluster of very small dots on my chin that went away in a few days. So now I'm using the BHA every other day (before Differin), and using Differin every day still. Still tweeking and perfecting my regimen. I may begin to use BHA's during the morning and Differin at night, just to decrease irritation and peeling, but then I don't know where to fit in my tea tree oil, which I currently use in the morning.

But no significant pimples, NO CYSTS! YAY!

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Still trying to figure out whether or not to use AHA or BHA. Anyone have any thoughts about this?

I feel like BHA is making me break out into tiny pimples, nowhere near the cysts I used to get, but still bothersome.

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Hi didi-When I used BHA or AHA- I always break out in tiny pimples and my skin looks really red, so I don't use it but some people say that it purges your skin, so that is why you get little pimples. Does your skin feel irritated or red other then from the Differin? Hope you find a regimen that works for you!

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hi cuddlebug! thanks for the advice. I have since stopped using AHA and BHA. I felt like it was giving me tiny pimples, or maybe it's a second IB with Differin? No irritation, no redness, still a slight peeling at times, but otherwise not too irritated. So guess the acids weren't irritating me, but they were giving me tiny red bumps. I'm feeling slightly frustrated that after 9 weeks of differin, I am still breaking out. Granted, pimples are smaller; however, shouldn't it be pretty clear and stable at this point? Guess I won't have high expectations until after 12 weeks.

So WEEK 9:

Still no cysts, which I'm feeling anxious about. I feel paranoid that one will pop up any minute, especially now that I'm on my PMS week. Last month, I got a cyst during my PMS week (though I normally get them during my ovulation week), I think due to the initial breakout due to differin. Still, I don't trust the lack-of-cysts yet. I had a scary moment today where I thought I felt a tender spot on my chin (indicating the birth of a cyst), but it just turned out to be nothing. RELIEF!

I have several small red pimples on my checks and even my forehead. I NEVER GET PIMPLES ON MY FOREHEAD? I can't tell if it's another IB from differin, or if it's from my AHA, BHA use, so I stopped using all acids and am focusing on differin and tea tree. I also started using a new bottle of Complex 15, this time is the thicker body lotion form (not the face cream), which actually absorbs better and feels better on my skin.

SO I guess I've yet again simplified my regimen.

AM: Teatree oil, complex 15, shiseido suncreen.

Noon: Zinc 50 mg

PM: Differin, complex 15.

Guess TIME is the only thing that's helping with my red/point marks at this point.

Oh, I'm going to take an Aleve tonight, just in case.

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Middle of Week 9:

So most of the red little bumps that were on my cheek and forehead have gone away. There are still some there, but mostly gone. :) However, I did wake up with two small, inflamed zits with tiny whiteheads on my nose and chin. I took an Aleve just now to help with that, and also dotted them with a bit of duac (which I've stopped using 99.9% of the time) for anti-inflammatory purposes. Overall, I think my complexion looks more stable and smoother.

I'm getting my period tomorrow so maybe these little bumps were due to a combination of PMS and BHA/AHA reaction.

I would say that I'm more haunted by my scars than anything else. I still can't leave the house without putting concealer on those spots, but I do think that they are fading very very slowly, so I'm using a tiny bit less of concealer than I usually do. Not enough to be significant though.

Another thing is my face overall is EXTREMELY OILY. It's like an oil slick. I have to oil blot twice a day, and both times it's disgusting how oily those oil-obsorbant papers are. So Differin, tea tree, and zinc hasn't really helped with the oil factor. I'm considering taking vitamin B5 but I'm scared that my already thinning hair (from stress) will thin even more if I take therapeutic levels of B5. So I'm staying away from that for now. I can live with oily skin more than i can live without hair!

I'm getting married in 6 months and hope that my skin will require no makeup by that time! :)

Update of Regimen:

AM.

1. Origins checks and balances facial wash

2. 100% tea tree oil, dilluted with some water (all over problem spots)...wait a few minutes

3. Complex 15 lotion

4. Shiseido SPF 50 sunblock.

Noon.

1. Chelated Zinc 50 mg

2. (1 tablet of Aleve if during ovulation or PMS week, for 3-4 days)

PM.

1. Origins checks and balances

2. Differin...wait 20 mintes

3. Complex 15 lotion

4. (dab on Desitin if needed, on inflammed acne or cysts)

6. (Exfoliate maybe once or twice a week with St. Ives or Dove's microdermabrasion)

7. (1 tablet of Aleve if during ovulation or PMS week, for 3-4 days)

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