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Crabby_Patty

Just come back from the doctor!

Ok so I went to the doctors this morning to see about being referred to a dermatologist.

He asked me what i had tried and said that if I go to a derm they would try me on everything else before they even suggested Accutane ( I am not really aiming to go on this by the way it would a last resort), and that I he can give me those others things to try , which are things like oral antibiotics , Retin-A.

So basically I have not been referred to a dermatologist! The doctor has instead given me this concoction

Minocycline - 100mg to take 1 a day

Tretinion to apply in the morning

Azelaic Acid to apply at night

He said to take the antibiotics for 5-6 weeks and go back to see him. It just seems like alot of stuff, mainly the creams, I dont fancy putting both on my face everyday.

Does this sound like a typical regimin that a doctor would give? Which cream would be better to use?

I dont want to make everything even worse?

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Most likely, that is exactly the sort of regimen a dermatologist would have tried. Unfortunately, it isn't easy to get Accutane even when you have severe acne. I have been on 7 antibiotics, 6 different topicals, 2 types of birth control, and several other medications, and my derm is only now admitting (reluctantly) that Accutane may be the only solution for me.

I would give those medicines a try and see what happens. Maybe it will be what you need!

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Ok so I went to the doctors this morning to see about being referred to a dermatologist.

He asked me what i had tried and said that if I go to a derm they would try me on everything else before they even suggested Accutane ( I am not really aiming to go on this by the way it would a last resort), and that I he can give me those others things to try , which are things like oral antibiotics , Retin-A.

So basically I have not been referred to a dermatologist! The doctor has instead given me this concoction

Minocycline - 100mg to take 1 a day

Tretinion to apply in the morning

Azelaic Acid to apply at night

He said to take the antibiotics for 5-6 weeks and go back to see him. It just seems like alot of stuff, mainly the creams, I dont fancy putting both on my face everyday.

Does this sound like a typical regimin that a doctor would give? Which cream would be better to use?

I dont want to make everything even worse?

Yes, it does. I dont know why you need 2 creams though. I use retin-A .1% (tretinoin), and it works pretty well. Use it only every other day alternating with a moisturizer.* And be sure to use a gentle face wash, like Purpose or Clean & Clear sensitive skin.

Using tretinoin every night will irritate the $hit out of your skin and make it worse.

Good Luck

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thanks for the advice peeps! I think I may just try with one of the creams for now. To be honest I dont really fancy taking the Minocycline - from what i have read I cant seem to see any one who has had brilliant results from it. Plus will antibiotics only sort the problem out for as long as I take them?

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I'd consider taking the minocyclin but only for a month or two and then TAPERING the dosage down to avoid an acne flare or bloom that can happen with cessation of mino/doxy, other antibiotics.

The mino could help with the initial outbreak from tretinoin. The azelaic acid also has antibacterial properties.

I'm not sure why the doc recommended the order she did; retinoids are generally applied at night. You might try using the tretinoin at night and the azelaic acid in the morning but I'd go slowly with both to get your skin accustomed to them. If you do pick them up and your chemist supplies the prescribing information, please read it carefully to get an idea of the application method and how often to apply to get used to it. Sometimes the prescribing information or even the consumer information will have that information. I remember my package insert had that information on how to use the Retin A I used some 20ish years ago. :)

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I would second the suggestion of starting the retin-a slowly. Start out using it every other night or even use it- skip 2 days use it etc... wait 2 weeks go to every other night.. wait 3 weeks go to every night. Retin-a can irritate your skin at first and can also cause purging so ease you way into it! Antibiotics have never really helped me but you should definitely give them a try. Probably your dr. is thinking the antibiotics will counteract some of the purging you can get using retin-a and keep it in check while your skin adjusts. Good Luck!

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Well I decided to use the retin-a at night instead of morning. ( i have not started the antibiotics)

Its only been two days and already I can feel major cysts coming up. I have spot treated with the alzelaic acid in the morning.

Can you moisturise after applying the retin-a? and does retin-a help with oiliness?

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Retin-A dried me out terribly, but I was still oily underneath the flakes. I always give topicals about 20-30 minutes to set in, then moisturize over them. It's a MUST with Retin-A because your face will start peeling!

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well I have been using the retin-a for just over a week now, the major cysts that came up have gone down again pretty quick and my jawline ( where my acne is the worst) has gone down quite a bit too, I can still feel the cysts under the skin but the area is alot flatter - it is usually quite raised and bumpy with the cysts! I stil have lots of reds marks. I have some flakiness but that is mainly on the cystic spots themselves. So all in all it is an improvement.

But omg the oilyness! My skin has become soooo oily! Its normally oily anyway but has got worse. before the retin-a I was using Dermalogica Mattifier under my makeup which is really good at keeping shine at bay but even that is not working since starting the retin-a! I have started using an spf moisturiser which might be making me shiny

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Hey Crabby!

I was also gonna suggest using the tretinoin at night but it seems like you already are. The doc probably prescribed the Azelaic acid to get rid of red marks. That is what it is supposed to do. I was also prescribed tretinoin .025 and the first few weeks were horrid. I started getting way more cysts on my jaw than I have ever had but after the fourth week they really started to go down and my skin feels way smoother. There still are red marks but they are way easier to cover up now with makeup. As for the oiliness, my skin still feels super oily. It startes out fine then but mid day I have a slimy face. I hate that feeling. Good luck to you. Let us know how it turns out!

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Hi there CP: The following link is an excellent read to help you through your retinoid experience: http://www.acne.org/messageboard/Info-reti...ial-t98395.html

As others have mentioned, it's fine to moisturize after using Retin A. Wait at least 20 minutes after applying the retin A before moisturizing. Emu oil is marvelous, jojoba oil has adherents, or you could check out the recommended moisturizers: http://www.acne.org/moisturizers/rcat5/page1.html#browse

Make sure you're also waiting at least 20 minutes after cleansing before applying the Retin A! Your skin is disrupted even with the most gentle of cleansings so your skin needs to recover a bit before applying the Retin A. It's also a good idea to use a gentle cleanser like Purpose, Basic, or Cetaphil. Some derms also recommend Dove.

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Thanks guys.

Well I feel like I spoke to soon, my skin is not looking too great the last couple days. have not had any major big cysts break out but have noticed smaller whiteheads, also can really see my pores looking quite large and they seem to be filled with major gunk!! Gross I know.

Is this my skin purging out? I have read Labgirls post about the IB and it seems to make sense to what is happening to my skin right now.

I am going to check out the moisturiser reviews . Also can I have read on other threads that it is no ta good idea to exfoliate, but my skin looks so dull and a bit flakey. Can I use a scrub in the morning even just once a week or something?

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I would not exfoliate at all while you're getting used to the Retin A; it's exfoliating chemically for you. You risk getting very irritated and potentially having to stop all topicals while your skin recovers IF you exfoliate manually/mechanically while getting used to a chemical exfoliant.

It does sound like you're getting the initial breakout. Running an ice cube over your face (GENTLY!!!) twice a day can help soothe reddened skin. Try it, you might like it! :)

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just thought I would update if anyone was interested.

No real improvments but nothing majorley serious either, have had 2 new spots come on my right cheek and I can feel a small one on my jawline. ( I really need to control the need to keep touching and fiddling with my face). Still loads of red marks, although the red marks round my jawline and neck seem less angressive then usual.

I have been waiting a least 20 mins after cleansing like Wynne said before applying the retin-a and I only apply a small amount, I do find that after the retin -a has dried it starts peeling off!! It's like it just siiting on top of my skin and not sinking in!! Its like a film peeling off. Like I said I really try not to apply to much. I wait another 20 mins to moisturise and its starts balling up.

I can tell its strong stuff, when i apply it around my nose I inhale the stuff and it nearly knocks me out!!!! :wacko:

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