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Alright everyone, I need some help here. So I've tried numerous prescription medications just like everybody else has. And after awhile they slowly start to not work anymore. But I've finally found one that I've been using for a few months that seems to do alright. It's called Ziana. I'm sure most of you have heard of it. My dermatologist told me it would get rid of moderate/severe acne and keep it from coming back but of course that is all bologna because after it goes away, a week or two later it will come back in the exact same spot.

It's not that I have horrible severe acne. I find that my main problem is that the only type of acne I get is nodules. I don't get the easy-going whiteheads that dry up and go away after a day or two. I always suffer from nodules that stay for countless days to weeks. I'm starting to notice that this Ziana is not working as well as it used to. Currently I have a couple nodules on my forehead and on my jaw line.

What I need is something new. I do not want to continue using Ziana. I have read that it makes you break out horribly if you quit cold turkey so I'm trying to wean myself off of it slowly but surely. But I do not want to end up doing nothing about my acne in the end. I've found that sometimes vitamin E skin care cream helps to lessen the severity of the nodules and reduce the swelling and redness. I am just scared that the vitamin E will eventually start to make me break out. I also use a benzoyl peroxide facewash in the morning around 6 and also at night around 10 or 11.

I was wondering if anybody had any suggestions as to how to switch this up so the nodules will not reappear as much? The Ziana just dries out my skin and doesn't do much for the acne. I have a hard time finding a good treatment because most require you to apply it in the morning and at night but seeing as I have to go to school, I don't like to go with a bunch of crap on my face or having my face be all oily and nasty.

I also suffer from acne on my chest, shoulders, and back. There is barely any on my chest, although there is numerous annoying tiny scars, which I hope the vitamin E can help out with without causing more acne. On my shoulders its usually small pimples, not that many, but then on my back sometimes I get a few nodules every once in awhile. Body acne seems even harder to work with because I apply Ziana at night but laying in bed will irritate my skin. I have very sensitive skin also.

I apologize for the length of this post. I've never posted anything on this site before and I just need some help! So please, any suggestions for the nodules on my face would be fantastic!

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Ziana is a strange combo tretinoin and topical antibiotic. If its starting to stop working that suggests that it was the antibiotic part of the cream causing the improvement which the bacteria are now becoming resistant to. Having said that tretinoin is a very powerful topical, but takes a long time to work :P.

Personally i wouldnt use retinoids or antibiotics, because retinoids are very hit and miss and antibiotica in the long run only make it worse.

Id advocate swapping to a benzoyl peroxide cream, consider following the regiman, or maybe just spot treat - it works both ways, which is what i love about BPO.

If BPo doesnt work i also advocate photopherapy, you can buy lamps on the internet that either give out blue, red or UV light, although id avoid UV (cancer and all that) - these are supposed to be surprisingly effective. :) - well i find it surprising anyway :o

Diet is also something you should consider - give up dairy is my main advice. No other creature on this planet would eat dairy after infanthood, only we and omesticated cats drink it and :o surprise acne is only a symptom shown in humans and domesticated cats.

If your body acne does start to turn extensive and uncontrolable you should maybe consider accutane :(

Anyway good luck with whatever you decide to do

Edited by Claudio

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Try playing with diet and supplementation. I don't know this for a fact, but I get the impression from my experience that nodules and cysts are even more directly related to something "internal." That's not to say that a topical can't help a bit, but it doesn't seem to be as effective.

If you haven't toyed with the idea of giving the "no-dairy" diet a trial run, you should. Plenty of people benefit from that one. Beyond that, I'm a fan of diet and supplementation as a whole. Look into zinc, inisitol hexanicotinate, pantothenic acid, and some of the other stuff people mention on the forums. If you aren't desperate/nearsighted enough to be crying for isotretinoin by now, try some of the "homebrew" methods people have been coming up with around here.

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Ah well thanks guys. So would you suggest that I try to get myself off of the Ziana? I suppose it doesn't work that much anymore and I'm guessing the longer I use it the worse things could be if I rid of it later. Last night I didn't use any Ziana and all I did was put a little bit of vitamin E cream on parts of my face and body. It didn't do much except reduce the redness a little bit. But I put it on again this morning and by tonight they have tremendously reduced in swelling size and feel like they are in the last part of the healing process.

As with the no-dairy diet things, I would suppose that I really already don't eat or drink any dairy. Unless you want to count milk with oreos once every couple months.

I was reading up about the AHA+ that the website sells. It seems like its a great spot treatment along with a good moisturizer. I'm wondering, since my acne isn't really over a large area, it's just a few moderately severe nodules, that maybe this AHA+ could help. I read something about how you shouldn't use it until you have been doing the acne.org regimen for a couple weeks because of benzoyl peroxide? But I am currently using a benzoyl peroxide facewash and have been for a couple months. Would you guys suggest maybe switch to the AHA+ instead of using vitamin E cream since the AHA can serve multiple purposes? Let me know please!

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best bet is to use bp with moisturizer in the morning and some retinoid like differin .3 in at night. I used ziana for over 2 years and it was great for 6 months but then it stopped working on my chin.

I switched over to differin with better results, though not exactly perfect. I still use Ziana on my forehead and it's just as affective... along with bp in the morning.

if you stop using ziana... you might get acne underground and once you start using somehting else you might get a bad or another "initial" breakout. So I would just keep using it but add something else in the mornings.

Edited by mboona

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