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Retin-A + BP for Hormonal Cystic Adult Acne?

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Hi!

I'm a 35 year old woman with hormonal acne that presents as cysts (painful, red and full of stuff), usually 1, 2 or (rarely) 3 at a time during ovulation week. They stay for at least a week, sometimes 2 and they are HUGE, so though the rest of my face is clear pretty much all the time, these 1 or 2 pimples really make me feel self-conscious.

I've been using Retin-A cream .1% for the last year; before that I had the gel which was better, same strength, and used for the previous maybe 2 years. I also used Finacea cream during the day, and occasionally spot-treated with BP (though it never worked and always seemed to make things look worse/too dry/more noticeable). It seems that in the last 4-6 months the Retin-A stopped working to control my hormonal acne, and in desperation, I started the regimen a week ago.

After about 8 days on the regimen, the 2 big bumps I started with on my face are still the only thing there but have gone down quite a bit, though they are still red -- something I'm not used to since the Retin-A always made pimps, red spots, etc. disappear really quickly after they were "dead." My face is dry, beet red and looks awful.

My question for those of you w/experience is this: I'm worried about going off the Retin-A for too long, since it took so long to get used to (IBs, adjustment) and I like the wrinkle-fighting power. I just know that I need something stronger/different for the hormonal stuff that comes out on ONE side of my chin/lower cheek once a month, always in the same exact spot.

Options I'm considering: Using the Retin-A at night and the regimen during the day only on the effected area, asking a derm for the Retin-A gel and trying that again w/modified regimen during the day, getting off RA all together and doing a salicylic acid/BP combo (another thing I tried once at a derm's suggestion and worked for a while) or using the AHA I've already bought but not used (too soon on regimen) for anti-aging...???

If anyone with experience in this area could give me feedback, I'd appreciate it. I feel like the insane irritation my skin is experiencing w/the regimen is overkill for the 2 zits I get every month, but on the other hand I'm reeeeeally sick of those 2 zits and how they take over my whole face for 2 weeks out of every month. These are not just little bumps, people, but monsters.

Anyone had similar experience and found something that worked for them?

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