I started using my first retinoid regimen after 2 years of on and off success/failure with Dan's BP regimen. I had read up a lot on Retin A Micro and decided it was time to attack my acne with prescriptions. My acne at the time was moderate-severe. I had 4-5 smaller zits with usually between 1-3 active cysts on my face.

The dermatologist put me on a regimen of:

• Retin A Micro (0.1%) at night
• Clindoxyl Gel (BP 1% + Clindamycin Phosphate 5%) in the morning

I tracked my progress for the first 3 months or so and after a fairly mild initial breakout, I noticed my complexion GREATLY improving after the 40 day mark. At this point, I had maybe 1-3 small zits on my face at MOST, often times none. At the 3 month mark, it was so successful that I was actually considering options to heal my remaining red marks and left over scars (but never pursued any treatment for this). During this time, my face was peeling a moderate amount also.

In the last maybe 2 months, my skin has become progressively worse. Back to it's original state where I would have a 5+ small zits and 2-3 active long standing cysts.

I'm confused as to why the regimen has stopped working... none of my products are expired. I'm using the same moisturizer and cleanser. I'm very patient and TIME my drying/application times. And I'm consistently exercising and eating healthy like I was earlier on. The only variable that has changed is that it's winter now... but don't tell me that has such a huge impact. I hardly spend any time outside and my face isn't any drier at all.

I've considered going back to the derm, but I know he would simply move on to prescribing me accutane. I REALLY want to avoid such a powerful drug if at all possible. I powerlift and I don't want to wreak havoc on my joints (and also not be able to enjoy the sunlight in summer).

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TL;DR:

Had incredible success with Retin A Micro (0.1%) and Clindoxyl Gel for almost a year... until 2 months ago when everything started getting worse again. Would like to avoid accutane if at all possible.

I'm in the same predictament. Is your skin better in the summer? Since we're both in cold, unsunny climates currently, it could be that. I also think that sometimes our skin/hair/etc can become resistant to the products we use over and over.

I'm in the same predictament. Is your skin better in the summer? Since we're both in cold, unsunny climates currently, it could be that. I also think that sometimes our skin/hair/etc can become resistant to the products we use over and over.

Well it was better in the summer (almost 'cured'), but I don't want to pin everything on winter. Retin A should work regardless of seasons shouldn't it?

One thing I HAVE also changed is how much I'm using. I used to use 2 pumps like it recommended on the box. I've gradually increased that to 3 pumps since I feel like I can cover more of my face that way. Did you start using more as well?

I'm going to try using a bit less product and see how that goes.

Update:

-after reading a few logs of accutane and bodybuilding/powerlifting... (long term joint/tendon pain, less growth, horrible sleep) I definitely don't want to be forced into using it.

I'm in the same predictament. Is your skin better in the summer? Since we're both in cold, unsunny climates currently, it could be that. I also think that sometimes our skin/hair/etc can become resistant to the products we use over and over.

Well it was better in the summer (almost 'cured'), but I don't want to pin everything on winter. Retin A should work regardless of seasons shouldn't it?

One thing I HAVE also changed is how much I'm using. I used to use 2 pumps like it recommended on the box. I've gradually increased that to 3 pumps since I feel like I can cover more of my face that way. Did you start using more as well?

I'm going to try using a bit less product and see how that goes.

Update:

-after reading a few logs of accutane and bodybuilding/powerlifting... (long term joint/tendon pain, less growth, horrible sleep) I definitely don't want to be forced into using it.

Yea it should work regardless but in the winter time our skin isn't getting the Vitamin D it needs and also becomes somewhat drier. Also I think the cold air sensitizes the skin in the winter so the products may be irritating our skin and causing more acne. Mine started getting bad end of december, I did go back to my dermatologist because I can't deal with having cysts, so all she did was inject and offer antibiotics. You could try using a product with a higher dose of BP in it. I'm not sure, still trying to figure it out! I had my doctor check my vitamin/mineral levels just to see if something is low, haven't found out yet.

One more thing, acne can develop because of too-active skin cell shedding.. so maybe take a break from the retin-a for awhile?

True. I really hope that using less RAM will fix this. I'm also going to stop moisturizing before bed. I find my skin is very very oily and all flaking has stopped completely.

Post your vitamin profile results if your doc finds anything deficient. I've been watching my diet very closely throughout as well

Clindamycin stopped working for me after about six weeks. This is fairly common as it has been in use for awhile and your skin's bacteria will become resistant to it. The good news is that you can use it again after about a year, when your bacterial profile will have changed. However, until then, you need something else to kill the bacteria. I would replace the antibiotic gel with BPO 2.5%, which you can just buy here. Bacteria cannot become resistant to BPO as it works by simply bursting the bacteria.

Clindamycin stopped working for me after about six weeks. This is fairly common as it has been in use for awhile and your skin's bacteria will become resistant to it. The good news is that you can use it again after about a year, when your bacterial profile will have changed. However, until then, you need something else to kill the bacteria. I would replace the antibiotic gel with BPO 2.5%, which you can just buy here. Bacteria cannot become resistant to BPO as it works by simply bursting the bacteria.

Hmm... I've actually never even considered that the bacteria would become resistant, seems so obvious now - especially after so many months. I'll try stopping the clindoxyl and see if anything changes when I replace it with some benzoyl peroxide.

Do you think continuing to use the clindamycin would make it WORSE than if I just stopped using it (without replacing it with BP) ?

same here! I was on 2nd round of Accutane last year and started RAM afterwards to maintain clear skin (I'm very oily and acne prone, 1st round of Accutane only lasted 1 month after I stopped taking the drug). Anyway, RAM worked wonderfully for approx 2.5 months, then for ~1 week, I was too busy on trips and did not take it, my skin flared up and RAM stopped working since. I also tried other brands of retinoid with 0.05% and 0.1% but nth works now.

I have been so tempted to go back on Accutane and swear to put RAM on every night afterwards but now I'm reading your story, maybe it would have stopped working even if I had not neglected my skin for that 1 week..