I'm in my 20s and have had hormonal acne for 10 years. Retinoids only worked for me when I was on Accutane, but even then...I hated them.
Over the course of the years I've been on various antibiotics and also realized that even though I've used Retin-A on and off for ten years, all it does is make me purge when I cave and attempt o use it. Same with Ziana, which gave me cysts. I used Aczone and it gave me puffy papules. I've tried clindamyacin and it's lost it's efficacy (maybe because my tub is expired? I noticed it wasn't as effective as 10% BP a month ago).
I know purging is normal, but when it comes with cracked red skin and makes mild acne severe...it doesn't seem worth it. When I was on Accutane the initial purge lasted a week, and then I got some relief. I've been struggling ever since I went off the drug and am worried about going on it b/c I'm healing from a surgery.
Now that the antibiotics I'm using seemed to have stopped working, I am tempted to try Epiduo, but the horror stories about massive cystic initial breakouts are scaring me.
For those of you with adult hormonal acne/oily skin--what was your experience? Was it worth it? How long did the purge last for you? Did your dermatologist prescribe anything else (an antibiotic, birth control) to use in conjunction with it? (I have been on aldactone and it did not stop the painful menstrual cysts I got, but it led to horrible discoloration/bruising and made my hair fall out in clumps.)
I have thick skin, so all "serious" acne is deep and long-term, not whiteheads on the surface.
Should I steer clear of it based on my hatred/poor reactions to retinoids and just go on Accutane?
Adapalene and benzoyl peroxide on their own had very little positive effect for me but I've been using Epiduo for 14 weeks now and I'm absolutely loving it. It's by far the best topical I've ever used (and believe me, I've tried a lot). I didn't get a significant initial breakout at all, it was just slow improvement right from the start for me, but that might have been because my acne was severe and cystic to begin with. I very rarely get any cysts these days though and if I do they go away in a few days. I'm also on antibiotics (Lymecycline) and birth control (Dianette) at the same time. I've been keeping a log which is in my signature if you're interested. I'd definitely recommend trying Epiduo before plunging into Accutane because, in combination, it has done wonders for me in the past few months.