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Differin 1 Week, Almost Clear - Celebrating Too Early?

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Skin: "very very mild" comedonal acne, oily skin

Drugs: Plexion (sodium sulfacetamide + sulfur facewash), and Differin (adapelene 0.1% cream)

First several days: a few pustules, then nothing new. Old blackheads still there, blotchy skin tone, dry skin/eyes (I keep my acne drugs far away from my eyelids! Dunno why...)

Is it possible I got lucky, my Differin/Plexion worked that quickly/in sync w/my skin renewal cycle, and my IB is over, especially given I had mild acne to start? People write about retinoids taking months to really kick in.

Because if it's NOT possible, then that means it was the Plexion at work, and I would stop Differin before I get a crazy cystic IB everyone seems to write about on this forum, and just rely on the Plexion continuing to suppress my weak acne.

I'm just scared of the IB...

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I can guarantee its not the differin. It usually takes a few weeks for the IB to happen but its not possible for it to have done anything in the first week. Its not like BP which is killing bacteria differin speeds up skin turn over. Im not saying youll have a bad IB I just dont think it was the differin clearing your skin.

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Checking in again to confirm it wasn't the Differin (Adapelene 0.1% cream).

2.5 months in, just had the worst breakout I've had in a while, kind of frustrating that I'm still not totally cleared by the topical retinoid. Overall it seems to smooth my skin, but my latest breakout has shown that I still get acne, and the downside is that they tend to leave more intense hyperpigmentation scars after they're gone, due to my skin being made more sensitive by the topical retinoid.

I will give it another month and a half max and re-assess. Clinical trials were done up to 12 weeks, but anecdotally many say the cream is less absorbed and takes longer to have full effect, up to 4 months and more. I don't want to waste like half a year or something trying something which will only give me more scars (hyperpigmentation) so if it doesn't clear me by 4 months I will either switch to 0.1% gel (clinical trials show better results with adapelene gel, but never been directly compared against adapalene cream), or a non-comedogenic benzoyl peroxide wash of some sort + Klaron and forget the topical retinoid all together.

Still get some dryness as side effect, especially around the eyes.

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3.5 months on Adapalene 0.1% Cream didn't clear me so I added a Clean-and-Clear Benzoyl Peroxide wash. That made me break out.

At 4 months, I didn't see any improvement overall (possibly still due to irritation from BP wash), so I stopped the BP wash and switched to Epiduo (adapalene 0.1% + benzoyl peroxide 2.5% gel). The brand name Epiduo was actually cheaper than generic Adapalene thanks to a coupon.

Currently on my 2nd week of Epiduo, still on the Sulfur Sulfacetamide facewash too. It seems whenever I start a BP treatment I get these little papules breaking out all over in random places on my face, and I have some of that right now. I am tempted to conclude that BP doesn't work well for my face and causes more breakouts due to irritation, but I've noticed I get much less irritation now from the Epiduo than when I started. I will give it some more time and see how it goes. If the irritation/breakouts get much worse, I will just revert back to Adapalene 0.1% Cream (which is more gentle) and see if that helps over time.

For me, systemic antibiotics (doxycycline, etc.) and isotretinoin just isn't worth the side effects. Antibiotics aren't a permanent solution, and many ppl report their acne coming back worse. I think honestly what may happen is if topical retinoids can't clear me, I'll just have to try OTC topicals on my own (azelaic acid, etc.) and try to fix it myself. Dermatologists are surprisingly unhelpful. They don't want to give me systemic drugs (not that I want them anyway), and the topical retinoids that they push on everyone don't work that well at all.

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you just may need a stronger retinoid like retin a or taz. Be prepared for an even bigger breakoout tho. They are much stronger than differin. If your face is congested and differin cant cut it, you may have to bump up to a stronger retinoid. But be prepared, they will bring any clogs/congestion to the surface.

Good luck

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Review of Epiduo

I quit Epiduo after <2wks trial. 1 week of any BP product seems to give me improvement, but by the 2nd week mark, the irritation catches up and causes red, flaky, oily skin, and many new papules.

Review of ~5 months on Adapalene (Differin)

Reduced new acne lesions somewhat, as compared to before treatment. I used to get lots of comedones and a few papules/cysts each week, now it's mostly small mild papules, but they all leave very bad PIH due to how retinoids thin the skin. I have pale sensitive Asian skin.

I'd say ~75% clearance, but I want 100% clearance so my hyperpigmentation can finally heal, or else I'm just adding more marks never-ending. It's like using a bucket to dump water out of a leaking/sinking boat, if you know what I mean.

If you just saw a photo of my face, you'd say my face looks worse now after 5 months of Differin because of all the hyperpigmentation red spots, although my skin texture is slightly better. Not too satisfied with the treatment overall.

Future Directions

So I want stronger clearance than Adapalene 0.1% Cream. I have Epiduo, and Differin 0.3% Gel.

I'm going to try Differin 0.3 for a week (I just have some tiny sample tubes) and see how it goes.

Otherwise, I can try alternating Adapalene 0.1% Cream with Epiduo (same thing + 2.5% BP), like Epiduo every 3rd night, in order to reduce irritation but hopefully still get some benefit from BP.

Edited by AOE2
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