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Hi there

I've been stalking these forums for around a year now and FINALLY decided to get myself involved.

I'm 25 (26 this month) and have suffered with mild-moderate acne for as long as I can remember, it tends to run in our family, my dad had awful acne until his 20's which he cleared up permanently with a course of Tetracycline, and my younger brother had it until recently which he cleared up with some cream from the doctors (I'm presuming Benzoyl Peroxide). I had tried BP in the past but suffered so so badly I thought I may have been allergic? Or possibly just went too far too soon with it?

My acne tends to be along my jawline and on my chin, where my pores have been visibly blocked for literally as long as I can remember. Nothing seems to clear them! Sometimes its inflammed (from picking unfortunately) but mostly they're just these horrible irritating bumps deep under my skin, with various recurring cysts thrown in too for good measure. Of course they drive me insane, I pick, they get inflamed, and the vicious circle continues!

Anyway, after trying everything under the sun, here I am!

I resorted to making the trip to the doctors, so much embarassment (not sure why, it must be common, right?), and I broke down in tears and couldn't even tell him what was wrong ! He prescribed me 3 months(!) of Erythromycin and to go back after 5 weeks. This did absolutely nothing except give me terrible stomach cramps, sickness, and if anything my acne was worse.

Saw another doctor last Thursday and he prescribed me Lymecycline, and a product called Epiduo. I haven't seen too much on this site about this product, but its basically a 2.5% BP and a 0.1% adapalene gel. It seems to be going well, I'm using a pea-sized amount once a day in the evening only and using it as part of The Regimen, with Cetaphil cleanser and moisturiser twice a day. I'm starting to see results, I don't have any inflammed spots, 75% of those white bumps have cleared, and I don't seem to have any particularly active spots - just marks and bumps left from previous picking escapades . However, after 3 nights' application, my skin is red, scaly (but not peeling), warm, and the last application stung so so badly. Mainly, the severe itching is bothering me! I'm going to persevere as I'm seeing results, but just wondered if anyone else has any experience with this?

I know on The Regimen the dosage of the BP needs to be ramped up once the irritation subsides, but I'm not sure if the same would need to be done with Epiduo? Their website is a bit vague in saying 'use as directed by the doctor', but I didn't really get any direction, just to use once per day! Do I go from a pea-sized amount to a fingers length? Do I move to twice daily?

Also another thing that concerns me is that when I went to pick it up from the chemist, every single pharmacy in the area has no supply of this stuff...they all said it was due to a 'manufacturing fault' and they didn't know when it would be back. The lady found a lonely tube on the wrong shelf when she was looking for an alternative and that's the only reason I got some. Anyone know if this is a recent/temporary thing, or is it going to be like when they discontinued PanOxyl? I don't want to get used to something only for it to then disappear forever!

Anyway sorry for rambling, just wanted to fill you all in and hope for some kind of moral support .

Thank you all for all your stories, hints, tips, suggestions that I've stalked for the last year or so!

(P.S. I'm finding the Cetaphil moisturiser really really greasy/shiny, and this drives me insane, like I want to just wash it off! Anyone know of any good alternatives that are non-comedogenic?)

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Hi Nicole,

First of all, DO NOT ramp up Ediduo, less is definitely more with this product.

When I first started using it, my doctor (who I think is brilliant and incredibly knowledgeable with all things acne) said to only apply a pea size amount every 3rd day in the first week, then every 2 days in the second and then if all is well (that is, no redness or peeling) then apply every night. Its important to let your skin adjust to the product first rather than concentrating on 'getting clear'. Its usual for a topical antibiotic to be used alongside epiduo. I use eryacne (not sure if available in the UK, as I'm in Australia) but I'd suggest you ask your doctor for something similar. So basically you apply epiduo, then a very thin layer of the topical antibiotic over the top (and also the topical antibiotic in the morning too) and then its important to moisturise. With the moisturiser, again less is more. Only apply a pea size amount and spread it all over. As you're using epiduo you aren't following the regimen so its certainly not necessary to apply gallons of moisuriser.

So in simple terms I would suggest you ask your doctor for a topical antibiotic to use alongside epiduo, only apply epiduo every few nights (but the antibiotic both morning and night) and build up slowly from there, and also reduce the amount of moisturiser you're using.

I have found both the regimen (which got me clear in the first place) to be great, and then after 2 years of following the regimen I switched to epiduo which I find really works well for me too (with a lot less effort compared to the regimen).

Good luck with it all....and let us know how you get on. :)

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Thanks for the reply

Glad to hear of your success on Epiduo! When I return to the doctors after the course of oral antibiotics I will definitely enquire about a topical. So far so good on the Lymecycline though, no side-effects as yet!

Definitely seeing why the doctor suggested 3 days off, followed by 2 days off etc. My skin was so itchy and flaky last night after 3 days of applying a pea-sized amount everywhere, that I only applied literally a dab to the worst areas. I'm thinking that even though I'm letting it dry, the moisturiser is moving it around anyway. I might give it a break tonight and see how it goes, I'm just desperate for my skin to build up this tolerance asap..it's such an embarassment having to come to work looking like this!

As for moisturiser, I am literally having to plaster it on. No exaggeration, I was using 4 pumps a time of Cetaphil moisturising lotion yesterday, and did that about 5 times throughout the day. I can't see how I would possibly get away with using a small amount until the tolerance has built up? May be just a case of trial and error of getting the Epiduo dosage right in the first place, or maybe finding a better moisturiser?

The bonus is that other than the redness/flakiness, my skin hasn't been this clear for as long as I can remember! It's early days yet, but I'm seriously thinking this stuff works miracles!

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I also used to apply gallons of moisturiser, and additional applications throughout the day just like you. But my doctor said to stop doing that, and advised that its a catch 22 situation with the more you moisturise, the more you need to moisturise.

He told me to apply only a small pea size amount and to basically 'suck it up' and break my moisturiser addiction. He promised me that if I kept up with the reduced amount for 2 weeks I would notice a huge difference. I told him that I hardly see how as I have always had to moisturise all my life as I had extremely dry skin. Anyway I gave it a go (you know, to prove him wrong) and found at that he was right and I was wrong. The first week was awful, with my skin flaky and feeling tight all the time, but by the middle of the second week it was fine, with the flakes gone and my face no longer feeling tight and dry.

give it a go, I promise you it will work. You should have a good moisturiser though, i feel cetaphil is far too thick and greasy. Can you get cerave in the UK?

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I held off the Epiduo last night (first night off in 6) and noticed an improvement in the redness, I have no itchiness, but my skin is very flaky! I presume this is just one of those things I have to go through, shedding all the 'bad' skin for new skin to come through, so I'm coping. It sucks a bit because I work in a food manufacturing place, so I'm having to stay clear of any production.

I think if I stick to a one on, one off type regime for now I won't need to coat myself in moisturiser, so fingers crossed. Just not sure whether to risk the Epiduo tonight, or just leave it then have another good go at it over the weekend while I'm away from work. It's working so well that I'm just fearful of leaving it a couple of days incase I start breaking out again! Acne paranoia seems to be taking over my life at the minute!

I've just had a quick search and it appears CeraVe isn't available in the UK, but I can buy off eBay or Amazon for free shipping and a reasonable cost (only about £2 more than I pay for Cetaphil) so may be an option? Which cream would you recommend? There seems to be a few in the range.

Edited by Nicoleblk9

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I'm not sure myself, but if there is a lotion, go for that rather than a cream. Remember you're trying to beat your moisturiser addiction.;)

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I will do, thanks for the advice!

I was good yesterday and only used 1 pump after applying my Epiduo and left it at that! Used another pump after washing it off this morning and actually got very little redness and irritation! Result! Just slightly itchy in the neck region, not sure how it ends up there but it must be the way I sleep. Maybe my skin is getting tolerant to the Epiduo already.

I did have a minor breakout yesterday, had something that felt like the beginning of a cyst and could have cried seeing as I've not had one since I started Erythromycin nearly 2 months ago, however applied the Epiduo last night, and it had come to a head by this morning! I just seem to be getting a few blackheads, which is something I've never really had before. I presume it's because of the skin shedding is exposing all those previously closed comedones.

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So today is just over the two week mark since starting Epiduo. I've missed a couple of days here and there because my limit seems to be around 3-4 consecutive application days before my skin burns. It's not so red, it just feels like I'm being stabbed with 1000 needles repeatedly when I moisturise after application! First 3 consecutive days seem fine though.

My CeraVe turned up yesterday! Got a generic lotion and a daytime one with SPF. It's autumn here in England which is notoriously pretty naff weather, but it's actually been quite sunny, so been living like a vampire until I got my hands on this stuff! Looking forward to some nice walks in the sunshine this week. Cost me around £20 with shipping for both from Amazon if any other UK are interested. Not bad when Cetaphil is £9 from Boots anyway, and it's so so much nicer on the skin. Feels lovely and thick, creamy, and soaks into the skin quickly with no greasy residue.

On the acne front, my skin is amazing! It feels so so soft and smooth! Aside from around 5 closed comedones (amazing as 2 weeks ago I had so many that I couldn't count them, well into the 100's), a few blackheads, and an odd zit popping up after washing in the morning, my skin is so so clear! I looked at my "before" picture yesterday and just couldn't believe the difference. Maybe one day I'll pluck up the courage to post the picture here, but right now I'm just not ready.

All in all, I love Epiduo!

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Yeah I'm flaking like crazy! The burning, irritation, stinging, redness etc. has pretty much totally subsided (as long as I take a day off once a week), even with using little to no moisturiser. The moisturiser does nothing for the flakiness, unfortunately it's just one of those things you have to go through to get all those stubburn clogs out.

On another note, my initial breakout seems to be well underway. I'm into week 3 of treatment now (19 days) and I have several new closed comedones, a few nasty red lumps (papules?) that are a bit sore but not deep enough to be cysts, and loads of blackheads. Combined with the flaking, it's not pretty. I've also got a few scabby bits from the massive flake-out the other day that I had to try and scrub off to be presentable for work. I'm hoping this doesn't last too long as I was seeing such good results before this! Half the battle for me is forcing myself to leave them alone - no picking or poking at it!

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4 week progress report:

1/3 of the way into the 12-week treatment period and I LOVE EPIDUO!

  • The flaking has reduced (just a slight flakiness, usually while I'm at work without my moisturiser, I think the CeraVe has seriously helped).
  • The burning has subsided. Ok it burns a little when I apply my moisturiser after the Epiduo, but I think thats the reaction between the glycerin and the BP.
  • I'm just very slightly red, but I have a fairly red complexion anyway.
  • I went to work today with literally no make-up on and wasn't bothered for the first time in around a year I'd say.
  • I just looked at my pre-Epiduo picture and WOW. What a difference!
  • I still have some stubborn deep clogs that I can see, but instead of 100's (too many to count), I now have around 10, all localised to my jawline, and one post-picking scab (I'm trying really hard but sometimes I don't even realise I'm doing it).
  • My skin is so so soft, the texture is smooth and generally amazing where I have no acne (cheeks especially).
  • I still have some lingering hyperpigmentation that I was worried about, but after seeing the 'before' picture again, I'm no longer worried.

I'm seeing my parents tonight for the first time since before treatment when my skin was at it's worst (we'd just come back from 4 days' camping at a music festival with no showering, and a giant alcohol and junk food binge). My mum had then (subtly ) commented on how bad my skin had gotten over the Summer, so I'm hoping she'll see a difference!

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Glad to hear about your results, Nicole. It must be a huge relief to find something that works for you.

I'm on about my seventh (!) year of the regimen, which I've used on and off and which has sort of worked for me but never entirely cleared me up - I still get bad breakouts, and my skin's never fully adjusted to the regimen. The only reason I keep coming back to it is that my skin will break out so terribly when I come off it.

I'm now curious to try epiduo, which I hadn't heard of until now. From I've read, it's essentially just 2.5% BP. Do you know if it differs markedly from other BP products, like Panoxyl, or Dan's BP (which I what I currently use)?

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Hi Shadrach

Wow 7 years! I suppose it's worth it if it works, I plan to keep using Epiduo for as long as I physically can through fear of the acne coming back.

I'd seriously reccommend Epiduo, it is 2.5% BP, but also contains 0.1% Adapalene which I think seems to be the more effective ingredient. I say this because usually on the regimen you ramp up the dosage once your skin adapts, but with Epiduo, you only need a pea-sized amount all of the time as the efficacy doesn't actually increase with increased amounts. Also, people coming off the regimen tend to start reacting again when they use Epiduo instead (i.e. the burning, itching, peeling etc.).

From what I've read, the BP and Adapalene combination means that somehow the ingredients work in synergy, so one increases the effectiveness of the other. The adapalene is a type of topical retinoid, and it prevents the overproduction of keratin which clogs pores and in turn prevents pores from becoming bacteria breeding grounds, while the BP penetrates and kills any bacteria that slip through. It seems to exfoliate the skin to expose any deep clogs and bring them up to the surface.

The first few weeks were hell for me with the burning and peeling. I'd tried BP before but gave up after 3 days, so all of this was fairly new to me. Maybe as you're quite used to the BP already, the effects wouldn't be as bad.

I'm just starting to get frustrated with these stubborn blackheads, which is so strange as I barely ever got blackheads before Epiduo. I presume they're all previously closed comedones. The fact the Epido has totally stopped burning/drying out my skin makes me wonder if it's still working, but I'm still not breaking out and I'm getting clearer by the day so it must be. Two stubborn deep pimples have popped up by my nose though, and no matter what I'm doing to them, they won't come to a head! Quite frustrating.

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May I ask how long you used the product Anton? I only ask as the general feel I'm getting from most people is that it is a lengthy process - around 12 weeks to see a vast improvement.

Although, something that works for one person may not work for another! I hope you've found something that works for you.

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May I ask how long you used the product Anton? I only ask as the general feel I'm getting from most people is that it is a lengthy process - around 12 weeks to see a vast improvement.

Although, something that works for one person may not work for another! I hope you've found something that works for you.

I'm allergic to an ingredient in epiduo, not sure what it was, but my allergist and dermatologist said so. I stopped using it, acne pretty much improved and now im only left with fewer blemishes.

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Hi, Nicoleblk9, so glad to hear you having good results with Epiduo.

I've tried this product in the past, and had similar good results - but I eventually stopped using it because the redness/itchiness became just too much, but after reading this thread, I now suspect that I may have been using too much, too often.

So you're saying you use only a pea sized amount for your entire face?. How do you manage to spread that amount of gel so far? As soon as i apply it to my face/neck it becomes completely absorbed and invisible. I used to have to use at least a little finger length to cover the areas I needed, which is obviously considerably more than the recommended amount. Thanks.

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I have to admit when my skin was a bit dry and flaky, it was so difficult to make the pea-sized amount spread, and I was using probably half a pea for each affected area. Now that it's smoothed out, I can quite easily made a pea-sized amount (albeit that of a large pea!) spread into a thin film over most of my face. The key is to just keep taking dabs of the original pea-sized blob lightly using another finger and trying to gently spread that as far as you can. I can get about 6 'dabs' from my pea sized amount, which does my chin (1 dab), both sides of mouth and upper lip area (around 2 dabs in total), two cheeks (one dab on each), and my forehead (the smallest dab here as it seems to spread very far for some reason). Any slight residue on my finger I use on my nose, as it is prone to peeling so only use the smallest possible amount.

It may feel like you've barely used anything, but it has definitely worked for me! Most of the negative effects have subsided except a tiny bit of flaking here and there, but I have sensitive skin anyway and it reacts badly to our miserable English weather, so that could partly be the cause!

I see you're also in the UK - have you had any trouble getting hold of Epiduo? When I got my original tube, it was only by chance as it was an odd tube at the back of the dispenser for another product - they had originally told me there was a 'manufacturing fault' and they hadn't had any in for ages, and weren't getting any in the near future. Went back for my repeat prescription last week (2 months on) and was told it was still under manufacturing fault, they weren't getting any for at least another 3 months (!!!), and to go back to my GP for an alternative. The thought of that terrified me, as Epiduo is the only thing that seems to have ever worked. I asked the pharmacist for my prescription back and she said she couldn't, as she'd given me the Tetracycline that was on the same one, and to get in touch with my doctor again. The receptionist at the doctors told me she couldn't get the GP to print me another prescription and I'd need to make another appointment, which could take weeks. Anyway, funny thing about it all is, if I look online at registered legitimate pharmacies (e.g. Pharmacy2U), they have Epiduo in stock and will issue it with a valid NHS prescription! I feel like I'm being fobbed off a little bit.

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Thank you for your reply; In the past I have had no problem getting hold of Epiduo, but I stopped using it about 3 or 4 months ago due to extreme redness, but after reading yours, and other's posts on the subject it is now obvious that I was using way too much. Your 'dabbing' technique clearly seems the way to go. My neck (shaving line) is my only real problem area, so getting a pea sized amount to spread using the manner in which you detailed should be entirely possible with a bit of practise.

I placed a repeat prescription for the gel on Friday with my GP, and will be picking it up and taking it to my usual pharmacist tomorrow - however, they always have to order it which takes a day, so I will let you know on Wednesday if they have any problems locating it.

Best regards.

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That would be great thanks!

After being fobbed off with the 'manufacturing fault' excuse, I emailed Galderma (the company who make Epiduo) for confirmation - and they said there has been no manufacturing fault. All that has happened, is they have switched from manufacturing the tube to making a pump version, and this needs to be specified on the prescription. Looks like I'll be back off to my GP to see if I have any luck there. For now I have enough to last a while at least.

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Sorry for my late reply!
I had no problem with my prescription, and it was indeed in a new pump form.
I've just actually used it for the first time, and the amount dispended per pump - which is the recommended daily dosage - is such an incredible tiny amount that I simply can't imagine how it's going to be effective. Even with a dabbing technique, it barely seem to cover any sort of area beyond that which it is immediately applied to. I used 3 pumps in the end, one for each side of the my face, and one for the entire backside of my neck, and even that that seemed like a stretch to make it spread far enough to cover more than a few inches.
Time will tell!

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I'm pleased you got hold of some! I'm going to try going back to my GP for a new prescription, need to call up for an appointment when I remember.

Maybe it'll get easier as your skin smooths out? Like I said, I was having to use quite a lot to get it to spread over my rough skin to start with, but can get away with a large pea-sized blob now as it just glides on quite easily. Are you using a cleanser before applying the Epiduo? Maybe the cleanser is over-drying your skin so your skin is soaking up the Epiduo too much?

On another note, I scratched/picked a hole in my face on Saturday during an anxiety attack and it's pretty grim. I'm so frustrated with myself and no idea what to do to put it right. I'm not sure if putting Epiduo on it will make it worse, or if it'll promote healing and kill any bacteria? I have a sort of scabbed-over-wound at the moment that is very dark and constantly tingling.

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Reading this forum and other places, there's not really a consensus on whether BP should or shouldn't be applied to a healing 'wound'. I, personally, find it helps with the healing time - and it definitely for me helps with fading the residual red mark, but I think everyone has their own opinion on this matter

Whenever I'm unfortunate to have a breakout which has been severe enough to cause any bleeding and ultimately scabbing, I usually apply the BP as normal, then use a very thin layer of Sudocrem directly on top of the scab before I go to bed.

I'm on my 5th day back on Epiduo, and with using just three pumps (about a peanut M&M amount of gel) I am already having really fantastic results. I have mild, to moderate acne around my shaving line on my neck, and infrequent, but fairly nasty, breakouts on my chin & sometimes forehead). I'm almost completely clear, having not had a new pimple for 3 days, and the existing spots are fading very nicely indeed. My skin is looking smoother, and not red to the point that it is noticeable to anyone other than me. Hooray!

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Fantastic news! I also had unbelievable results within a very short time period of around 3-4 days. In fact, I think I actually saw a difference the morning after the first application! However be warned, I went through a bit of a purge after around 3-4 weeks. It wasn't horrendous, and not as bad as it was to begin with, but it was strange having all types of spots that I'd never had before! It cleared up really quickly though, and as soon as that break-out cleared, the side effects disappeared (burning, peeling etc.).

I ended up putting a tiny amount of Epiduo on the scab, being really gentle to not break it and make it bleed, and put a bit of sudocrem on (before I read your advice too!) and believe it or not, it dried up and fell off the next day just leaving a small red mark. It's almost gone now! Definitely learned a lesson there.

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