This is my first time posting on this site even though I have been reading user posts for years and it has always helped me. I'm 30 and still break out. I've had periods of being relatively clear here and there, but pretty much ever since I was 18 I've had really sensitive, acne-prone skin. It was doing pretty well until the fall, when my stress levels were through the roof for personal and professional reasons and I wasn't sleeping. It began getting so bad that I finally saw a dermatologist for the first time in ages and had two cortisone injections to cysts on my forehead and chin. He also put me on Doxycycline in December and I'm still on it, though weaning off. In late December, he prescribed me Ziana (Clindamycin 1.2% and Tretinoin .025%). I've used it every night.

I am going into my 7th week on Ziana and I'm still "purging." Granted, I had a LOT of clogged pores when I started (in part thanks to some awful skin care products I was talked into buying after a facial) and definitely a few bigger pimples/small cysts. The first 2 weeks I was itchy and oily all the time and then it started to calm down and my face was looking clearer. Then, around week 4/5 my skin started really purging and I've basically had nonstop whiteheads appearing and then disappearing on my chin, jaw and mouth area within days and they are hard to cover up. That being said, my skin does seem to be improving incrementally and things are healing faster. It's super frustrating and embarrassing to deal with this at my age, though.

Has anyone else used Ziana or another retinoid (I know Ziana is different because it includes Clindamycin, but just thought I would open it up to other retinoid users) and had purging for this long? At what point do I go to my dermatologist and say, "this treatment isn't working?"