I'm in a panic and feel I may be losing control of my acne scarring. I had 3 new scars form on my nose in the last month. My last scar prior to this was roughly 2 years ago. I thought I was on a regimen that worked.

I have extremely oily skin on my nose. I am mainly dealing with blackhead type acne and anything else is somewhat rare.

My nose is my main area of concern and where most of my scars are located. Most of my scars seems to stem from the same phenomenon: 2 pores merge into a single, long, deep, ice-pick like scar. Sometimes this process starts with the formation of a strange white scab that takes several weeks to slough off. There is usually no acne of concern leading up to this.

I never pick at my skin or scabs. I have a strict hands-off policy, and try not to even touch my face when I have an itchy spot. I modified my died several years ago: no dairy, no sugary beverages, no caffiene, no alcohol.

Possible contributors to recent scarring:
I went through a high stress event
I used sunscreen on my nose (I'm not sure why, but this causes changes in my skin, including the opening of pores)
I may have gently rubbed a few of these spots on my nose

My night regimen:
Gently wash face with Cetaphil Daily Facial Cleanser
Wait 20-30 minutes
Apply Tretinoin 0.05% (very small amount)
Apply Cetaphil Moisterizing Lotion

My morning regimen:
Gently wash face with Cetaphil Daily Facial Cleanser
Let dry somewhat
Apply Cetaphil Moisterizing Lotion

My gut feeling is that the Tretinoin is the cause of these strange scabs and my scarring. I've been on this stuff for many years and every scar I have occurred while using it. It's extremely harsh, and causes my skin to peel and slough. After washing my face my nose is basically covered in a dead layer of skin. My skin seems really fragile and I don't feel I can even touch my skin without getting a scar. I'm curious what the consensus on Tretinoin is? Is the community using this product and having good success with it? My dermatologist ensures me that it can't cause scarring, but I'm not so sure.

I recently visited my dermatologist and was prescribed a lower concentration: Tretinoin 0.025%. I have started using it and plan to use it to taper off by applying it at lower and lower frequencies. Since this stuff changes the biology of the skin, I don't feel comfortable just straight up stopping it.

I was also given a sample of Epionce Lytic Gel Cleanser. Does anyone have any experience with this? It seems to have really good reviews. My hope is that it will be effective enough with my blackheads that I can stop the Tretinoin and not replace it with anything. I just don't trust any of these topicals anymore.

I am looking for any and all feedback from the community on my situation. I am very anxious as I don't know when this current episode will end, or how my skin will react to the changes to my regimen.

-Chris