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After totally ignoring my acne problem (moderate papules, few pustules, no cysts, all over my face) after Dan's regimen didn't work for me, I finally decided to go to a dermatologist to get help with the problem. Armed with all of the knowledge I gleaned from this site, I went to a very nice doctor with quite beautiful skin herself to get started.

Her advice was that I come in once every two weeks for microdermabrasion treatments and cryotherapy treatments. It seemed reasonable at the time and she had pictures of folks whose skin cleared up nicely with microderm. However, I was 20 minutes late to my first appt, and she CANCELLED it! evil.gif She didn't want me as a patient; I don't want her as a doctor. There are plenty of places that will accomodate me whether I get stuck in traffic or I get lost finding the place, etc.

So I went to a Medi-Spa nearby to my campus to a physician's assistant. I am not wary about going to PAs. If a doctor/PA/nurse is an idiot, I will walk out. I've done it before to a gynecologist, and I once went to a nurse practitioner that I would've trusted with my life. I don't pass judgment based on that.

She was very sweet, and again, had gorgeous skin herself. This was the regimen she put me on:

1) Aquaveda Salicylic Acid Wash

2) .05% Tazorac Cream (nightly for 2 weeks), .05% Tazorac Gel (nightly for 2 weeks).

3) Clarisonic

4) Orthocyclen

Let me tell you about Clarisonic. It is a skin brush that you use to cleanse the skin. It does not scrub, it just rather brushes the skin (think of a toothbrush that's too soft) and helps to sweep the pores clean. I love it. It's fun, it feels good, and it's gentle. I think it helps to lift some of the residue from the heavy cream meds and heavy moisturizing. They claim the brush removes more sebum than washing w/ your fingers. Whatever. Most people on this site would consider it a waste of money; it is simply a feel good product and it hasn't hurt at all yet so I will continue to use it.

I'm going back to her in 1 month so that she can give me a deep cleansing facial and do some extractions and check the progress of my skin. I like this arrangement because she can assess my skin's condition monthly and adjust the regimen as needed.

As for the regimen, the wash is great, as is the Clarisonic brush. The tazorac is causing some mild peeling as it should. There has been some clearing around my forehead and chin, but something rather horrible is happening around my temples and jawline (these two areas react poorly to anything except neutrogena and water). Hopefully these areas will clear up and start healing too.

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Lots of peeling across my nose, but no where else. Well at least I'll have a pretty nose...

No "it'll get worse" breakouts so far. I'm keeping with the cream for one more week, then moving on to the gel. The gel is supposed to work better, but she started me on the cream because it is supposed to be less drying. I get the itchies quite a bit too, but overall I'm tolerating the tazorac well. I like the fact that the salicylic acid is in the wash, not something that I have to leave on the skin. I didn't like the layering aspect of Dan's regime. It seems like this regime avoids that, I only have one "thing" on my skin at a time (either tazorac or moisturizer/sunscreen), and my face is always clean.

She said the goal of this regimen is to shorten the skin cell turnover time. I figure after we've gotten that reduced/normalized, then I can start looking at some antibiotics and/or benzoyl peroxide if I'm still having trouble. The ortho will take care of the hormones in a few months if that's contributing to it.

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I messed up today!

I gave my skin a rest from the tazorac last night because the itching was so bad. I also had a reception to go to and felt that I had to have some foundation on. I only wore it for about 5 hours though, so hopefully it won't be much of a setback.

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The taz is finally getting to my skin. I just washed w/ the salicylic acid wash and it burned quite a bit. I'm still going to do my dose of taz tonight, but i don't think i will wash again tomorrow morning. I will just splash w/ cold water, and hopefully the irritation will not cause any major initial breakouts.

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My face is really sore. A friend of mine thought I had been tanning, not good. I will probably stretch the taz cream to last 2 more weeks, then go to the gel, instead of going to the gel next week. The gel is supposed to be more effective, but more drying. I don't know how some folks are using Taz .1%. It's brutal!!!

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I got it at the Medi-spa, but you could definitely find it on-line. It makes me look forward to washing because it feels so nice on my skin.

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Update: I used Taz .05% cream for 3 weeks, and have been using the gel for one week. The gel is really working on my skin. I have so much skin shedding around my chin, I really am a bit grossed out, but I'm happy it's gone and can't clog my pores any more. Every morning, I have large patches of dead skin shedding off my chin, cheeks and jaw line. The Clarisonic brush helps slough off some of the skin and relieves the itchies. After I get the dead skin off, the skin underneath is really soft. The PA said that the Taz works to break up abnormal keratinization, so I guess these are the areas my skin has abnormal skin built up. I'm not surprised b/c I've always had a large patch of dark skin across my chin that I think may be a scar. Hopefully it doesn't go down so far that the Taz can't lighten it. This is probably the main reason the BP regime alone couldn't clear all of my skin (only my forehead). I have a ton of abnormal skin that is blocking oil and dead skin from getting out of my pores, and probably was blocking the BP from getting in. When all of the skin is gone, I'm very confident that what's underneath is going to be very beautiful. I really didn't have the "initial breakout." The pimples I had seemed to dry up and fall off w/ the dead skin. I use a heavy moisturizer w/ sunscreen to help me not look so dry.

Looks like the Taz will work! I will give confirmation of that in a month or so

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I'm still sticking with my regimen. I also added some BP (6% Triaz pads) in the morning. It doesn't dry out my skin like I expected. My forehead actually gets repulsively oily, but I wipe it off during the day. The taz is causing my skin to peel a lot and there was a couple of nights that the taz felt so painfully itchy on my skin I wanted to cry. I will be bumping it up to .1% tazorac from .05% in about 3 weeks, so I hope that transition is painless. I'm still getting blemishes, mainly around my temples which have always been particularly stubborn. My temples are clear until I start medicating my skin, then they break out horribly. If I am not medicating my skin, every other part of my face breaks out except my temples. Weird, huh?

Anyways, most of my acne is gone, including the zillion comedones on my forehead which generally bother me the most. The pustules that pop up on my cheeks are pretty much dried up, and the abnormal skin in that area is being "burned" through by the taz. My chin is pretty much cleared as well, and the abnormal skin is being burned through by the taz, but a whole lot more quickly than my cheeks. I'm expecting full results in the next 2 months or so. It's a pain, but I have to get nice skin for my wedding next june.

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