I can tell a significant difference in my skin after one month. I am still on Presidine to help with those nasty flair ups shown in my last photo. They seem to come and go with first thing in the am they seem to be the smallest. My skin is super dry but I am using a Clinque lotion that has been awesome. I have noticed nightmares almost nightly. My lips are also super dry. All of these side effects have been well worth it for me. My dr has said that I may have to remain on the medication on this low dose for up to a year. It's uncommon to stay on it that long but it is doable.