Sunday, March 20, 2011

Retin-A: Is it the miracle treatment your adult acne needs?

Adult acne can be complicated to treat because most acne products available on the market are designed to handle teenage skin.  Although acne has some similarities at any age, adult acne--specifically found in women--has some unique characteristics that make choosing a topical treatment a challenge.

Adult acne is usually more inflammatory than teenage acne.  Medicated cleansers and drying agents irritate the skin, and for many women the side effects aren't worth pushing through and leave them unhappy with their skin.  What makes adult acne different?  Older skin.  Teenage skin, though oily and reactive, is more resilient than adult skin and tends to tolerate harsher treatments. 

Typically adult acne is brought on by a sudden hormonal fluctuation.  This triggers excessive sebum production.  The pores get clogged quickly for one of two reasons.  They either aren't large enough to let the impaction through or a slowed cell turnover rate leaves dead cells in the follicle, which makes a clog inevitable. 

Adult acne and teenage acne are both caused by excess sebum, but you wouldn't know it from looking at the surface of the skin.  Because the oil is trapped inside the follicle instead of lubricating the surface of the skin, many women mistake dehydration or a damaged barrier function for a dry skin type.  Moreover, many women have dry, flaky patches scattered amongst their papules and pustules.

Assuming that acne imposters aren't at fault and that we've handled the necessary lifestyle factors, adult acne deserves a special plan of attack.  Benzoyl peroxide and overcleansing can accelerate damage and add to irritation. This often makes acne even worse and damages the barrier function.

I've posted an article on anti-aging tips, which you can check out at the link below:
Top Ten Anti-Aging Tips for Acne Prone Skin

Another option is available only by prescription and is highly successful in boosting collagen production while treating comedonal acne.  Retin-A (tretinoin) comes in several strengths and formulas, which can be determined by your doctor.  Developed in 1967, this miracle drug is loved for its cosmetic benefits, as well as its effectiveness in managing skin disorders.  However, Retin-A is available by prescription only.  Other brands use similar-sounding ingredients, but no product available in stores affects the skin like tretinoin does. 

As with any prescription, you should always follow your doctor's instructions precisely, which may differ from what I discuss below.  Your doctor may also decide that Retin-A is not best for your particular acne or combine it with another medication.

Unfortunately Retin-A is often misunderstood, causing many to have negative experiences with the medication.  When used correctly, it is generally well-tolerated, although side effects can occur--especially at first.  However, some people with delicate skin cannot tolerate this treatment.

Your doctor will instruct you on how you should use the specific product he or she prescribes.  The routine I describe is based on my own experiences and is consistent with the general guidelines for proper use.  You may also look over the FDA's literature by clicking here.

Retin-A is essentially Vitamin A.  More specifically, it's a topical version of retinoic acid, which is what differentiates it from the Vitamin A you see listed on moisturizers.  For some bizarre reason that scientists don't fully understand, retinoic acid accelerates the rate of cell turnover on the skin.  Since an abnormal cell turnover rate is often responsible for the congestion at the root of acne, this can solve the acne dilemma with diligent, careful use.  Retin-A is not a spot treatment, and it doesn't fix your skin overnight. 

You must be patient with Retin-A.  Many people give up too soon.  Your skin will not clear for about six to nine weeks of treatment, and the first two weeks are unpleasant for some. During your appointment, your doctor may be willing to perform an in-office procedure like a cortisone shot(s) to jump start results.  Regardless of whether you elect for any immediate results, Retin-A will help you prevent future acne and clear any congestion inside the follicles. 

Retin-A can cause drying, flaking, redness, and irritation as the skin begins to shed itself.  Moisturizers can help reduce symptoms, but Retin-A must be used very specifically to even be effective. 
Unlike AHAs and BHAs, retinoic acid actually redesigns the structure of the skin, making it look and act younger.  In addition to a rapid cell turnover rate, Retin-A also stimulates fibroblasts in the dermis to produce more collagen.  This provides firmness to the skin, as well as wrinkle reduction.  The dryness you experience upon initial use is usually temporary.  Often oilier skin are unaccustomed to depending on moisturizers, but don't resort to heavy creams.  A water-based fluid with calming ingredients is often sufficient.

It is also imperative that you discuss any beauty services you plan on receiving with both your doctor and those actually performing them.  Many facial treatments  cannot be used on Retin-A clients or will need to be customized for you.  Waxing services are notorious for causing damage to Retin-A users because the top layer of the skin is known to come off along with the unwanted hair. It is not uncommon for you to be asked to stop your medication 48-72 hours before receiving an esthetic service.  This disruption may affect the outcome of your treatment.

Sunscreen is not considered optional while using Retin-A.  Daily SPF is required, and you must remember to take extra precautions when spending time outdoors.  Sunscreen must be reapplied every two hours, and protective clothing often is also necessary.  If you experience a sunburn of any kind while using Retin-A, you must wait for the skin to heal before resuming treatment. 

Though redness is a commonly reported side effect, you should report it to your doctor if your skin feels tender and irritated.  Some people do not recognize an actual burn they're experiencing within the first few weeks.

Unless you have been instructed to do so, you must stop all other acne medications when you begin Retin-A.  For many, this means throwing out the old products and starting from scratch. If you want to customize your routine, partner up with your doctor to do so.  Aside from the damage misuse of this medication can cause, it is a shame to make careless choices with your skincare that could change the product's effectiveness.  Retin-A is chemically unstable.  The active ingredients found in most other acne medications or exfoliators will make the medication ineffective. 

It is best to begin your Retin-A treatment slowly because otherwise the skin can become so irritated that you must discontinue use.  Typically clients begin incorporating Retin-A into their nightly routine three nights out of the first week.  If well-tolerated, Retin-A can be used every other night during the second week.  Your particular treatment may vary, but most dermatologists suggest starting slowly until you can comfortably use the product nightly. 

Some doctors recommend using Retin-A both morning and night, but this is decreasing in popularity--especially with female patients.  I personally have witnessed better results from nightly applications in myself and others, but I don't write the prescriptions.  

Retin-A should be applied to clean skin.  Only use a mild, nonmedicated cleanser during your nightly routine because a plethora of common ingredients are contraindicated.  Most dermatologists suggest using Cetaphil, which is readily available.  However, many clients complain that Cetaphil does not provide a sufficient cleansing for them.  Substituting other cleansers is more problematic than you may think because many botanicals, menthol, and AHAs/BHAs are not options.  One client of mine asked for alternatives she might use that do not contain sulfates, and I had to rule out over fifty "mild cleansers" before I found some she might like from the Sephora website. (Literally fifty.)  A few that I have found include:
  • First Aid Beauty Face Cleanser
  • Laura Mercier Flawless Skin One-Step Cleanser
  • Laura Mercier Flawless Skin Oil-Free Foaming One-Step Cleanser
  • Kinerase Gentle Daily Cleanser
Though I have not reviewed the ingredient list, both Kiehl's and Dermalogica offer a variety of cleansers that you could discuss with your doctor.  (Not all of their ingredients are publicly listed at this time.)  When choosing a cleanser, always double check the ingredient list.  Many mild cleansers designed for sensitive skin contain menthol to reduce irritation.  This is specifically contraindicated by the manufacturer.  Natural cleansers are particular problems because they often contain higher amounts of essential oils.  Aside from pure glycerin bars, I can't think of many options available at the health food store.

Using a toner during your nightly Retin-A routine is a waste of time, in my opinion.  I suggest using a cleanser that is designed to function without one.  Combined with a good makeup remover, your cleanser should rinse easily with warm water and leave behind no residue.  As you are rinsing, you may want to switch to slightly cooler water to enjoy a more freshening effect.

Pat skin dry with a clean towel, then wait a minimum of twenty minutes before applying the Retin-A.  Some dermatologists suggest waiting even longer.  This sounds silly to most people, but it's an essential direction.  Your skin must be completely dry before you use Retin-A and oily skins especially cling to more hydration that you can't feel.  Moreover, the friction of cleansing can often stimulate blood flow that can make you more prone to a reaction.  Set a timer if you have to, but don't rush to the next step.

Wash your hands with soap and water immediately before applying Retin-A.  Aside from being hygienic, you don't want to destabilize the product.  Apply no more than a pea-sized amount to evenly cover the face and onto the neck.  Retin-A is not a spot treatment, and you always want to lean on the side of caution.  Unfortunately some tubes dispense out more than needed, so always look at how much product you're using.  Resist the temptation to overmedicate. This is the number one Retin-A mistake.  Unless your doctor tells you otherwise, you should never reapply after you've dispersed the product.  The product should feel weightless and look invisible. 

I suggest dotting the product onto the forehead, cheeks, and neck, then spreading to the rest of the face.  Avoid the eye area, and be sure not to get inside the lips or nostrils.  You should also use as little as possible on the chin and upper lip because this area is the most prone to irritation.  (This is why I don't recommend dotting the product onto the chin area.)

Wash your hands immediately after applying.  Ignoring residue on your hands may result in accidentally wiping more product than desired on the skin or (worse) getting the product into the eye.

Leave the product on the skin for one hour before applying any moisturizer.  Again time is important.  And check the ingredients.  Many acne sufferers don't need to moisturize, but even some of the oiliest skins may face some dryness.  Anti-inflammatory ingredients like aloe, chamomile, and green tea can help soothe redness and irritation. 

Hydrating at night will also make flakiness less apparent during the day.  Choose an oil-free product unless instructed otherwise. 

Your morning routine isn't nearly as strict.  Your doctor may recommend using another topical product or chemical exfoliant at this time, but any morning routine must include another cleansing and sunscreen without exception.   Blue Lizard, Bullfrog, Dermalogica, Clinique, DDF, Neutrogena, and Coppertone all have sheer broad spectrum SPF 30 products specifically designed for the face.  Apply your sunscreen as your daily moisturizer to minimize that greasy feeling sunscreens can leave.  You may want additional hydration if dryness or peeling are bothersome.

After using Retin-A for several weeks, most people's only side effect is flakiness.  Some flaking is inevitable, since Retin-A causes the skin to literally shed.  This is normal and is not the same as dryness. 

Many people find that a gentle physical exfoliant cuts down on the flaking.  Only introduce a scrub once your skin is no longer inflamed from acne or irritation.  My personal top choice is Kinerase PhotoFacials Daily Exfoliating Cleanser.  The granules in this product are rounded and almost melt into the cleanser, but it provides consistent results that you can use in the shower every morning without irritation.  Dermalogica, Shiseido, Clarins, and Clinique all offer other options with microbeads in various strengths.  Avoid scrubs that contain seeds with uneven edges or anything that feels scratchy.

A facial cleansing brush like any of the popular Clarisonic models can also help remove any visible signs of the shedding process.  I suggest using the "delicate" brush head if you choose to use this method of cleansing.

Some say that Retin-A causes an initial "purging", but this is often misconstrued.  You should not experience any new lesions after the first few days of treatment.  (Within the first day or so is coincidence.)  Retin-A will push the clog to the surface, so some blemishes may appear larger than before you started your treatment. You may also notice congestion you might not have been able to see as easily before, but any bumps covering large areas are not normal and could be a reaction if seen within the first few week. Though you may be less satisfied with your skin's overall appearance during the initial side effects, the acne itself should not worsen.  Swelling or redness may fool the eye, so concentrate on soothing any inflammation instead of attempting to spot treat the lesions.

New breakouts could also occur from suddenly stopping other acne medications that may have been starting to work.  Ask your doctor for instructions on stopping other treatments.

Those with very sensitive skin may need to use Retin-A less frequently.  Some doctors suggest applying Retin-A to the skin for only fifteen minutes, then rinsing it off when first used nightly.  Discuss this option with your doctor if leaving it on overnight is too uncomfortable.

Retin-A stands apart in the treatment of adult acne because unlike other acne treatments, it gives you beautiful skin in addition to curing your breakouts.  Whether you choose Retin-A or not, your adult acne deserves more than kid stuff, so partner up with a dermatologist or esthetician to conquer that complexion.

Retin-A tips anyone?


  1. My esthetician has instructed me to make sure I apply my tretinoin cream on while my face is still moist from washing. What difference will this application make in comparison to waiting until skin is completely dry as you suggest?

    1. Excellent question! Thank you so for commenting! The reason I advise waiting to apply tretinoin cream to dry skin instead of applying it to wet skin is primarily because this is how the medication's guidelines recommend using it. In my experience, following the instructions precisely gives better and more consistent results with less complications. However, there are exceptions to these rules, and your doctor should be one to advise you on this if there's any question in your mind. Applying tretinoin to wet skin means more is absorbed at a faster rate, which can be a good or a bad thing depending on your skin. When tretinoin is used to treat photoaging, this is commonly advised for faster skin rejuvenation. However, since acne is an inflammatory condition, I would make sure that your skin can tolerate the medication without unwanted side effects before attempting to tweak the way you apply it. Making acne angry can have some terrible consequences. Often cleansing in and of itself can be very irritating for those with acne, so a brief waiting period alone can make an otherwise irritating product much more tolerable. Does that make any sense?

    2. skin bleaching Thank you for publishing this information. It is really essential for me.

    3. Thank you for reading! I'm glad it was helpful!

    4. The chemical composition of tretinoin is such that it does not react well with water. If you are instructed to apply it to a wet face, these instructions are wrong.

  2. I just starting using Retin-A Micro gel 0.04%. I am using Blue Lizard face sunscreen spf 30, but my skin still seems red. I use Retin-A every other night. I am using it as a mild skin peel to help remove pitted acne scars. Is there on brand of sunscreen that is best to use while on Retin-A? Thanks

    1. Hey Erin! Thank you for the excellent question! There are many excellent brands of sunscreen that can be used with Retin-A, but there is not one single brand that is the best. Blue Lizard is an excellent choice because it contains zinc oxide instead of avobenzone. However, it also contains octinoxate, which is irritating to some (but relatively few) people. You could try something like Neutrogena Pure & Free Baby, which contains only titanium dioxide and zinc oxide as the sunscreen. Regardless, Retin-A is quite irritating for some people, so I would have a talk with your pharmacist and/or if you're frustrated with the side effects because there are plenty of other factors that may be influencing your skin's condition. Hope this helps!:) Thank you again for reading and commenting! Fondly, Elizabeth

    2. Could I have said "excellent" any more times in that last reply??? Or "contains"?! BAHAHA! I also meant to say "pharmacist and/or doctor"...not just "pharmacist and/or..." I apologize for not proofreading before posting. Fondly, Elizabeth

    3. Pathological approach for using Retin A in various treatment.

  3. hello! i just wanted to ask a question! im going to start using Retin A soon. I know how to use it at night. But, i was wondering about the mornings since i wont be using the retin a during the day. I made a plan for the morning on what to use, but I'm not sure if the plan is good or if it will end up harming my skin! This is my plan: Wash face with Cetaphil Cleanser. Next, apply Neutrogena Pore Refining Toner, then use an SPF 30 sunscrean. This is what i have planned and I am not sure if it will workout or not. Keep in mind that I have naturaly oily skin and I havn't used the Retin A yet. I shall start as soon as I can once I know what to do in the morning! Thank you sooo much!

  4. oh, and im 25 years old, just incase my age is needed!

  5. Also, I forgot to mention, what do you think I should use; the Neutrogena Pore Refining Toner, or should I use a toner with salicylic acid in it? Do you know of any good toners with salicylic acid in it? THANKS! I will be checking up on this blog to see if you replied!

  6. Sorry, I also forgot to add, that i DO NOT have any acne. My doctor prescribed Retin a to me because I have large white and blackheads.

    1. Hey nabnab! Thanks so much for taking the time to comment! This is a really interesting question, and I'm sure a lot of people can benefit from this. The Neutrogena Pore Refining Toner contains some problematic ingredients that are not recommended to be used with the Retin-A, such as alcohol, witch hazel, and peppermint. Additionally, using another medicated product that contains AHAs/BHAs during the first few weeks of using Retin-A is too much for a lot of people and could lead to too much irritation and dryness. Even if your skin is oily now, it may change while you're using Retin-A. Eventually you can add in an anti-inflammatory toner that has salicylic acid in the morning, like those offered from Paula's Choice...but you may find it's not even necessary. Above all, listen to your doctor. If he tells you that the toner's okay, then by all means, ignore me! Your choice of cleanser and daily SPF sounds great though, so great job on protecting your skin! Good luck with the Retin-A! Thank you again for taking the time to read and comment! I really appreciate it! And let me know if you have anymore questions. Fondly, Elizabeth

  7. I have been using Tretinoin Cream 0.025% for less than a week but had a question about it: I have oiler skin and it seems as though my skin appears to be a little bit more oily in the morning after using this at night. Is the gel better for my skin? I read somewhere that oily skin does better with the g/el formula, is this true? I have noticed some congestion like you mentioned above and would love it for the blackhead on my nose to completely disappear if I can while using Retin A. Will by black heads eventually clear up on this prescription? or should I switch to the gel formula?

    1. Hello,

      What you're experiencing is very common, so thank you for taking the time to ask this question.

      Many people find that their skin becomes slightly shinier throughout the day when they are using Tretinoin (Retin-A) regardless of whether they are using the gel or cream formula. I know the shine can be annoying, but it doesn't necessarily mean the product isn't working. In fact, in my experience, those that experience increased oil production often have the best results with Retin-A because their skin is more tolerant of the medication.

      The controversy over whether or not the gel is more effective than the cream is a different matter. The cream vehicle is slightly comedogenic when you look at the inactive ingredients list. Without the medication (active ingredient), the cream would not be ideal for acne-prone skin because it could theoretically clog pores over time. However, the cream is much easier to tolerate than the gel, which is more drying and deposits the medication into the skin a bit more quickly. Irritation can be a real concern.

      Your doctor likely prescribed the cream because it's more easily tolerated than the gel. However, if the cream feels heavy and your skin isn't experiencing any other unwanted side effects, it would be worth asking your doctor if he/she thinks you should switch...especially if you notice your blackheads becoming worse.

      I know many people with oily skin who've had excellent success with both the cream and the gel. It should clear up blackheads if used consistently over time. If you don't see any results, doctors will often switch patients to the gel for the reasons I stated above.

      Please note that while your skin may be getting oilier, the Tretinoin is working to make your cell turnover rate more normal, so you'll get less breakouts. The excess oil may be annoying, but it doesn't necessarily mean that you're going to experience more acne.

      Good luck! Thank you so much for reading and commenting. Let me know if you have more questions. I'm always happy to help!

      Fondly, Elizabeth

    2. Hi Elizabeth,

      Everything you said makes completely sense to me, and it is true that so far I have not experienced and negative side effects from using Tretinoin (Retin-A) what so ever. I will take our advice and wait it out a little while longer and see if my blackheads clear up more and if not then I will contact my doctor and ask to possibly switching to the gel form. I guess it doesn't hurt to try and weigh out each form and see which works out for me the best, and thanks for answering my questions so quickly because it really does help me out!

      Thanks again, Sarah

    3. Hey Sarah,

      You're welcome! Sounds like you've come up with a good plan. Good luck! And keep us posted on what happens! :)

      Fondly, Elizabeth

  8. Hi - thanks so much for your blog! This is some of the best, most comprehensive info on acne I've found! I have suffered from acne and very oily skin for 20 years. Recently I started Retin-A Micro (switching from Differin which didn't give me the best results), and my face is breaking out like crazy! I have been on it for 4 weeks. The package insert says "acne may worsen in initialweeks," but your post says it doesn't make you break out initially... can you clarify? I am confused and not sure what to do.

    1. Hello JennyB77,

      Thanks so much for your kind words and your great question! The reason that statement is included on the insert is because it’s an irritating product. Anything that causes irritation theoretically can make acne worsen because it’s an inflammatory skin condition. Irritation worsens inflammation. However, if someone begins using Retin-A gradually the way I describe, this normally doesn’t happen. Often they’re mistaking a reaction for acne, which can look quite similar. Overmedicating skin can also cause skin drama as well.

      Overall, adding an irritating product into someone’s routine that already has clogged pores won’t stop the breakouts you would have seen anyway from surfacing. If the product is irritating your skin as well, it will seem like the acne is worse.

      Basically the medication hasn’t taken full effect yet. Clogged pores are a result of irregular cell turnover rate. All blemishes begin with a microcomedone inside the pore, which we can’t see with the naked eye. Retin-A does not take care of those microcomedones we already have.

      Retinoic acid is telling your new skin cells to function more optimally to stop this process from happening again, but it won’t clear out the pores that are already clogged. You should see results by 8-12 weeks though. If not, I would speak to your doctor.

      If the type of breakout is particularly unusual for your skin, I would contact your doctor even sooner. Sometimes the vehicle can cause problems for certain skin types, or a different or additional medication is needed. Because you're switching medications, there could also be other factors going on.

      I hope this was helpful. You are also welcome to email me anytime at
      Thanks again so much for commenting! Please keep in touch, and let us know how your skin is doing. Good luck!

      Fondly, Elizabeth

    2. Makes perfect sense. Thanks for explaining it. My skin is slowly but surely improving - I had a mass breakout on my forehead, which historically is the first place I break out. The rest of my skin looks great - so I'm just waiting for that area to clear. I'll keep you posted!

    3. I'm so glad to hear your skin's improved! I definitely look forward to hearing updates. :)

      Fondly, Elizabeth

  9. Hello, I have suffered 3 years of my life with cystic acne and i have been on retin a for 4 months. They haven't changed at all, except one and thats because it got a little bigger! the rest of my face cleared up 100%, all except the cysts. so should i keep using retin a or switch to something else?

    1. Hey Nick,

      Since cystic acne occurs deeper within the skin, it normally requires internal treatment as well, such as antibiotics or--in extreme cases--Accutane. There are also holistic options that many dermatologists are using, such as zinc glutamate. You can also ask your doctor about some of the newer combination therapy topicals that are available. These combine an antibiotic like Clindamycin or Benzoyl Peroxide with a retinoid, which provides a more intensive treatment.

      Hope this helps! Please let me know if you have any more questions!

      Fondly, Elizabeth

  10. Hello,

    I just discovered this very good article. I have been suffering from acne for 10 years now (I'm 25 yo male).

    Peroxid Benzoyle did fine job the last months, using a 2,5% gel + moisturizer. However it was auto-medication and I started to have more blackheads + congestion.

    So I saw my derm, who prescribed me a Retin-A equivalent in my country, cream form. It has isopropyl myristate inside, which is rather not cool in my opinion.

    After 10 days of use, using it every other night, I noticed that :

    - my skin became oily (not a real problem at the moment, as it always become oiler when summer comes)
    - my skin is peeling a bit but overall I am tolerating the product very well
    - my skin is breaking out like it would break out without Pero Benzoyle.

    I am very concerned with the last point. I get 1 or 2 new spots a day. They look not very inflammed, but congested. Some whiteheads comes too.

    The new moisturizer she gaves me is non comedogenic (certified) and is very light.

    I use it at morning + night. I shave with non comedogenic very smooth gel specific for acne skins and I am becoming concerned by this breakout...

    1. Hello Vince!

      First of all, thank you so much for your kind words and for taking the time to comment!

      What you are going through is not uncommon. In fact, I have gotten a lot of emails and comments about this sort of issue recently.

      I think one of the main issues here is that you were seeing some results for the Pero Benzoyle... but not the ideal results. Stopping that medication may have complicated the situation and makes it difficult to determine whether or not the Retin-A is a good choice for you.

      Everything you're experiencing is a normal initial response to Retin-A that should go away after six weeks. It doesn't mean the medication will not give you results down the road. However, if it's particularly bothersome, I would contact your dermatologist. Many people use benzoyl peroxide or some other topical disinfectant in the morning and their Retin-A at night with great results. Your dermatologist can advise you on whether or not this is the best choice for you.

      You can also ask your dermatologist about combination therapy. There are treatments that are now available that combine retinoids and benzoyl peroxide. In the U.S., we have a medication called Epi-Duo, which combines adapalene (Differin) and benzoyl peroxide in a gel formula. Adapalene is like Retin-A, but it can be used simultaneously with benzoyl peroxide (unlike tretinoin.) I don't know if this product is available everywhere, but it may be worth asking about.

      Hope this was helpful! Please let me know if you have any other questions. Good luck!

      Fondly, Elizabeth

    2. Hello Elizabeth,

      Thank you for your answer and your time. It is really cheerful and any long time acne sufferer knows how it is .

      I have great news. My first breakout (which was quite bad, with swelling of the skin, etc) is clearing up fast and I have to say, touching wood, that my complexion is better than it ever was.

      I use :
      - Retin-A cream 0,05% (french equivalent) at night. No moisture.

      - Eucerin Aquasporin Light moisturizer at day

      - Zinc 30mg /day
      - Effaclar (La Roche Posay, don't know if available in the USA) cleanser
      - Serozinc (a special "toner" bundled with zinc in a spray form, just water + zinc + some minerals, pretty useful after shower)

      This is a fast routine (takes less than 3 min), with not a lot of products, perfect to preserve manlyhood =D

      The only "side" effect still persisting is post-shaving inflammation, which lasts something like 30 minutes, very bearable.

      I have to add : I am a very hard acne sufferer. Family thing. Luckily, my skin is very tough and I don't really scar.

      However, I had red marks from a bad breakout last year (induced by BHA... my skin can't tolerate it). In 2 weeks, retin-a made them nearly disappear (not totally, but nearly).

      I was following a hard Benzoyl Peroxide treatment. Like 2,5% gel morning and evening every day on the whole face then moisture etc. This kept my face clear. However I had a bad complexion with this, like my skin was not healthy, pale with reddish spots, never really well moisturized. I don't think Benzoyl Peroxide is a good option for me anymore.



    3. Hey Vince!

      I am SO happy to hear your skin is improving! That's fabulous news!

      It sounds like your skin was just struggling with switching from one medication to another, which happens to a lot of people. Benzoyl peroxide can be very difficult for many to stop using--even without Retin-A.

      Zinc is amazing for breakouts. I take it myself, but I try to only take it for three months at a time because it can deplete other nutrients and decrease immunity with long term use at high doses. I'm also a huge fan of alpha lipoic acid, which has really helped me with redness from past breakouts, replenishes antioxidants in the body, and stabilizes blood sugar. I would definitely talk to your doctor before starting any new supplement, but it's worked wonders for me.

      Sounds like you've got a great routine going! Just make sure you're protecting yourself from the sun, especially since you shave, which physically exfoliates the skin. Zinc oxide may help with the inflammation you're experiencing and shouldn't cause any sensitivity.

      Thanks so much for commenting and keeping us updated! I'm so glad to hear your skin's improving. And thank you so much for sharing your experience with Benzoyl Peroxide because I know many people feel the same way you do and can benefit from learning about your experiences. Stay in touch!

      Fondly, Elizabeth

    4. Hello,

      Well, I spoke a bit too fast. I am now like 20 days into my tretinoin regimen.

      A new breakout appeared, it is not a big one however I did the mistake to pick a bit and I learnt the hard way : tretinoin makes my skin fragile. And being heavy on caffeine makes you pick.

      I don't really know if they were caused by tretinoin because Iwas trying melatonin supplementation as well and I suspect it to be one of the causes...

      Regarding ALA, I will definately take a look. Sun is a real concern. I will go to vacation in spain in August and I will have to wear real good protection and I fear sunscreen induced acne...

      Benzoyl Peroxide is a trap for me. It works, but, as a chemist, and someone who studied pharmacology extensively, I cannot imagine applying BP on my face every day for years.

      Every time I tried to stop, breakouts appeared, and it was emotionnally hard. But I cannot imagine stains, and BP on skin 2 times a day every day.

    5. Hey Vince,

      You think the melatonin may have caused your breakout??? That's really fascinating! I wonder why...

      Thanks so much for sharing,

    6. I think it was definately not the melatonin. I'm now understanding that Retin-A is going to be a long ride, and a difficult one.

      I'm at 3,5 weeks and... My skin is pumping out whiteheads and small pustules, they come overnight, very fast, and some of them get away with the shaving (and the blood... sigh...) It s really hard right now.

      However I can see the positive results sometimes : my skin is becoming smoother and smoother, the spots heal fast (in 2 / 3 days), and red marks fade. However I think I will still have 1 or 2 months of breakouts...

    7. Hey Vince,

      I'm glad to hear you're having some success, but I know it's frustrating to have to continue to deal with the occasional breakouts. What has your dermatologist said about your progress?

      Good luck! And thank you for commenting!
      Fondly, Elizabeth

  11. Hello there!

    I'm so glad I found your blog! I started Retin-A about 5 and a half weeks ago, although it feels like an eternity! I've been suffering from adult acne for about 4 years now, but it became severe around this time last year. I tried to go on Retin-A around August of last year, but was not using it correctly (2x a day) and my face was very red and irritated until I stopped in November. I used the oil cleansing method since then, which was ok - but I really wanted to try Retin-A again for the anti-aging effects, as well.

    Like I mentioned, I started Retin-A again 5 and a half weeks ago - applying it only once at night, with a non-comodegenic face cream, and then in the morning I use only Neutrogena SPF moisturizers after cleansing. The first week was fine - I didn't see any adverse reactions like I did last time (extremely red and burning skin, lots of flaking). However, my skin started to break out even more, and it's the kind of acne where it looks like 2 or 3 pores in the same location have been clogged. I rarely pop them, unless one breaks while I'm washing my face... but they keep appearing.

    I know I'm not the only one who's asked this in the comments, but is this normal? As I mentioned, this seems to be the only adverse effect I've experienced this go 'round, and every where I've read says to stick with it - but should I put up with the breakouts until they clear all the way? Or is this a bad reaction to the medication?

    The breakouts tend to stay in patches on my face. I have one on each cheek, right in the middle, and then another on just the left side of my forehead, and then a patch on each side of my chin. If I cover the patches up, I can tell that the texture of my skin is improving so much. But when will my whole face look normal again?

    Luckily, I've found a good tinted moisturizer to mix in with my SPF, so the redness is easier to cover during the day. But I'm just tired of my face looking disgusting when I work out and when I go to bed and wake up each morning. It's really taken a toll on me emotionally, but I'm willing to work with the medication if I know that this is a "normal" period to go through.

    Any advice you can give would be much appreciated!

    Thanks so much, this was such a wonderful article. :)

    1. Hey Amanda!

      Thanks so much for taking the time to read and comment! I really appreciate your kind words.

      Okay... Yes, it is normal to experience a bit of flaring when starting Retin-A, but I can't accurately say whether or not that's what's going on here because I don't know how the breakouts looked before for comparison. Your dermatologist should be able to tell if you're making any progress, but I know the waiting experience can be brutal! However, since you said the texture is improving, I would stick with the medication--especially if you're not experiencing any other adverse reactions.

      Be sure that you are using a water-soluble cleanser to prep your skin, as those that don't rinse easily can often leave patches of skin that don't absorb the medication as efficiently. Oil cleansers are awesome for removing makeup, but I would suggest following up with a mild, rinse-off cleanser to prep the skin and remove any residue.

      Also patches of breakouts can often indicate "acne cosmetica", so you may want to check any makeup items like bronzers or hair products that could be coming into contact with these areas, leading to either clogged pores or irritation.

      You could also ask your doctor if a prescription topical disinfectant would be appropriate for you to use in the morning. This can really help with stubborn breakouts when you're seeing progress with Retin-A...but not as much as you expected.

      I hope this was helpful. Please let me know if you have any more questions. I feel like I was a bit vague here, but this is always a difficult question to answer. As you can see from the other comments, you're not alone here. Many other people have stuck with it and had great results. Stay in touch!

      Fondly, Elizabeth

  12. hi

    i will start use retin-A 0,05% cream with this two products:

    they are good? the ingredients are compatible with retin-A?

    gratz for the blog, have lot of information.

  13. i saw this 2 products that seem better:

    what you think? bioderma or avene products? or none are good?
    btw i have a very oily skin, will be retin A gel better than cream?


    1. Hello Styken,

      I only saw a full ingredients list on the Bioderma, as the Avene had only a partial list of ingredients for me to look at. However, from what I saw, I believe the Avene might be a bit better as the Bioderma contained fragrances and also included chemical sunscreens that could potentially be irritating.

      I would talk to your pharmacist and/or dermatologist about whatever you decide to use though because--like I said--I didn't see a full ingredients list for the Avene.

      As for whether you should use a gel or cream formula, there are pros and cons to each. The cream may be comedogenic after months of use, but the gel contains alcohol, which can be irritating. I usually suggest using the cream until you know how your skin will react, then switching to the gel if you find your skin becomes oilier. Then again, ultimately the decision's up to your doctor who will be prescribing it. He or she can explain why or why not one is better for you than the other.

      Hope this was helpful. Thanks for commenting!

      Fondly, Elizabeth

  14. This was SO useful, thank you!
    I have a few questions though! I'm sorry if you feel as if you've answered them already- I just want to clarify!
    I am only 14 but have been battling with acne for about two and a bit years now. I tried so many products but about a year ago I decided my skin was getting worse and nothing was working and me and my mum agreed it would be better to try and get it sorted as the spots were becoming increasingly worse.
    I went ot the doctors and was given various topical creams containing benzoyl peroxide and salicylic acid and nothing worked so I was put on antibiotics called Oxytetracycline around last October. I took them and up until about three months ago they worked wonders and I was 100% clear. Three months ago my skin started breaking out horribly- worse than ever before and I spoke to my doctor and she told me skin could often become immune to the antibiotics and they could no longer prevent the bacteria forming as the bacteria becomes "stronger" if you like and your spots often come back worse! I was prescribed the contraceptive pill to try and prevent the acne but I got unbearable leg cramps so I was unable to continue. I was finally reffered to the dermatologist which took a couple of months and I visited last friday and I was prescribed Retin-A 0.01% and a different type of tetracycline antibiotics called Tetralysal. My skin is currently not awful in relation to other peoples acne but I always develop new spots and generally have 4 big-ish active spots all the time and various other "dying spots" but generally people say my skin is not too bad, but to me its awful and I am starting to get upset about it and depressed!(Sorry for such a long explanation but I want to be as clear as possible!)
    So here are my questions.
    Firstly, do you think the Retin-A will still be effective after the problems i experienced after the antibiotics I took and the fact that my bacteria is now "stronger"?
    Also, I was advised not to use moisturiser and only soap on my face, but surely if my skin becomes too dry it will produce more oil and the problem will worsen?
    She also advised I only applied it for an hour for the first few nights so my skin was able to get used to it, will it still be able to work?
    Also, I have 8 weeks of school and go back in September and if I start today will my skin be still in an awful state when I return?
    Finally, I am so self conscious without makeup and need it to be comfortable out the house and I am not good at reapplying throughout the day so I have a 10 hour sunscreen so I dont have to reapply but I am worried about the ingredients reacting with the Retin-A, its called Riemann P20 Once a Day 10 Hours Protection SPF 20 Medium, is this safe to use do you think, it seems very strong and packed with chemicals?
    I'm so sorry for all the questions and I should have asked the dermatologist but at the time I didnt't think and I have to wait 3 months in between appointments! I thought your advice was fantastic and I love reading all of your very informative posts! Sorry for all the questions, I realise you may not be able to answer them all I just feel like I need reassurance because I'm petrified to start using the Retin-A!!
    Connie x

    1. Hey Connie,
      Thank you for taking the time to comment and ask all your intelligent questions! I’m sorry to hear that your skin has been so stressful for you, but with the help of your dermatologist, I’m sure you’ll be able to manage your breakouts.
      Before I answer your questions, I wanted to ask… Do you live in the U.K.? I’ll get to why I’m asking in a minute. I want to answer your questions in order though first.
      Retin-A works by normalizing cell production. In order for acne to occur, our pores have to clog with dead skin cells and oil. People with acne have an inherited trait called retention hyperkeratosis. What this means is that your skin cells are producing so quickly that your skin can’t shed them fast enough, making clogged pores inevitable. Retin-A penetrates the skin and tells your skin cells to start behaving themselves and stop doing this. As a result, your skin cells start exfoliating themselves properly. This allows the oil your skin produces to expel more easily. It also has an anti-inflammatory effect once your skin gets used to the medication and accelerates wound healing.
      Retin-A does not kill bacteria, but it is often used with antibiotics to jumpstart the treatment. When the pores are already clogged, bacteria feeds off the oil inside the follicle. The antibiotic is killing that off and will probably only be used temporarily. (Your doctor will decide when you don’t need it anymore.) The Retin-A is a more long term solution. Some teens grow out of their acne. Others do not. It depends on your genetics. However, if you wanted, you could use Retin-A for the rest of your life, and your skin would age really beautifully. It does need to be used consistently though in order for you to reap the benefits.
      Most teens usually do not need to use a moisturizer. Applying sunscreen in the morning will provide everything a good moisturizer would—as long as it’s not alcohol-based. Many foundations will also provide moisture and environmental protection that can replace a moisturizer. I only really recommend moisturizers to teens during the winter months. Even then, I would only suggest using them once a day. If you notice your skin becoming dry and tight, I would recommend switching your cleanser or contacting your doctor about adjusting your medication. Your skin should feel comfortable after you wash your face—never tight. If it doesn’t, you’ll experience more side effects from your medication. Oil production is controlled by hormones, and as long as your skin is not irritated, you should not produce any more oil by not using a moisturizer.
      The Retin-A will still work if you only apply it for an hour at night. It’s important to ease into treatment because if your skin becomes irritated or sunburned, you’ll have to stop treatment until your skin heals, which is not fun and delays results. Since antibiotics can also make your skin sensitive to the sun, leaving the medicine on overnight could make your skin too sensitive at first. The results you’ll get will be similar to what others see by applying the medication every other night. However, clinical studies have recently shown that it’s better to use medications consistently...

    2. I can’t predict when you’ll start to see results, but many people notice improvements within two or three weeks of treatment. For some people, it can take as long as twelve weeks. Six to eight weeks is pretty typical. Quite honestly, it will depend on how consistently you use it. Don’t stop taking the medication if you think it’s not working, and don’t be surprised if your skin looks worse before it looks better. Since some people notice flare ups in the first few weeks, I would just try to get past that stage now while you’re out of school. A lot of people are so worried that their skin will get irritated or that they’ll have a breakout when they start Retin-A that they barely even use the product. I would just use it exactly as you’ve been instructed, and if you don’t like what you’re seeing, call the doctor to make sure what you’re experiencing is normal.
      I live in the U.S., and here it is illegal for any sunscreen to claim to last ten hours. However, every country has different regulations on sunscreens. I have heard good things about the Riemann product, and when I looked at the ingredients list, it looked almost identical to the sunscreen I used when I took Accutane at your age. For me, it was fine, and the only problems I had were on my chest where I didn’t apply it on a daily basis. Back then, no one ever reapplied sunscreen, but I somehow never burned. I’m super pale and burn very easily even when I’m not on medication, so needless to say, I was very impressed with it. That’s my personal experience though, and it’s not based on any kind of research.
      There are a couple of concerns I have about using this product with Retin-A. For starters, the product is alcohol-based. Alcohol is one of the skin care ingredients that you should not use with Retin-A, as it can be quite drying. (You also won’t get the moisturizing benefits of sunscreen I mentioned above.) Secondly, the product contains chemical sunscreens, which can be very irritating to sensitive skin. Since Retin-A sensitizes the skin, you may find it stings when you apply it or that it increases any flushing. If you choose to use it, I would patch test a small area on half of your forehead first. That way if you have any irritation, you don’t have it all over your face...

    3. I usually recommend physical sunscreens, which contain either zinc oxide or titanium dioxide. They don’t produce heat on the skin, which causes the sensitivity. It’s often difficult for me to recommend sunscreens to people outside the U.S. because the regulations are so different, but I would highly recommend La Roche-Posay Anthelios, which is available in most countries. They sell a mineral sunscreen, which contains titanium dioxide. It’s very light and suitable for sensitive skins. Their chemical sunscreens contain Mexoryl, which provides some of the best protection available. I never have any issues with their sunscreens, and my skin freaks out whenever it has the opportunity.
      I would also contact your doctor and/or pharmacist and ask what they recommend you use.
      You mentioned not reapplying often, so let me address that really quickly. From what I read, it sounded like you’re not reapplying because you don’t want to mess up your makeup, which is totally understandable. If your makeup is still on, the sunscreen you’ve applied underneath should still be intact. If you need to touch up your makeup, that’s the time to reapply. You can purchase makeup that includes SPF to make reapplying easier. I usually apply sunscreen in the morning under my makeup, then carry the SPF wipes and a power with SPF in my purse to use throughout the day. You should also use sun protective clothing like hats and sunglasses when you’re outside because sometimes sunscreen alone isn’t enough. If you’re planning to be outdoors, try to avoid being in the sun between 10 in the morning and 3 in the afternoon.
      I hope this was helpful. Feel free to ask me anything anytime. I’m always happy to share anything I know with you—even though it’s all quite general. Most of my posts are related to adult acne, so I can’t tell you how excited I was to see a teenager reading my blog. It made my day! Let me know if you have any requests for upcoming posts you’d like to see. I just filmed a video on Retin-A that I will be posting as soon as I edit it, and that should provide some more information for you. Let me know if you have any requests for upcoming posts you’d like to see. Many people are nervous when they start using it, but as long as you pay attention to your skin, diligently use sun protection, and only use a tiny, tiny amount, you should be in good shape. Good luck!
      Fondly, Elizabeth

  15. Oh and also! I heard it was bad to use Sulfur products with retin-a and I have been usin a sulfir spot treatment for a while now and I even applied it this morning and intend on applying retin-a tonight, is that a problem? x

    1. Hey Connie,
      I would call the doctor or pharmacist and see what they say. You’re correct that you should not use sulfur at the same time as Retin-A. This is because it is such a strong drying agent. You mentioned that you were using it as a spot treatment. If you only dotted it on a blemish or two, I don’t think it would be much of a problem if you weren’t noticing any dryness. If you used it over large areas or notice any dryness from the sulfur, you should wait a day before starting the Retin-A. It’s generally recommended that you wait until the side effects of the sulfur have gone away before you start the Retin-A. If you haven’t waited long enough, you’ll notice stinging where you apply the Retin-A, and you can wash it off. If you can't get in touch with the doctor, you could always patch test the Retin-A in a small area on the forehead to be safe. =)
      Fondly, Elizabeth

    2. Thank you SO much for everything! Firstly, may I just say you have put me at ease so much! Ever since I was prescribed the Retin-A I have cried so much, in fear of using it! I don't even fully understand why I'm so emotional about it, I think I just know how upset I get when my skin is really awful and I'm expecting my skin to suddenly be practically falling off and covered everywhere in spots! But thank you so much for your helpful comments! I really, truly appreciate the time you have taken to reply in such detail and you've made my day!
      Firstly, I do live in the UK!
      Your comments about the moisturiser were very reassuring because when she said not to moisturise I was shocked because people always seem to talk about it being so essential even if you have oily skin, I suppose I didn't appreciate this was often more aimed at maturer skin perhaps!
      The Dermotologist didn't specify how long before I could leave it on over night, do you have any recommendations or should I try to get in contact with my doctor or something?
      I'm planning to start on Wednesday in order for the small amount of dryness caused by the sulfur to go and I'm also away Tuesday night. Nevertheless, hopefully I will be over the worse by the time I am back at school!
      Thank you for looking in to the sunscreen, although I used that one on holiday last week and it was very effective all day, it did smell rather strong and did irritate my skin a little. I have ordered some La Roche-Posay Anthelios, but until it arrives I have some remaining 'Simple Sun Sensitive Protecting Facial Lotion SPF50' ( which seems pretty gentle, do you think this will do for now?
      Thank you for the information about make-up reapplication etc, thats partly why I purchased the 10 hour sunscreen but what you said was very reassuring!
      I apologise for my long response and all of my questions! I understand it might be quite irritating but I've been so worked up about using it and I'm so, so happy I've got the information I need to start using it with confidence!
      I was doing lots of research on Retin-A (perhaps too much- some of the awful stories you hear can be very off putting!) and I stumbled across this blog post and I can't tell you how happy I was! I now have your blog bookmarked and have enjoyed reading your other posts! You explain everything so well!
      I'm excited to see the video! Once again, thank you SO much for all your helpful advice and comments! You really have made me so much happier and made my day! Now I just have my fingers crossed that Retin-A works for me!
      Thank you, thank you! Connie x

    3. Hey Connie!

      You are very welcome! I'm so glad you found the information helpful. Never apologize for having questions! It just shows you have a brain...and you're using it! I appreciate that you've taken time out of your day to visit my blog, so ask as many questions as you want.

      Please don't let other people scare you. You are obviously very smart and cautious when it comes to your skin care. Not everyone is.

      Many of the horror stories you read are from people who didn't do their research or listen to their doctor. Like I said in the post, many people get sunburned and continue using their medication, thinking it's a sign that the medicine is working.

      Yes, there are people who can't tolerate Retin-A. But you've seen a doctor who believes this is the best choice for you. If something goes wrong, all you have to do is call the dermatologist. There are a lot of people who use the Internet as an outlet to vent their frustrations. For some unfortunate reason, people are more inclined to post their negative thoughts than their positive ones. Don't let them get to you. =)

      The Simple sunscreen is much more moisturizing, which sounds good. It's always a good idea to patch test your products before you try them everywhere just to be on the safe side, but since you've never had a problem with it, I don't see any reason why you couldn't use it. Just rinse it off if it stings.

      It's probably a good idea to ask the doctor how many days before you leave it on overnight. It may depend on how your skin reacts. I would be surprised if it was any longer than a week though.

      I'm thinking I might do a post on teen skin care. It's kind of ridiculous how little quality information is out there. When I was a teen, everyone pretty much said you'd grow out of acne and dismissed the emotional agony I was going through. And I would read all I could about skin care without knowing that all of the advice basically didn't apply to anyone under 30. There are a lot more options now fortunately, but I think it's difficult to know what's true, what's not, and what's relevant. Any thoughts?

      Fondly, Elizabeth

    4. I can't explain how much happier you have made me! I keep saying it, but THANK YOU SO MUCH! All my questions have now been answered and I am so much more comfortable about using Retin-A!
      You've been so helpful and I will let you know how it all goes!
      I think a post on teen skin care would be so beneficial. I couldn't agree more! When teen skin care is discussed, yes it covers blemishes but it often only covers minor perhaps monthly breakouts and the odd spot and always seems like its for teenagers a little curious about skin care and never for those who are pretty cautious and careful when it comes to skin care. I'm probably not making much sense but what I'm trying to say is I feel the things mentioned in books etc. aren't anything I don't know and they usually conclude by recommending something along the lines of an anti-blemish Neutrogena cleanser or something, which may be perfectly adequate for people with the odd blemish, but it never covers much more. I'm not trying to be stuck-up I just feel the content is never very detailed! I feel as if I'm left to spend hours on the internet researching and usually there are so many conflicting pieces of advice I find myself completely confused with all the information! So overall, I think that's an excellent idea! :)
      Thanks again, Connie x
      (Sorry for the long hard to understand sentences!)

    5. Hey Connie,

      You are TOO funny. I laughed so hard when I read, "They usually conclude by recommending something alone the lines of an anti-blemish Neutrogena cleanser or something..." It's so true! You don't sound stuck up at all! Well, I'm glad you like the idea. I'll get to work on a post then. Definitely keep me updated on the Retin-A! I look forward to hearing from you.

      Fondly, Elizabeth

  16. Thank you for all of this excellent information! I am a 27 year old female and started Tretinoin cream .0375% one month ago. In the beginning it worked like a miracle-my face completely cleared up and I had very little peeling. Then about 2 1/2 weeks in, my face broke out horribly and seems to be getting worse. Particularly my chin and cheeks have large patches of acne on it (I know this kind of acne is usually considered hormonal-but could it also be a bad reaction to the Tretinoin? I also just started menstruating). Is it normal to have your skin completely clear up and THEN "turn" horrible? I'd imagine if it was an allergic reaction it wouldn't have worked so well for the first 2 1/2 weeks, right?

    I have also recently started using Cetaphil Derma Control Oil Control Moisturizer SPF 30 and have found that the SPF makes my skin entirely too oily. In general, moisturizers with SPF really seem to bother my eyes and are very difficult for me to wear. Is there a moisturizer without SPF that you would recommend that will dry matte but is also good for people on retin-a? I have very combination skin, especially now with the acne parts of my face very dry and the rest very oily. I was looking into CeraVe products, because I am also on a budget. Do you have any experience with any of their moisturizers?

    Finally, I was given the Tretinoin cream .0375% as samples and written a prescription for Retin A .04%. However, my insurance doesn't cover it (and there is no generic apparently at that percent), and will only cover the generic at .025% or .05%. Which should I switch to? Or, because my skin has gotten so oily, should I just switch to the gel at either .025% or .01%?

    Thank you so much for all of your help! My insurance doesn't cover visits to the dermatologist, so every time I go it costs me almost $200 and like I said, I'm on a tight budget!

    1. This comment has been removed by the author.

    2. Hey Katie,
      Thank you so much for leaving this comment. I’m going to try and be as helpful as I can here. I know this situation is very, very frustrating.
      It sounds like you were written a prescription for Retin-A Micro, which is a time-released formula of Retin-A. It is quite different from the original Retin-A because it is less irritating and doesn’t contain any comedogenic ingredients or any alcohol. The dosage isn’t just different. The medication is released differently, and the vehicles are different as well. Obviously your doctor wrote you that prescription for a reason based on what he or she observed, and I’m assuming the reason that he or she gave you the samples of the tretinoin cream (Tretin-X, maybe?) is because creams absorb less quickly into the skin and most closely resemble the time-released formula. The original forms of Retin-A are a lot more irritating and can cause potential problems. However, sometimes your doctor can call your insurance company and tell them that it was medically necessary for him or her to prescribe Retin-A Micro instead of Retin-A based on the assessment of your skin. Most doctors have no problem doing this. (Why would they be happy about an insurance company telling them how to do their job?) It’s a pain in the butt, but it may be worth it to deal with the annoyance. If your insurance approves it, you should also qualify for a discount card through the manufacturer, which will lower the price of your Retin-A Micro even more.
      My point is that you definitely need to call your doctor. As an existing patient, they should be willing to work with you and answer your questions. There’s no reason you’d need an appointment to get this settled, and one of the nurses should be able to assist you over the phone free of charge. Please mention the flare up, which is pretty common but may not be normal for your skin. (Without knowing your history, I really can’t speculate about it.) I also wouldn’t purchase any new moisturizer until you get this prescription fiasco settled because the new formula may make a lot of changes to your skin, and I don’t want you to waste your money.
      I think Cera Ve’s a great line though, but it’s not exactly matte. Just saying.
      I’m sorry I didn’t answer any of your questions directly, but hopefully this information is along the lines of advice you were looking for. Please, please, please stay in touch and keep us updated. Good luck!
      Fondly, Elizabeth

  17. Thank you so much for your help! The prescription my doctor wrote me was actually just for regular Retin A cream, but she did give me samples of Tretin-X which is what I've been using. Is there that big of a difference between the regular Retin A cream and the Tretin-X? I'm almost positive my insurance will not cover Retin A Micro, so that concerns me.

    Also, the flare up has been of cystic acne, which is relatively unusual for me, at least in this large of a quantity. I really don't want to give up on the Tretin-X, but I'm so concerned that my skin is only getting worse (especially because it cleared up so quickly in the beginning!). My doctor's office is actually closed for the rest of the week, so any advice you can give me until I'm able to speak with them would be SO greatly appreciated!! THANK YOU!!

    1. Hello Katie,

      By now your doctor may be back, so I apologize if this advice comes a bit late.

      It's quite common for there to be an initial breakout with tretinoin, but everyone's skin responds differently. It's not uncommon for the breakout to look much more inflamed than what you're accustomed to seeing. This initial breakout usually occurs within 2-4 weeks of starting treatment.

      Cystic acne can be concerning if it leads to scarring, which is usually more common in teenage acne than adult acne.

      If you are really worried about how your skin's responding, you could try using less of the product or using the product less frequently. This may, however, delay results...and may not help the current situation you're having with your skin. I would try to be consistent with the plan you've layed out with your doctor as long as your skin isn't feeling excessively irritated and you're not experiencing any other side effects. If you can, you might want to leave a message on your doctor's voicemail, as he or she may be checking his or her messages while on vacation.

      Essentially Tretin-X and Retin-A are both tretinoin, so if you respond well to one, the other shouldn't be an issue. You may notice some slight differences when switching from one to the other, but they are the same medication...just in different formulas. Some people tolerate Tretin-X better than Retin-A, but many people can handle both with no problems after the first few weeks.

      I hope this was helpful. Please keep in touch. Good luck!

      Fondly, Elizabeth

  18. Thanks for all the information I was wondering if it would be alright to use Retin-A followed by Clinique dark spot corrector serum for the night time routine? What are your thoughts on Dr Wells Mega Bright serum from origins?

    1. Hey ech310n,

      The prescribing information for Retin-A suggests staying away from products that contain spices, so I would be concerned that the turmeric in the Clinique Dark Spot Corrector would cause irritation. Similarly, the Origins Mega Bright Serum contains lime, which isn't supposed to be used with Retin-A. I have nothing against the products themselves, but they're not ideal to use with Retin-A because they could cause sensitivity.

      It's really tricky trying to correct hyperpigmentation because it requires an aggressive approach to be effective...yet anything too aggressive can cause more hyperpigmentation. Whatever product you choose to use, I would suggest patch testing it on a small area of the skin before applying all over the face.

      You may also want to look at products that contain niacinamide or nicotinamide, which has been shown to have lightening effects when combined with Vitamin C. I don't know if your skin can tolerate Vitamin C. If you start using it, try using it at the other side of the day from your Retin-A to avoid irritation. Regardless, niacinamide is a fabulous ingredient with low risk of causing any side effects that also boosts the barrier function. Licorice extract would be another excellent ingredient to look out for. Your doctor can also prescribe hydroquinone to spot treat any problem areas. Hope this was helpful! Please let me know if you have any other questions!

      Fondly, Elizabeth

  19. Hi and thanks for a really helpful post!
    I've been using Retin-A 0,05% nightly for almost a month now (the weeks before that I could only use it every second or every third night because it made my skin so dry). It still makes my skin extremely flaky and it's almost impossible to use makeup because it looks so terrible. I have two questions. Before I started this treatment I liked to do home made facial masks either by mixing natural yoghurt and oatmeal or just by applying honey to the face. I've used honey in the mornings at the same time as the Retin-A in an attempt to handle the flakiness, but I'm not sure if it has helped or made everything worse. I stopped using honey about a week ago and at first my skin got better but then it got worse again. I keep breaking out and the skin is still extremely flaky. I haven't tried the yoghurt mask but it has really helped my skin when it has been dry before. I wanted to ask if it's good or bad to combine honey or yoghurt and oatmeal with Retin-A. Also, do you know any concealer that works with Retin-A. I'm trying to avoid makeup as much as possible but my birthday is coming up in a few weeks and I would really like to be able to look okay at least for a night.

    1. Hey Sanna,

      Yogurt, oatmeal, and honey are all amazing ingredients, but for right now, I'd suggest keeping your routine as simple as possible. Honey is sticking and can pull at those flakes and oatmeal is a form of manual exfoliation. At first this can help, but eventually it just lifts other skin cells and doesn't really improve the overall flakiness. I also would stay away from the yogurt because just touching your skin (and wiping at it or drying it) will add to the process. You'll be able to do these treatments again soon, but for now, try to make your skin care as uncomplicated as possible.

      As far as concealer goes... I like the Dior Nude Skin, but it only comes in a few colors and doesn't provide full coverage. Since you're peeling, anything that's not an exact match will jump out on your skin more than ever, so I would suggest looking at what you have and modifying your technique.

      I don't really care for creams or anything that's longwearing (or liquid-to-powder/cream-to-powder) because they can look dry on the skin and are difficult to blend over patchy skin.

      If you have a liquid concealer that's yellow based, that would be best. If the concealer looks terrible over the area, you can mix in a smidge of an eye cream (which usually contains caffeine and is super concentrated) or regular moisturizer that doesn't contain SPF or active ingredients, and apply it with a (super clean) synthetic brush in a downward motion. I use a magnifying mirror for extra precision. You can cover the area in thin layers until you build up the right amount of coverage. Keep a clean, damp sponge on hand and blend as you go, then go over the edges again when you're done. If you have a finely milled loose powder, you can set it with a clean dry sponge using the tiniest amount of product, then go over the edges with the damp sponge again or a clean brush. Applying a primer underneath your makeup will also help create a smooth surface. Throughout the night, you can spritz your skin with a hydrating mist (that has no alcohol) to keep your skin from looking dry. It takes longer to do this, but it really works.

      Happy birthday in advance! =) Let me know if you have anymore questions.

      Fondly, Elizabeth

    2. Thank you so much for your answers! I'll definitely try mixing my concealer with eye cream! I've heard that aloe vera is good as well, but maybe I should wait to try that as well and just let my skin rest as much as possible?


    3. Hey Sanna,

      I agree that it's probably best to wait. Save the aloe vera for soothing sunburns, which hopefully doesn't happen. Right now I think rubbing your face too much with even the greatest ingredients is just too stimulating. Let me know how the concealer works for you!

      Fondly, Elizabeth

    4. I found a yellow based liquid concealer from Isadora and it worked really well to mix it with the eye cream! Thanks a lot for the tips!
      Actually my skin got so dry and red around my mouth that I didn't use retin-A for a couple of days, now I've started to use it every night again and so far it seems like it's going better. I still get small pimples but there's no rash and they disappear quite fast.


    5. Hey Sanna,

      So glad to hear that things are getting better! The area around the mouth is very sensitive to retinoids, so it's important to take it slowly to avoid irritation. And I'm so happy that some of my tips worked for you! Thanks for keeping us posted!

      Fondly, Elizabeth

  20. Hi again,
    Maybe I should add that I'm 22 and I mostly break out on my cheeks and jawline now. The weeks before I started using Retin-A I noticed that there were like lots of tiny bumps beneath the skin on my left lower cheek, and that's where the worst break-outs have occured now, so maybe it's the Retin-A pushing whatever that was to the surface?

    1. Hey Sanna,

      Totally normal. I get messages about this all the time, so don't worry about it. I've said in responses to other readers that it's not technically pushing things to the surface, but that's just splitting hairs.

      Your skin's a little irritated right now, which will always worsen acne a bit. And since Retin-A doesn't exactly unclog the skin, there's nowhere for the microcomedones inside the pore to go while the medication starts to work. Thanks for sharing this! Most people don't realize this is normal, but you seem to know what's happening. It should go away in a few weeks, but sometimes people like to adjust their medication if they can't push through it otherwise.

      Fondly, Elizabeth

  21. I'm so sorry its me again! I've searched the internet for answers to avoid hassling you again but I haven't been able to find suitable information so I'm back! So sorry!
    I've been using Retin-A for about 3 weeks now and I have a few questions just about if what I'm experiencing is normal.
    When I started my skin was developing one or two small spots everyday which weren't painful and disappeared overnight without any hassle but recently I have started to develop much bigger painful ones which don't clear up as rapidly and one that is even verging on a cyst which I've never previously had, is this normal?
    I'm also not sure if I'm lucky or the Retin-A isn't working properly as so far I haven't experienced extreme peeling, redness or drying other than small amounts of dryness on the more sensiitve areas of my skin, is this bad?
    Finally, over the last few days I've been really worried to the point where I've cried! I've only ever suffered from red aftermarks from where I had spots but never the sort of indented scars. Not sure if that makes sense but I'm not sure what they're called! But I'm noticing even if the spot hasn't been paticularly bad at all and it hasnt even popped or been picked, afterwards I'm getting tiny, tiny indentation which appears like a very enlarged pore if that makes sense. It sometimes happens when i wash my face and the "dead spot" kind of falls off and I'm left with these marks. I'm not making much sense but I hope you can understand! Should I be concerned about this and is this the start of severe acne scarring or will these fade?
    Sorry once again for so many questions! Hope I'm not too iritating!
    Connie x

    1. Hey Connie,

      Please never ever apologize for commenting here on the blog! I love hearing from you and sharing your experiences will be helpful to others. I am so sorry that you have been frustrated with your treatment, but many, many people go through this too.

      The only person who can really tell you what’s going on with your skin right now is your doctor. Is it possible to call him or her? In the U.S., this is pretty customary, but I don’t want to assume that I know everything about the healthcare system works in the U.K.

      Meanwhile, I’ll share with you what I can, which I hope can give you some peace of mind. For starters, it is possible that your skin is having trouble tolerating the dosage of the medication or the medication itself…or that you needed a slower introduction when starting the treatment. Take time to first note that you are using the right amount at the right frequency. (I’m sure you are, but it’s one variable that you’ll be able to eliminate.) Also if you have any open wounds, you’ll want to avoid those areas and that may mean you need to use slightly less of the product because you’re covering less space.

      According to medical professionals, Retin-A does not cause the skin to scar more easily, but I have heard of this issue anecdotally from many people. It’s usually a tolerance issue, and the way it’s handled (unfortunately) varies case-by-case. Please be sure you’re not picking at your skin because that definitely causes problems like you’ve described. You'll also want to be extra gentle when cleansing, trying not to move the skin as much as possible. Also note that sometimes these “indentations” are really part of the peeling process. Our skin tends to break out whenever it is inflamed, so the reason your breakouts are getting worse may be because of the stress of starting a new medication. It is not uncommon to have what is called an “initial breakout” where the skin looks worse before it gets better.

      Perhaps it would be helpful for you to take a picture of your skin without makeup on once a week (not anymore than that), so you can track your progress. Often it is difficult to stay objective when we look at our face on a daily basis.

      You may also want to try talking to your mom about how upset you’re feeling. She can give you another opinion about whether or not your skin’s improving, and whether or not whatever course of action you’re planning to take is coming from a rational (instead of emotional) place that’s best for both you and your skin. Trust me, I’ve been there. Acne made me feel crazy. I cannot tell you how often I sobbed in my room uncontrollably about something that went wrong with my skin, and it’s easier to go through it with someone you trust—even if it is somewhat humiliating to talk about. Just try to remember why you’re doing this and remember that you have options. It’s your choice whether you want to stick with this medication and make a commitment to the six to twelve weeks it may take to see results. And it’s your choice if it’s ultimately not worth it, and you want to try a different option. However, medications do take time to work, so please don’t give up on it without talking to your doctor.

      Like I said, you may just need to ease into using it a bit more slowly.

      Regardless, you’re not alone. Please leave me a message anytime. I was out of town last week, so I apologize for the delay. But I’m rooting for you! Keep me posted! Let me know if you have any more questions. =)

      Hope this was helpful,

    2. Once again thank you for all your help!
      I am able to contact my GP for an appointment but I'm not sure how much they'd be able to help regarding this, but my mum said she was happy too I'm just sacred in case I'm bothering them when they aren't able to help.
      I've stopped using such an abrasive face cloth to attempt to prevent any more of these scar things, but when I think about it, it may be due to peeling as some are appearing in places where I can't even remember having a spot. Although, is it possible for scarring to appear ages after a spot? And also, is it posssible to scar even when the spot wasn't bad or picked at? Aldo, if I was to get indented scarring are there any effective treatments to get rid of them? I know they generally are often there for life, but I was wondering if there were any options because I'd hate to get rid of all my acne and be left with scarring. I'm probably overreacting as so far no one cna even see these marks even when I mentioned them!
      Also, I read that Retin-A could help reduce pore size but I've actually noticed mine have gotten if anything bigger, does this often happen?
      Finally, so many peope talk about what products you can and can't use and people say to use gentle things generally. I have a few products which probably aren't typically gentle and include ingredients such as alcohol. I did patch test them and they were fine and when I apply them I get no irritation or dryness etc. is it okay to use these? Or will the ingredients potentially interfere with the Retin-A and alter results or are gentle products recommended only to avoid irritation?
      I spoke to my mum and she said generally my skin was looking better than ever and I had told her before the treatment that I may want to stop due to initial breakouts but I asked her to try and persuade me not too. I ended up looking at the pros and decided to carry on. My skin feels amazing other than the blemishes and my makeup applies really lovely and I've managed to (after so much trail and error!) get a flawless face without looking caked in makeup, which I was worried about. For some reason disccussing the good points makes me feel better about it, so sorry for rambling on!
      I'm sorry again for so many questions and I appreciate you get so many and its lovely how much time you put into your detailed responses and its useful reading everyone elses experiences! I realise my questions aren't the easiest to understand and theres a bit of repetition from last time, but hopefully its not too confusing! I also know I'm young and I probably sound a bit obsessive over my skin and I'm probably over analysing it but my acne does upset me alot.
      Thank you so much for all your answers so far!
      Connie x

    3. Hey Connie,

      I get what you're saying. You are very articulate, and what you're experiencing is not at all unusual. Obviously I can't see your skin, but if what you're describing is what I think it is, you shouldn't have to worry about long term scars that will haunt you the rest of your life or anything. That doesn't mean you shouldn't get it checked out though because I don't want you to suffer through unnecessary complications or experience any red marks if you can avoid it because those can be really frustrating.

      You're doing the right thing going to see your GP. Don't for one minute worry that you might be bothering your doctor though! That's an order! You are a patient, and he or she is someone paid to provide a service to you. Without patients, they're out of business. If the doctor doesn't know how to help you, then guess what? You just showed them something new, which educates them. That could help their future patients that are going through the exact same thing as you. That's something you should feel good about doing! And, most of all, you deserve the time and attention they are giving to you because you deserve to be treated well. Please don't ever feel like you don't.

      Meanwhile, I love your questions and always look forward to hearing from you. In fact, I was starting to worry when I didn't! You are never hassling me, and your age doesn’t mean your feelings aren’t valid. Sure, you are going through a time in your life when appearance is emphasized, but that doesn’t mean acne isn’t always stressful or that you’re being immature.
      Whether you’re fourteen or forty, acne is devastating to a person’s self-esteem, but you have the strength to take control over it instead of feeling victimized by it. Do you know how many people never get treatment because of shame or because they’ve just given up all hope that they can feel good about themselves? Wanting to look good is very healthy when we’re taking care of ourselves and don’t neglect the world around us. It’s normal to want clear skin. Just don’t let acne victimize your emotional being. We’re always happier than we think we are because there’s so much in this world to be grateful for that we get distracted from when we’re stressed. Staying positive is crucial to achieving any goal, and you’re doing it. That’s awesome. And keep talking to your mom. She sounds like a good woman, and she obviously supports you. I was a butthead when I was a teenager, and I suffered for way too long because I never talked to my parents about my problems. Looking back, it’s funny, but I was really miserable at the time. (To be continued...)

    4. Connie, here's Part 2 of that reply.

      Getting back to your skin, here's my opinion from what you’ve told me: I think the reason you're noticing a difference in the size of your pores and (partially) these scars is because the skin can swell when you first start using Retin-A. This occurs because of increased blood flow to the skin, as well as some slight irritation. Your pores aren't actually becoming larger. It's just as illusion because of what's temporarily going on in the surrounding skin. A lot of women experience the same thing with their wrinkles or dark circles for the same reasons. It's just drawing attention to flaws that were too minor before to be noticeable—not making them worse. It could also be happening where the lesions are falling off. The lesions are coming off as part of the shedding process, but they look so noticeable structurally to you because of this swelling. The only difference is that the lesions are coming off differently because of the Retin-A, which wasn’t happening before. Does that make sense?

      The products you’re using may or may not be problematic. I really don’t know without looking at them. Using products with a lot of alcohol (meaning it is listed in the first third of the ingredients list) could cause a few problems other than irritation. First of all, it removes lipids (oils) from the skin, which allows more product to get into the skin. In other words, it can make your medication stronger potentially. That could increase side effects. Secondly, they can also be stimulating, which might add to the swelling I was talking about before. Take your products with you to the doctor, so they can look at them. And try to keep your routine simple.

      About scarring… It is possible to get one even when you haven’t picked at it, but this occurs with cystic acne or in those genetically prone to scarring. Picking and abrasive products typically cause something called excoriations, which are wounds that eventually heal…but they do so very, very slowly. Scars are structural damage that occurs in the dermis (the underlayer of skin where collagen is produced), which means that the acne has to be deep enough to do that kind of damage. Retin-A actually promotes collagen production, so something really traumatic would have to occur to trigger these kinds of scars when you’ve never had them before. You can apply Polysporin or Bacitracin (not Neosporin) to excoriations or open sores to protect them if you’re worried, and that can keep the Retin-A from hurting the area, while helping it heal faster. Just don’t get it on the skin that’s not open.

      I think I owe you a couple of posts I promised you a while back. I am so behind on them, which is kind of embarrassing. But I swear I haven’t forgotten about the post for teens. I’m just trying to decide what all I need to cover because there is so much general information. Maybe I should divide it into a series. If so, what would you like covered?

      Keep in touch! I want to know what’s happening with you, and—like I said—I worry when I don’t! ;)

      Fondly, Elizabeth

    5. I honestly believe without you I wouldn't have survived using Retin-A! I say this so much but thank you!! All your advice was lovely and made me so happy!
      I have an appointment booked with my GP for this week!
      These last few days I think I've definitely began the initial breakout as its called. For the past couple of weeks my skins been pretty bad but its gotten worse these last few days. I did read a lot of people had clear-ish skin for about a month and then the initial breakout started, so I'm hoping thats the case. Is there a general amount of time the inital breakout tends to last? I know thats a bit of a silly questions because it often just depends, but I'm back at school in 3 weeks and I'm just wondering if my skin may have calmed down a little?
      Also, what you mentioned about the pores etc made sense and was really useful, so thank you! However, I'm just wondering if they will look like that as long as I use Retin-A, or when my skin (hopefully) is clear and used to it will they return to normal? Or is that something I'll have to live with using Retin-A? Just at the minute its getting to me that up close my skin looks pretty bad and I hope that eventually I'll be happier without makeup, because right now I get upset looking at myself in the mirror without it.
      It still bothers me that I'm not physically peeling and my skin isn't paticularly dry or irritated and was only dry the first couple of weeks and honestly, not even that dry. This sounds mad that I'm worried but its just because so many people complain about it and some people say its what you want to see! Is it because its only 0.01% or because I eased myself into the treatment, or because of my moisturising sun cream I use in the mornings? Or is it just not working?
      Finally, is it okay to use a moisturiser in the mornings if my makeups not applying right and I want to smooth my skin but I dont need sun cream because for example I might just be having people round and not going outside? Its quite an intense moisturiser by clinique but it doesn't make me too oily it just smoothes out my skin and I've had no irritation. Will it stop the Retin-A from working or anything?
      I have asked so many questions once again! I hope I'm not making you feel like you're repeating yourself too much. But I promise I won't ask so many next time!
      About the post on teen skin, it sounds odd but I would really like something about the emotional effects of acne and bad skin perhaps. I don't want to suggest silly things and I'd probably sound demanding because there is so much I'm clueless and curious about! I also don't want to suggest things that aren't eve possible to discuss in detail and potentially unanswerable! The series is a brilliant idea though and look forward too it!

      Thank you again! Conie x

    6. Hey Connie,
      I love your ideas for the series! They’re great! I was thinking about doing a post on the psychology of acne, but I didn’t know if it would interest anyone. I appreciate your insight, so don’t hesitate to share your thoughts on what you’d like to see. You're such a sweet girl, and I'm happy to know that I've been helpful during your treatment. =)

      Now to answer your questions… You’re right. Everyone is different, and I can’t really predict how long your initial breakout will last. Usually it subsides in a few weeks. Some people say they experience it for months, but I highly doubt they’re using it as instructed if that’s the case. A lot of people freak out when they see that their skin is starting to break out, so they slow down their treatment, which just delays the recovery process. If you use your medication as intended, then you should see improvement in your skin in about six weeks from when you start using it. Just don’t try to treat the breakouts because that will irritate the skin, and don’t alter your routine too much.

      I should also note that since you’re using that antibiotic as well, you should have significantly less issues with an initial breakout. The antibiotic is fighting the bacteria, so it should be much milder than what you would see in someone who isn’t using antibiotics. I know going back to school is stressful, but I wouldn’t let that keep you from using your medicine. If you’re still breaking out, then you can always cover it with makeup. Your skin will be clearer much faster if you stick to the treatment plan, and you’ll be surprised at how quickly your skin improves. If you stop using the medicine, the initial breakout will still be there, and it won’t heal any faster. Just keep reminding yourself why you’re doing this, and don’t let others’ bad experiences cloud your judgment. You’re going to have a great school year. =)

      As your skin gets used to the medication, any swelling you may be experiencing should subside. As long as you try to avoid irritating products, your skin should get used to the medication. Keep in mind though that your pores are developing during your teen years, so it’s possible that some developmental changes may occur as part of puberty. Adult skin is never completely poreless, but the Retin-A will keep them clear and looking as tight as possible with regular use.

      There are plenty of people who don’t experience dryness or peeling. I wouldn’t worry about it because not all side effects will happen to everyone. Some doctors do increase the dosage after a few months, but many do not. I wouldn’t worry about it. During the winter months, you may notice that your skin responds more to seasonal changes, so it could just be that the climate isn’t working against your skin right now.

      I think it’s a good idea to use sunscreen even when you’re not planning to be outside because UVA rays can penetrate glass, which can cause premature aging and pigmentation problems. Also sun exposure is cumulative, meaning that going outside for five minutes ten times a day is just as damaging to your skin as going outside for fifty minutes. If you really don’t want to use a sunscreen, you probably could use a noncomedogenic moisturizer very sparingly and only on the areas that feel tight… But it throws another variable into your routine, so I think it’s better to be consistent in your morning and evening routine whenever possible—especially since your doctor didn’t want you to be moisturizing.

      I just realized it’s been close to a week since you posted this comment. How was your appointment?

      I always love your questions, and I don’t think your ideas are silly. Keep them coming!

      Fondly, Elizabeth

    7. I look forward to the post!
      Firstly, I have good news! But I don't want to get my hopes up but I suppose I'm happy right now at least! I've been going for a run every morning and every night this week and drinking lots more water and generally eating healthier and having homemade smoothies etc. and taking caution with my skin and not using anything harsh or rubbing at it etc and after the awful, awful breakout I had the last time I posted, all but one of the spots have disappeared and I haven't had a new blemish in almost a week. Which honestly, I've never had in ages! I know this probaly isn't permanant but it feels really good and I actualy smiled when I looked in the mirror! Which is only inspiring me to carry on with Retin-A regardless of the breakouts I have yet to come because if my skin will become anything like this I'll be so happy! It may just be ironic it happened as I started all the health stuff but I enjoy doing that and I feel happier in myself so I'll continue regardless! I'm not going to get too excited because I'm pretty sure I'll have more breakouts! Sorry for sharing!
      By the time I'm back at school, which is soon, I will have been using Retin-A for 7 weeks I think, so maybe things shouldn't be too bad.
      I've also today learnt the hard way that when my pores are this bad when it comes to makeup less is definitey more which actually makes me feel loads more confident oddly! I think its because my skin can breathe! I start my serious exams this year so I'm hoping that won't have too many negative effects on my skin! I really hope my pores do calm down soon, because currently they are my main concern, only because its impossible to conceal them! Is there anything at all I could do to minimize them or help or is it best to leave it to heal over time? Its only I'd read someone left it a year and they weren't reduced! I know its silly reading into things too much!
      I went to my doctors for the appointment but they were running an hour behind schedule and I had a wedding to get ready for so sadly I had to re-arrange it and I go to Paris on Wednesday for a holiday so I have to wait until after then for another one!
      Thank you for your help regarding the face masks! I realise it must be frustrating asking you so many questions and to check out so many products but I hope you don't mind too much! I've tried to keep my questions down to a minimum however I was recently given a cleanser as a present and I realise it's probably a bit harsh to use right now but while using Retin-A will I ever at any point in the future be able to use it? I've heard great things about it but I think right now it's probably way too harsh, I was just wondering if I'll ever get use out of it.
      Once again thank you for being my life saver! I realise how irritating it must be habing the same person coming back with so many questions everyday! So I really truly appreciate your detailed answers so much! Thank you!
      Connie x

    8. Hey Connie,

      Why would you ever apologize for commenting on this blog, silly girl??? It is so incredibly flattering to read that I've helped you and learning about your progress teaches me so much. I love hearing from you, and your questions are great!=)

      I checked out that cleanser you mentioned, and I think you should be able to use it once your skin gets accustomed to the Retin-A. (You should--of course--check with the dermatologist about this though.) I couldn't find a complete ingredients list, but as long as it rinses clean and doesn't leave behind a residue or dry out your skin, I don't see why you couldn't use it...unless you were allergic to bees. I didn't see anything about it containing any exfoliating granules, so it shouldn't cause any irritation unless you're sensitive to one of the ingredients. For right now, I would stick to whatever routine you've already developed for yourself. The more consistent you are in your skin care routine, the better results you'll get. Once you're happy with your skin, you can patch test the cleanser for a few days to make sure it doesn't cause a reaction, then try swapping cleansers to see how it works for you.

      As far as dealing with enlarged pores, there is nothing that you can do to treat them because pore size is genetically determined. The best thing you can do is properly remove your makeup every night, use your Retin-A, and protect your skin from the sun. This doesn't provide any immediate benefits, but it will keep them from collecting any build up that can stretch out the follicle down the road. You also may notice that your pore size changes throughout the month, which is totally normal.

      If you want to reduce the appearance of pores, there are a few makeup tricks that will make them look less noticable. You can try using a primer to smooth out the surface of your skin. This will keep your makeup from collecting in the pores and creates a smooth canvas for your foundation. Secondly, you want to choose face makeup with a matte or semi-matte finish. Liquid foundations with dewy finishes will catch the light and highlight problem areas, making pores appear larger. If you choose a foundation that is longwearing and designed to keep oily skin shine-free, your makeup won't shift around and pool into any pores. Use these types of foundations sparingly and apply them in small sections with a damp sponge for the most natural look. Matte blushes and bronzers are also good choices for brightening the complexion. You can set your makeup with a translucent loose powder that you press into the skin with a puff or sponge. If you find this looks heavy, you can take a clean brush and gently brush away any excess powder.

      You certainly don't have to do all those steps, but they're just some suggestions that you may find useful when applying your makeup. You're absolutely right that less is more. I find that many women overdo their makeup as a nervous habit, and it doesn't always give the most flattering final result.

      I'm so glad to hear you're incorporating some healthy habits into your daily life, and it sounds like you're feeling less stressed. I'm a runner too, and my boyfriend jokingly calls me "the Golden Retriever" because he says that my happiness is entirely dependent on whether or not I need to be walked. (I should probably find that insulting, but alas, it's the truth.) If you take care of yourself, you'll always feel better about matter what's going on with your skin. You're very smart to be taking care of yourself at a young age.

      I'm so jealous of your Paris trip! I hope you have a lot of fun while you're there! Good luck on your exams! And keep me posted... I don't mind at all! =)

      Fondly, Elizabeth

    9. I'm glad you don't mind all of my questions! I say it so, so much but I truly appreciate it!
      I followed some of your steps and my pores looked a lot smaller! I must admit I was in such a habit of caking on so much makeup in the hope that I might feel happier but I've had compliments since I've went more natural!
      I agree!! Even though I haven't been running for long, I feel so much happier when I have now!
      Before I head to Paris and meet my GP after, I have one more question! Ever since I knew I was going to Paris I've planned to pick up some Bioderma Sensibio H2O after hearing so many incredible reviews! However, since I started using Retin-A I was wondering if I would get any use out of it? I've seen some people use it in addition to Retin-A. I know I shouldn't change up my routine right now but because its so hard to get over in the UK do you still thinks its worth investing in?
      I promise that's my last question for a while! Hopefully! Thank you again!
      Connie x

    10. Hey Connie,
      I’m so glad that those techniques worked for you! =)
      I am obsessed with Bioderma, and I recommend it a lot…especially for people using Retin-A. It’s an excellent makeup remover, and I use it whenever I need to remove my makeup in the middle of the day before I go running or work out. It keeps me from overcleansing and is extremely gentle. I wouldn’t use it as your cleanser, but if you need a makeup remover or a way to cleanse mid-day, it’s a very nice product. It’s difficult for me to say whether or not you’ll see any changes in your skin because I don’t know how you intend to use it or what you plan to substitute it for... But I personally stock up on it whenever I have the opportunity, which doesn’t always happen that often.
      Have fun!
      Fondly, Elizabeth

  22. Hi Elizabeth,
    I was prescribed the Retin-A Micro gel 0.04% by my dermatologist. She advised me to not use any moisturizers, or creams whatsoever. Not even liquid makeup! And she said to use spray-on sunscreen only, to spray on my hands then apply to my face. I purchased the Neutrogena Ultra Sheer Body Mist in spf 45 (Seen here: ) but upon looking at the ingredients I'm afraid it might make me break out! Do you have any suggestions for spray-on sunscreen suitable for acne prone skin while on Retin-A?
    Thanks so much for your help and your blog is a fantastic resource.


    1. Hey Tina,

      This comment was so interesting! I personally adore the Neutrogena sunscreen you mentioned, but I don't normally test out too many other spray sunscreens when I'm looking for new products to recommend because a lot of dermatologists are opposed to them. (People find it too easy to under-apply.)

      I think sprays are great for people who can't tolerate sunscreens, but most of them contain some amount of alcohol. This can be irritating when using Retin-A, so some people may need to experiment to find what percentage works for them. My boyfriend really loves the Coppertone Sport, which has a higher amount of alcohol...but most of them are pretty similar. Some just contain conditioning agents to buffer the alcohol's impact on the Neutrogena.

      Both Clinique and Paula's Choice have sprays available, but the SPF isn't as high as I think you'd need. There are also plenty of high end ones around from companies like Glytone, but I personally find the ingredients are almost identical to the ones in the drugstore at a much higher cost. I also find many have additives that are just not necessary and complicate your skin care routine, which is not what you want right now. I'd stick to the drugstore.

      I should also note that there are a lot of lotions that come in spray bottles now, which I assume aren't what your doctor had in mind. It sounds like she wanted you to use a liquid to get the active ingredients with the least amount of fillers. I could be wrong on this one, so you may want to double check...but almost all of the true "sprays" do contain some amount of alcohol. I usually avoid alcohol in skin care, so I thought I'd emphasize that here.

      My best suggestion would be to patch test whatever you try on a small area of your face before applying it all over. The prescribing information says to avoid products with alcohol and since you're worried about the product breaking you out, this really is the best option. If you see an ingredient like propylene glycol you might normally fear, keep in mind that the amount used is much, much less than you would find in most other products because it would change the consistency.

      If there's a certain ingredient you want to avoid, I may be able to offer some better suggestions. Hope this wasn't too vague! If you have anymore questions, please don't hesitate to ask. =)

      Fondly, Elizabeth

    2. Hi Elizabeth
      Thank you so much for your reply.

      I have no idea why my derm told me to get spray-on sunscreen. My dermatologist is in her 60's but she has flawless skin. I have been warned by others though that her information may be outdated. She is very kind though but very busy since she has so many patients, so the waitlist to see her is very long. I waited 3 months to get an appointment, and I won't see her again until November.

      Anyway I'm now only on week 2. When I put the Neutrogena spray-on sunscreen, it stings so I've had to stop applying.

      In the meantime, I have this Aveeno sun block stick in my house, do you think this would be alright?

      I plan on purchasing a La Roche Posay Spray Sunscreen, but I notice the second ingredient is Alcohol, so I'm still unsure I should purchase it.

      My skin is so dry and flaky now. Although my dermatologist told me not to use moisturizer, I really feel like I have to. Do you know what I can use to help the flakiness? Would be vaseline be alright? I have this Keihls Ultra Facial moisturizer (,default,pd.html?start=7&cgid=face-moisturizers) but it has oils in the ingredients list, so I'm hesitant to use it. I have the Cetaphil Moisturizer too.

      Thank you so much again for your help. Like I said my next dermatologist appointment is not until November so I have nobody to ask until then.

      I really appreciate you taking the time to reply and offer advice and suggestions.


    3. Hey Tina,

      Pretty much all spray-on sunscreens (including the LRP) are going to have similar formulas... And those formulas contain alcohol. One thought I just had if your skin is irritated by the sprays is that you might want to check out some of the sunscreen wipes available. They're also liquids, but they don't contain alcohol as often. Just be sure to look for ones that are individually wrapped, so they stay saturated. I know Supergoop makes some, and they contain physical sunscreens, which are less likely to cause irritation.

      I would be careful with the sticks because they're usually balms or solids with a lot of waxy ingredients. They're good for getting ears, around the eyes, and across the nose...but I wouldn't wear them all over your face. There are a lot of occlusives in them, and you'd be better off just using a lotion.

      As far as moisturizing, you probably don't want to do this at night because the Retin-A Micro is time-released, and there is a belief that the product won't work properly. Not all doctors think this is true, but if your doctor told you not to moisturize, that could be why. However, if during the day or on a night you're not using it, you absolutely had to, I'd say the Cetaphil is the best choice of the three.

      Hope this helps!

      Fondly, Elizabeth

    4. Hi, it's me again. I apologize for bothering you again with more questions. I just purchased a few more products (Took advantage of the Labor Day sales!) and I have some concerns about them.

      So since spray-on sunscreens have been stinging my skin, I've gone on to purchase the La Roche-Posay Anthelios with Mexoryl Ultra Fluid Lotion SPF 60 (from canada)

      and Neutrogena Pure and Free Baby Faces Sunscreen Lotion SPF 50

      I'm concerned about the amount of Dimethicone in the Neutrogena sunscreen. I see it's listed 5 times. Do you think this would cause more acne? I got it because it contains only physical sunscreens.

      As for the La Roche Posay Anthelios with Mexoryl Ultra-Fluid Lotion SPF 60, it is different from the one in the United States "Ultra light sunscreen fluid SPF 60". And I can't find a site that lists the ingredients of this version I got (LRP Anthelios with Mexoryl Ultra-Fluid Lotion) so I will just type them out here as I see them on the box.

      Homosalate (10%) , Oxybenzone (6%), Octisalate (5)%, Octocrylene (5%) ,
      Avobenzone 3% , Terephthaylidene Dicamphor Sulfonic Acid (MEXORYL SX 2%)

      Water , Cyclopentasiloxane , Alcohol Denatured , Cyclohexasiloxane , Styrene Acrylates Copolymer , Silica , Dicaprylyl Ether, Diethylhexyl Syringylidenemalonate , PEG-30 Dipolyhydroxystearate , Dimethicone , Triethanolamine, Glycerin, Nylon-12 , Polymethylsilsesquioxane, Dicaprylyl Carbonate , Lauryl PEG/PPG 18/18 Methicone ,Phenoxyethanol , Peg-8 Laurate, Caprylic/Capric Trigylceride, Caprylyl Glycol , Poly C10-30 Alkyl Acrylate , Disteardimonium Hectorite , Disodium EDTA, Dodecene , Poloxamer 407, Tocopherol , Cassia Alata (Candle Tree) Leaf Extract , Maltodextrin ,

      Are all these chemicals sunscreens actually bad for my skin? I have very oily skin and because of the retin-a micro gel (I'm now on Week4) and as I mentioned before, it's now peeling, and seriously flaky especially around the jaw, chin and forehead. How harmful is Oxybenzone, I'm reading conflicting reports about its dangers and its worrying me.

      The reason I got the LRP Anthelios Ultra-fluid was because I read dries matte on the skin, but the one I have been reading about is not the same one I purchased.

      Would I be better off with the cream version instead though I see that it contains soybean oil.

      And lastly, to combat the flakes, I purchased Cerave PM Facial Moisturizing Lotion. I plan to use this on evenings when I'm not using the Retin-a Micro, like you suggested.

      Wow I've asked so many questions now. I'm sorry for the long post yet again. I can't thank you enough for all the help and information you've provided.

    5. Hey Tina,
      You have done your research! It’s awesome to see that you’re reading ingredients labels, but I have one piece of advice that it has taken me a long time to learn… Don’t drive yourself crazy obsessing over every little ingredient. The fact is that just because a product contains a comedogenic ingredient doesn’t mean the final product will clog pores. I suggest looking for products labeled non-comedogenic, oil-free, non-acnegenic, and/or “won’t clog pores.” Look at their websites to see how they label products, so you can compare the lingo from one product to the next. It’s annoying that these terms aren’t regulated, but it’s impossible to be a very effective detective without a chemistry degree and the amounts of the different products.
      The best way to find the right product for you is to pick out the company you’re interested in, compare their range of products, learn how they label things, and rule out the products that don’t have those labeling buzz words. Does that make sense? For example, if I go onto Estee Lauder’s website to compare foundations and see that Resilience Lift is non-acnegenic and fragrance-free, I may think it’s the best choice for me if I don’t see that Double Wear Light is labeled as oil-free, fragrance-free, won’t clog pores, and non-acnegenic. Since there’s no consensus on how things are labeled, start by learning the language of the land. It really doesn’t benefit a major company to produce a product that breaks everyone out, so while it’s no guarantee, it’s your best starting point.
      After you pick out the product that the company has designed for your specific skin type, patch test it. Apply it to a quarter-sized area of your face for about two-four days before applying it all over your face to check for any stinging or breakout reactions. Applying it close to your ear on your cheek is normally best. And also take note of the texture. Does it feel heavy? Is it hard to remove? If so, then you’re probably more likely to have breakouts from it.
      Sunscreens are tricky, so this really is my best advice. To answer your questions specifically about the silicones, it depends on your other products, your skin, and your climate. If the product feels heavy or thick on your skin, then it will probably cause breakouts. Texture is huge. But silicones in and of themselves don’t cause breakouts as long as you don’t sweat in them and remove them properly at night with a cleanser or makeup remover that can properly break them down. (Not all can.) Otherwise, as long as you can’t feel it on your skin, it should be okay. Also remember that with physical sunscreens you only need a thin layer. Dot in it on the areas of your face, then smooth it out to cover all areas.
      Chemical sunscreens are controversial. While they have a lighter texture, they are not as good for sensitive skin and some provide inferior protection. La Roche-Posay has an excellent reputation though, and most dermatologists recommend it. You should patch test it though for sensitivity, and don’t automatically reach for the highest SPF on the shelf. Sometimes this can cause problems. I really love Mexoryl, but otherwise I prefer to use a blend of physical sunscreen and chemical sunscreen because it doesn’t irritate my skin but has a superior texture. As for oxybenzone, I’m familiar with the controversy, but there need to be more studies to give us any definitive information. If you’re nervous, you have plenty of alternatives.
      I’d skip the creams. You don’t need any extra oils. Try to find what feels comfortable.
      Great to hear from you! Love your questions! Keep them coming!
      Fondly, Elizabeth

  23. Hi Elizabeth,

    If you have time to reply to my questions that would be great! Your post has already been very informative already :)

    I just started taking Doxycycline (twice a day) and applying Retin-A at night. Should I exfoliate my skin or do any masks while I'm on this treatment?

    Also, Im not sure if you're familiar with Argan Oil, but could I use that to moisturize my skin at night after applying Retin-A?

    Thank you for taking your time to read my comment.


    1. Hey Jennifer,

      I'd suggest keeping your routine as simple as possible right no masks or exfoliation. Exfoliation is definitely not a good idea right now because scrubs and AHAs/BHAs will both cause a world of problems...even if it's tempting when you're flaking. Eventually you may be able to work an exfoliant into your routine, but you certainly don't need to. And I would discourage it for the first twelve weeks.

      Argan oil is very popular right now, and it's good for some because it's a very pure and simple product that doesn't irritate the skin. It might be a little heavy though unless you're in an extremely dry and windy climate. I usually suggest using a fragrance free moisturizer that contains niacinamide, ceramides, hyaluronic acid, and/or green tea when using Retin-A. These will repair, soothe inflammation, and hydrate instead of just protecting the skin with lipids. I would also be a little concerned that using an oil might remove some of the Retin-A because many people use it as a cleanser/makeup remover if you weren't extremely careful about waiting long enough before applying it.

      Hope this helps! Let me know if you have any other questions. Thank you so much for reading and commenting! =)

      Fondly, Elizabeth

  24. I've been dealing with cystic acne for about 6 yrs now, i'm 33 & have gotten it under control with Proactiv. I'm about to start retin a to help with the scarring, unevenness & the breakouts I still get. I can't thank you enough for this amazing blog, which was so informative. I'm writing to ask what moisturizer I should use & if I should use a different one at night & during the day. I'm going to switch my Proactiv for one of the cleansers you mentioned in your blog. I'm crossing my fingers that retin a works & becomes my miracle savior because it's been a long, at times depressing, journey for me.

    Again, thank you so much for this blog ... It's hard finding something as complete as what you've written.

    1. Hey Mrsbatista,

      Before you go shopping, I should warn you that a lot of those cleansers have changed formulas. (Forgive me! The post is a bit dated even though it's only been a year!) There are some other good ones out there though from the La Roche-Posay Toleriane range, as well as the Peter Thomas Roth Gentle Foaming Cleanser (for oilier skin) and Kiehl's Ultra Facial Cleanser. There are way more options at the drugstore from Neutrogena, Eucerin, Dove, Olay, and Cera Ve. Just look for something fragrance free without any active ingredients or exfoliating properties, and make sure your skin feels comfortable. I recommend sulfate-free cleansers, but that's all you can find and your skin is okay with it, then it's just a matter of preference.

      During the day, sunscreen is critical. In the post, I suggest using a sunscreen alone as your moisturizer. I prefer sunscreens with zinc oxide because it protects the skin like a moisturizer and doesn't cause reactions, but few moisturizers other than the Philosophy Hope Oil Free Moisturizer SPF 30 and Cera Ve Am Moisturizer use it. (They also generally have lower SPFs.) Some people also find that moisturizers with SPF are irritating and need separate products. If you feel you need extra moisture than your daily sunscreen can provide, you can use whatever you use at night. I don't like to do this because I think sunscreen works best alone, but if you live in a dry climate, you might need the extra protection. I find that my beloved Ulta MD Clear SPF 46 feels just like a moisturizer, so I just use it as if it were one. Skinceuticals makes a great option for those who want to completely avoid chemical sunscreens because its only active ingredients are titanium dioxide and zinc oxide.

      For nighttime, try to look for a product that is more on the bland side. Cera Ve makes excellent products, which include ceramides, hyaluronic acid, and niacinamide. Replenix CF Cream is a more expensive option that's quite lightweight and includes caffeine and green tea. I like fragrance free products, but if you're not struggling with side effects, the Proactiv Green Tea Moisturizer may work just fine. Whatever you use should feel comforting on the skin and never sting.

      What kind of scarring are you experiencing? Please let us know what kind of progress you make with this because a lot of people ask about this.

      Good luck! Keep in touch, and let me know if you have anymore questions. I appreciate your time, and thank you for being so complimentary of the blog. It makes me feel so good to read that!

      Fondly, Elizabeth

  25. I currently use Clinique's moisture surge & I love it b/c it's lightweight. I've never had a problem with it, but can I still use it once I start the Retin A? I use Aveeno Smart Essential spf 30, which I put on first & then my moisturizer b/c I feel that it doesn't moisturize as well as the Clinique. I live in South Florida so it's humid & hot.

    I have pock marks on my cheeks from how severe the acne was & I still have some red spots, but those are slowly going away ... very slowly. I wish I could send you the pictures of my face when it was its worst, which was last October. Right now I no longer have all those cysts all over & I'm down to just under the skin white heads & the occasional cystic outbreak here & there. I'm unhappy with the unevenness of my skin due to the scarring, which is what I refer to as the pock marks. When I put make up on my skin looks pretty flawless except where you can see some of the indentations from the scarring, but it's better than covering up the cystic acne!!! :)

    I'll look into the products you suggested & I can't tell you AGAIN how much I truly, truly appreciate you taking the time to give such great feedback. It's been a struggle for years & I'm so blessed to have stumbled across your blog.

    1. Hey Mrsbatista,

      You can absolutely use the Clinique Moisture Surge as long as it's still hydrating enough for you. (My skin actually got much oilier when I switched from BP to Retin-A, and I had to start using lighter products.) Some people struggle with chemical sunscreens and fragrances like I said, which are in the Aveeno... but others have no problems at all.

      If you want to send me pictures, you certainly may send them to my email address, which is I would love to look at anything you want to show me.

      Are you using the Retin-A alone or in combination with other medications or cosmetic procedures?

      Thanks for sharing again, and I wish you luck. Stay in touch!

      Fondly, Elizabeth

  26. I'm sorry to pester you with another question but when I'm around certain people without makeup I feel so self concious and I thought if I could buy or even make a face mask for the odd occasion of like sleepovers etc just to save embarassment. I know it sounds silly as I'll probably look more silly with a face mask, and it sounds odd but I'd feel a lot happier.
    I was just wondering, seeing as my skin so far is fine with everything I've used and I haven't got any irritation, would I be able to use a face mask once in a while. Maybe a sensitive skin one or something.
    If so, in the past I've had good experience with fresh Lush face masks but I've always used the acne ones so are they're any of these that you think would be okay to use if not are there any natural ones I could use? I'm not even looking for amazing results, just something I can put on my face and I know its safe I suppose!
    Obviously, I understand this may not be a good idea!
    Sorry again, Connie x

    1. Hey Connie,

      I don't normally recommend face masks because it's another variable, but I think every now and then at a sleepover, it would be fine. In fact, it's a brilliant way to feel comfotable in your own skin, and it's fun.

      Here are a couple of things to keep in mind...
      1. Don't sleep in your mask overnight. You'll still want to remove it (very gently) before you go to bed and apply your medication as you normally would. Remember that applying medication to damp skin will cause it to penetrate more deeply, which can be irritating to the skin. You'll still want to wait until your skin completely dries before applying the Retin-A.
      2. Avoid anything that leaves a residue on the skin.
      3. Avoid any masks that harden or contain exfoliating particles. You'll also want to stay away from masks that contain ingredients you're already supposed to be avoiding like menthol/mint, citrus, alcohol, spices, kaolin, or camphor.

      Out of the Lush masks, the Cosmetic Catastrophe looks like it would probably be the best one to use right now. I've personally never tried them, but I've heard great things about them. Be sure to patch test a small area of your face before you go to someone's house because having a reaction to a product can be pretty embarrassing.

      You can also make your own by mixing plain yogurt and honey. The proportions will be different depending on what brands you choose, but a teaspoon or two of yogurt mixed with a teaspoon of honey normally works well for me. You can also stir in a 1/2 avocado or banana or a teaspoon of cocoa powder (which will make it opaque and easier to hide behind) if you want to make the mask richer. Leave the mask on for about ten minutes, then rinse with tepid water. Bring along some cotton wipes, so you can be sure you get your face as clean as possible without having to scrub too harshly.

      Hope this helps! =)

      Fondly, Elizabeth

  27. Is it safe to apply Aczone Gel to my face while being on my Retin-A Micro Gel treatment? For example, applying Aczone in the mornings before moisturizing, or on nights when Retin-A is not being applied to my face? Would this be too irritating to the skin, and lose retin-a's effectiveness?

    1. Hello Hope,

      Great question!

      Since both Aczone and Retin-A Micro are prescription medications, your doctor will determine whether or not your skin will benefit from (or tolerate) both medications. The doctor should also give you specific instructions about how to use both medications to get the maximum benefits.

      Aczone (dapsone) is an anti-inflammatory topical medication that many people with sensitive skin find useful in treating acne. It is commonly prescribed along with retinoids and can even help prevent/control the dreaded "initial breakout" that sometimes occurs a few weeks into retinoid treatment. In clinical studies, dapsone has worked well with both Tazorac and Differin. While I haven't seen any studies conducted with Retin-A Micro specifically, I have no reason to think that Aczone wouldn't work with tretinoin as well.

      If you are experiencing sensitivity from the Retin-A, you may find that the gritty texture of the Aczone can be a bit irritating on raw skin, but the actual ingredient itself shouldn't be the cause of any irritation if you're a good candidate for this kind of treatment.

      Aczone should never be used with benzoyl peroxide because it can discolor the skin.

      If you plan to use retinoids and Aczone, the key is to make sure that you are properly cleansing your skin twice daily with a nonmedicated cleanser because both medications should be applied to clean skin in order to work properly.

      If you have any issues with incorporating these medications into your routine, I would definitely talk to your pharmacist or dermatologist. Like I said, these are both prescriptions, so they should never be used unless they are prescribed to you by your doctor.

      Hope this was helpful! Please let me know if you have any other questions, and thank you so much for commenting! Good luck!

      Fondly, Elizabeh

    2. Hi Elizabeth
      Thanks for answering my question.
      I was wondering why CeraVe Facial Moisturizing Lotion AM SPF 30 is often recomended with Retin-A but it doesn't seem to be oil-free?

    3. Hey Hope,

      To my knowledge, CeraVe Facial Moisturizing Lotion AM SPF 30 is oil-free, non-comedogenic, fragrance-free, and non-irritating, so it works well for many people with inflammatory skin conditions like eczema, acne, and rosacea. The entire line was designed to work well with topical medications, and because it provides excellent sun protection as well, it is a favorite of many dermatologists. It can feel a bit thick though for some with oilier skin. If this is the case, a facial sunscreen that doesn't contain a moisturizer may be more appropriate.

      If they have changed the ingredients list, please let me know because I haven't heard about any oil being added to the product, and I'd like to know if there's a particular ingredient you have concerns about. =)


  28. This was a very informative blog. I have been on Retina-A for just a week now and use it on Mon, Wed, and Fri. My skin is really sensitive so I only am using it 3 times a week. It's not giving me the irritation some others have experienced. I am also on Aczone as well as Metrogel, which I apply everyday, 2 times a day. I have gotten rid of every face wash that has salicylic or BP and have switched to Cerave hydrating cleanser. My dermatologist also recommended the Cerave cream moisturizer instead of the lotion because it is a little more heavier and can handle the dryness that comes with Retina A. I have only been doing this regime a week or so but I am just starting to have mild flaking. My forehead has broke out a little more but nothing to unusual. I really don't have any questions, but I did notice a lot of people need help finding a good sunscreen. I stumbled across this sunscreen by TRIA beauty. I had one of their blue lights and when I purchased the blue light it came free with it. Even though the blue light gave me no results for my acne, the sunscreen is amazing. It's oil-free, fragrance free SPF 32. The only ingredients it lists are zinc oxide and oxtinaxate. It is really light but really protects. I hope this helps for some people I think it runs about 14 dollars but it has lasted me a long time and if you are looking at higher end sunscreens anyway you are willing to pay a little more. I hope I do see some results with this new regime. I finally found a great dermatologist which I think really makes a difference when going through this.

    1. Hey Cherrycherrycola,

      Thank you so much for sharing your experience! I'm sure the information you provided will help a lot of people.

      It's so important to find a dermatologist you can trust, so it's great to hear that you're happy with yours.

      I've never tried the TRIA sunscreen, but it sounds like a good one. Thanks for telling us about it! And good luck with your treatment!=)

      Fondly, Elizabeth

  29. Hey, I have been on Retin a 0.05% since may 31st. It is now August 28. I have used retin a in the past,about a year ago with a super hydrating cleanser ( cera v, or cetaphil for dry skin, and it had almost cleared my skin up. I ended up getting a bad acne break out and stopped suing retin a, and in retrospect, I think it may have been from oil cleansing) Since May 31st, my dermatologist told me to cleanse with a 5-10 percent benzyl peroxide cleanser( I had a few cystic break outs), and every day twice a day with cetaphil oil control foaming cleanser. She also gave me clidasol cream to apply in the afternoon. At first the treatment went alright, and at the 7th week mark my skin went to complete hell, and I constantly have cystic acne. ( I should also note that I was taking Yasmin, and it did nothing for my acne, and seemed to create cystic acne like i had never had before, so I went off the yasmin, and went two cycles with no birth control, the first cycle had a minor cystic acne break out of maybe 5 cysts). So now I have been using my 5% benzyl peroxide cleanser that is gritty, much like the proactive cleanser every second morning ( at one point I used it every morning with no results), my clyndasol on break outs in the morning, and the La Roche Posay Anti helios fluid sunscreen spf 60 during the day. My skin has been extremely oil, weather i use the clindosol, or whether I use it all over my face,or as a spot treatment. My skin, before I started to use the retin a every night( I started off every two nights), has always felt a little tight after, and is still dry. My skin, as of now, has really painful cycstic acne and about 15 lesions ( normally, other than when I have my period, I have just black heads and white heads), it is always very oily a few hours after washing to the point where I am constantly blotting, and my skin is fairly red, and itchy. I am so upset because it just started to get worse and worse over time, and I dropped over 100$ on cleansers etc so this has been really disheartening. I called the dermatologist office, and even though i told them it was giving me social anxiety, they told me to seem my family doctor, which I can only see September 6th, or to wait until September 19th, which is when the next appointment is available. I have the appointment booked, but I am terrified of getting scars. I scar easily, never really have a lot of cystic acne, and I am broken out all over my cheeks, jaw line, and lip area, which is uncommon. Also, not very many white heads/ black heads have cleared up at all. What should I do? Sorry about the long comment, and if things are out of place. Thanks a lot for this article. I have a feeling the scrubs in my benzyl peroxide wash are a bad idea.

    1. Hello Roseknospe,

      I am so sorry to hear how frustrated you are. You did the right thing reaching out to your dermatologist, and while I don't know why they said you must see your family doctor, hopefully they have their reasons. Unfortunately I'm not qualified to give medical advice, but here is some information that may be of some use while you're waiting to see the doctor.

      Cystic acne responds best to combination therapy, which is why your doctor has prescribed so many different products for you. Each one has a specific purpose, so the best advice I can give you is to continue to follow your doctor's instructions as rigidly as possible. Daily treatment is essential, so try not to tweak your routine too much for maximum efficacy.

      A lot of times when we try to figure out what product is causing the problem and start tweaking the routine we're given, we simply stress ourselves out. That being said, I understand where you're coming from on the BP scrub. I personally am not a fan of physical exfoliants because I believe they provide inconsistent results and can thicken the skin. Some studies have also suggested that using scrubs that contain BP can weaken the barrier function. However, that is just my opinion, and many very good doctors disagree with me. If your doctor recommended using the particular product you're already using, then I would continue to follow his instructions until your upcoming appointment. However, if you bought the wrong product by mistake, you may find that a BP cleanser without the granules is much more effective for treating your cystic acne. For right now, I would try to be patient if possible because if your doctor changes your routine, that will have been a waste of your money.

      Another thing I should note is that the treatment of cystic acne normally requires internal treatment to be effective. Stopping your birth control pills means you're not using anything to control the hormones that could be contributing to your acne and excessive oil production. The doctor may want to try another brand, or he may want to try using antibiotics, spironolactone, or even Accutane. Accutane will also help with scarring, so if you're concerned about that, you may want to look into it. It comes with a lot of side effects, but it is an extremely effective medication if you're a good candidate for it.

      I've been where you are, and I know it's frustrating. Try to hang in there, and if you feel like you might not be following your routine correctly, contact your pharmacist, who can be of further assistance.

      I hope this was helpful. Please keep in touch and let us know what happens. You're not alone. If you have anymore questions, I'm always happy to help. Good luck!

      Fondly, Elizabeth

  30. This comment has been removed by the author.

  31. Hi, i have been using Green cream level 3 (which is 0.3 percent retinol ) in about a week and i'm using it every night after cleansing my face with Dermalogica medibac clearing skin wash. My question is if you sagest to use these two products together? And seqond question:Can i use retinol with credentials pore minimizing camphor masque or should i skip the green cream after the masque (i have to use it twice a week ) . Thanks

    1. Hello babochka,

      Thank you so much for commenting! These are great questions because they raise two very important points about using retinoids.

      Many people think that Retin-A is just a stronger version of retinol, but they are a little bit different. Retinol is Vitamin A, and retinoic acid is a derivative of Vitamin A that is much more unstable chemically. Retinol converts to retinoic acid (the active ingredient in Retin-A) once absorbed into your skin, which may be a bit confusing. In a way, you could say it's a weaker version, but on a molecular level, they're slightly different. The reason this is important is because retinoic acid is much more chemically unstable than retinol. Retin-A shouldn't be used with salicylic acid or AHAs because they destabilize the retinoic acid. Retinol and salicylic acid don't have that same issue, so you have more flexibility when building your skin care routine.

      Even though retinol is not as strong as retinoic acid, it can still be irritating to the skin for some and still may cause some photosensitivity and redness when starting. While there is no interaction between the active ingredients in these products, you may notice your skin cannot tolerate so many medicated products.

      It's a matter of trial and error. The safest way to avoid irritation theoretically would be to use all products from the same line, which have been tested together for safety and compatibility. I'll admit that I don't do that, and it's usually fine to mix products from different lines. However, I'd take it slowly if you’re prone to reactions (including breakouts.) Remove what isn't absolutely necessary at first and start out with your cleanser and treatment. If everything goes well, then you can try adding in the mask.

      Clinical skin care can be quite potent, so just pay attention to your skin in between any steps. If it's irritated, don't apply another irritating product until your skin calms down. Patch testing any new products can also save you a lot of unnecessary stress.

      I hope this was helpful. Good luck! Let me know if you have any more questions I can help you answer! =)

      Fondly, Elizabeth

    2. Hi there, I stopped taking birth control (yaz) 3 months ago and began to break out a little at a time. I now have pimples (red painful bumps) some have a small whitehead and some do not on my shoulders, upper arms, jawline, behind my ears and on my face. I started on retin-a about a week ago in hopes of getting this under control. Is this a common experience when going off of birth control and is retin-a a good solution. I've always suffered with minor pimples and blackheads, but had very clear skin while on yaz.

      Also, what is the difference in dosage? I'm using .05 gel currently with a little bit of dryness. Is .025 less effective?

      Finally, I purchased a glycolic cleanser several weeks ago by dermaquest. Is this safe and/or beneficial to use with retin-a?

      Thank you for hosting such a fantastic blog. Acne is a terrible problem that wreaks havoc on emotions and self-esteem. It's so important to know that there are others facing the same challenges!

      I appreciate any feedback you can provide.

    3. I also just realized that my moisturizer has alpha hydroxy. Why are aha's bad when using retin-a?

    4. Hey Marianne,

      Thank you so much for your kind words! It's so true that acne is difficult emotionally, and sometimes that can be very isolating.

      Your questions are fab!

      Yaz is commonly used as an internal treatment for the hormonal causes of acne, and it's very effective at regulating hormones. Unfortunately stopping birth control is a common cause of acne for women who've never had it before, and for those who've only achieved clear skin with the help of BCP, it can be very disappointing to find that your symptoms return when you're not taking the pill. Many of us have been put on oral contraceptives for other reasons, and we were unaware that the pill was what was keeping us clear. I have (and am) going through this myself, and that's actually what inspired me to start this blog.

      If you're trying to get pregnant or are pregnant, you should not use any form of retinoid (even OTC products) as these medications may cause birth defects. If you get pregnant while using Retin-A, please discontinue use and tell your doctor immediately. I used Retin-A temporarily when I stopped birth control pills before switching to another form of treatment, so I hope this doesn't scare you...but since I didn't know why you stopped using them, I thought this was worth mentioning.

      Glycolic acid and Retin-A should not be used at the same time because acids can deactivate the retinoic acid molecule. Even using it in a cleanser could potentially cause problems if not all the glycolic acid is washed away. Using these products in the morning is fine, but at night, skip the glycolic moisturizer for sure. It is generally recommended that you use a nonmedicated cleanser, but if you wanted to use the glycolic cleanser, you'd want to use a toner (without AHAs or BHAs) to ensure that any last traces of the glycolic have been removed from the skin. (Since this can cause irritation, it may not be worth the hassle.) Glycolics can cause increased irritation, so if you're having trouble tolerating the Retin-A, skip them until your skin adjusts.

      The dosages tell you how much of the medication is included, and your doctor will determine which is appropriate for your skin after analysis. Using a higher strength is not necessarily more effective, and more medicine usually means more side effects. There are a lot of factors that determine dosage, such as sensitivity, the severity of your acne, the thickness of your skin, etc. I wouldn't worry about it too much, since your doctor's the one writing the prescriptions. Just let him or her know what's happening with your skin, as he or she may adjust the dosage later on when evaluating your progress.

      Finding an acne solution when stopping birth control is trial and error, and there is no one way to treat it. It responds to medications though, so just remember that you will have to treat what you're seeing now and prevent future breakouts with daily treatment. It's annoying to have more high maintenance skin when you didn't before, but that's just the way you have to look at if you don't want to go back on the pill. Your skin is going to be more oily now, and the products you used before may no longer be appropriate. I found I needed to use something to disinfect the area because I live in a humid climate, but for some, extra exfoliation through Retin-A, glycolics, or salicylic acid is enough to keep the pores from clogging and manage breakouts. For long term acne management, retinoids and benzoyl peroxide are the two topical medications that won't lose their efficacy and can safely be used for years at a time (usually.) One or the other is typically used, but if both are needed, topicals like Epiduo make it easier to use both medications at the same time, which is convenient and takes away the trouble of working two incompatible ingredients into your routine.

      Hope this was helpful. Let me know if you have any more questions. Good luck!

      Fondly, Elizabeth

  32. Hello again!
    I've tried my best to hold back from asking questions for a while but I'm feeling a bit miserable today and I'm not feeling very well and I've got a few skin questions, once again! So apologies!
    Firstly, The facial wash I was using that was recommended by my dermatlogist is no longer sold anywhere nearby and I'm not sure if its been discontinued! All I have in the house that may be appropriate is Cetaphil Gentle Skin Cleanser. Is this going to seriously affect everything and ruin things?
    Also, my skin is suddenly acting differently, I'm starting to get no new spots for a couple of days then get a collection of under the skin spots starting to rise which take about 4 days to go but new ones appear at the same time, if that makes any sense! I never have really had spots that take a bit of time to even begin to clear. Is it normal to start experiencing spots like this later on during the course? I am pretty much consistently clear on my forehead, my right cheek and my nose but having worse than ever before breakouts on my chin and inner left cheek. I know I've often said how I haven't been peeling etc so is it possible that literally Retin-A has been doing nothing? Or am I being too paranoid!
    I was wondering if there were certain things I was doing triggering when I didn't breakout so I was thinking about maybe having like a diary of what I've eaten, if I've exercised, how much water I've drank and what products/makeup I've used throughout the day, or do you think thats too far and not really necessary?
    I'm sorry about this, I'm just feeling pretty miserable about my skin today because I had a bit of hope that it had improved after it being so amazingly clear last weekend but now its just about four stubborn spots and loads of red marks and really large pores! Sorry for the ranting and complaining!
    Connie x

    1. Hey Connie,

      It sounds like you're feeling a lot of anxiety, which I completely understand. It sucks that you can't find that cleanser, but I think using another one should be fine. The reason I recommend using the same thing is because switching up your routine a lot is really stressful on your skin and makes it hard to monitor your success. However, sometimes things get discontinued, and you have to use your judgment about what's the best substitute for it. I recommend using a mild cleanser that is very simple, which Cetaphil is. It should be fine as long as the product your dermatologist recommended didn't contain any medication. Just pick something and stick with it, but don't worry... Your treatment isn't ruined.

      As far as your breakouts go... Since you are clear on the majority of your face, it sounds like the Retin-A is doing something. Do you rest your hand on your chin and left cheek when you're at school or watching TV? The pressure may make your skin there more prone to clogging, or the Retin-A just needs time to regulate these areas. I wasn't sure if you were saying that these blemishes were healing faster than usual or not, but many people experience what seems like an entire year's worth or acne in the matter of a few weeks. It's like hitting the fast forward button on your skin.

      It's always possible that a medication won't work or that you'll need a stronger dosage, but there's nothing wrong with not having any side effects. Whatever you do, don't stop your treatment though. Just mention it at your follow-up appointment because if you stop, then restarting with a stronger dosage will mean you may have more side effects. Not good. I know you're nervous, and you're wanting your skin to clear as fast as possible... But you're doing everything right. You're just feeling the same anxiety that everyone with acne goes through. It is so hard to trust a medication enough that you don't analyze your skin 24/7. That's everyone's initial inclination. But your doctor will monitor your improvement, and the goal of treatment is to get you clear...not just clear enough.

      I think the journal's a great idea, and I recommend it elsewhere on my blog. Not only will it get your anxiety out of your head and onto a piece of paper, and you can look back at what you've been through. Memory is unreliable, so a journal will help you see how far you've come. There is one thing though... You must take it with you to the dermatologist! This journal will not be useful to you as a patient if you don't let your doctor see what's going on, and make sure you also write down a list of questions before you go. When we're nervous, we forget things, and we regret not asking more questions later. I think your dermatologist will appreciate how seriously you're taking your treatment, and it's important that you voice your concerns.

      Hope this was helpful. When's your next follow up? It should be soon, right?

      Fondly, Elizabeth

  33. Hi Elizabeth!

    I am a 20 year old female of Indian descent. I have been using Retin A 0.025% for my moderate acne, which my derm prescribed for me, along with Clindamycin and Doxycycline. Due to the regimen, most of my acne has cleared up which is awesome. I have been using Retin A for about 5-6 weeks now, and in the beginning, I had a lot of peeling and a bit of irritation. I used Retin A (sparingly) about 3 times a week. However, I recently starting experiencing extreme tightness around my mouth and chin area where I had most of my acne. I can't even open my mouth wide enough to eat breakfast in the morning, its so tight, dry and wrinkly. I sort of look like an old man around my mouth and chin area which is quite disturbing. My derm told me not to use any moisturizer because that would cancel out the effects of Retin A. But its become so difficult not being able to move my mouth properly that I decided to at least use 100% Aloe Vera Gel by Fruit of the Earth. I don't know if its working or not, I only started it yesterday.
    I was wondering if the tightness was normal and also if it would disappear soon. I haven't used Retin A in about 4 days now. I experienced all this this about 2 days after my nightly application of Retin A, so its definitely not because of any over medication. I don't want to stop the use of Retin A because it seems to be doing good to my skin- but at the same time, its becoming a literal pain in the 'face'.

    1. Hello Nash,

      While what you're experiencing is not uncommon, the side effects should at least be tolerable. I would be a little cranky if my ability to eat breakfast was being compromised! ;)

      Seriously though, a lot of people find that the dryness is pretty ghastly around their mouth. It's just that products absorb really well in this area, and it can become overmedicated more than the rest of your face.

      If your doctor told you not to use moisturizer, I'd be hesitant to even use the aloe vera though without telling him what's going on. I would instead call the office and let them know what's up. He may change his mind about the moisturizer and recommend one to you that's appropriate for your skin, but it sounds like he thinks moisturizer will actually interfere with the way the medication works.

      He might also phone in a different dosage or formula with a more moisturizing vehicle into your pharmacy, so you can continue to get the benefits of your treatment without all the unwanted side effects. The fact is that if you can barely use your medicine, it's not going to give you the same benefits as you would get from a lower dose that you could tolerate a bit better. Don't wait until your next appointment because this problem could be easily fixable, and it sounds like you were doing everything right.

      I would also make sure that your cleanser isn't part of the problem because a drying product you use before could make you more sensitive to the medicine. If your doctor recommended a specific one, then stick to what he said, but I just thought I'd throw that possibility out there. Also you can try waiting a little bit longer before applying the medication after washing your face because damp skin absorbs more product than dry skin. I mentioned this in the post, but I just figured I would mention any factors I could think of that might be contributing to the issue. Have you changed any products lately?

      Thanks for commenting! Please keep me posted, and let me know if you have any more questions! Good luck! =)

      Fondly, Elizabeth

  34. Elizabeth i think you are amazing the way you answer each question in depth.My question is whats the recommended age to start using retin a and once you stop it will your skin start ageing drastically?


    1. Hello May,

      You have no idea how much your comment made me smile! It means so much that you took the time to compliment me personally. I really appreciate each and every one of you that reads what I have to say, and I'm always honored when someone is interested in asking my advice. I'm kind of longwinded by nature, but I really enjoy answering all of your questions. I've learned so much from everyone since I started this blog. =)

      To answer your question... There really is no recommended age for starting Retin-A, and I definitely don't think it's the only medication out there to treat either acne or aging. I suppose if and when you start using it really depends on your goals--acne or aging.

      I can’t really give you a specific age for when a person should begin to use Retin-A because it varies depending on the person and what you’re treating. The two main uses are for treating acne and reversing photoaging. Since acne can occur at any time in a person’s life, the age isn’t consistent. Photoaging is caused by the sun and differs from chronological aging, so it just depends on the person.

      Most people in their twenties can benefit from using a chemical exfoliant as a nightly part of their skin care routine, but that doesn’t have to be Retin-A specifically. There are other options with fewer side effects for those that don't need it to treat acne. It's just nice to know there's a treatment that can be used long term to control acne that will also help the skin age so beautifully.

      Regardless of how or why a person starts using Retin-A, it’s important to note that Retin-A is not a substitute for a cosmetic procedure like a laser treatment or chemical peel, and the anti-aging benefits aren’t immediate. It takes about nine months to a year for the anti-aging benefits to kick in, and it needs to be used continuously for it to continue to have any impact on acne or aging.

      Hope that was helpful. If you have any more questions, please don’t hesitate to ask. This was kind of a vague answer, so if you need me to clarify anything, I’m always more than happy to help. Keep in touch! =)

      Fondly, Elizabeth

  35. Hi Elizabeth
    I need help please. My graduation ceremony is next week and my face is overwhelmingly dry and flaking. Makeup just makes it look worse too. I'm on Week Seven of Retin-A gel for acne. Is it too soon to use an exfloiating brush? Or at least exfoliate with a wash cloth?

    I'm deeply embarrassed of my face right now, its texture and it's appearance. It is peeling especially on the right side of my face and neck area. I feel self-conscious and even when I see strangers when I'm out running errands I just want to hide because I think they're grossed out by my skin. I know I have to wait a full 3 months and be patient to get results but as of now is there anything I can do to combat this? I'm dreading even going to the ceremony because of all the pictures that will be taken. I don't know if this will help in any way but I am also taking Vitamin A supplement, Vitamin C, Zinc and Magnesium. Is there a moisturizer I can apply to combat the dry skin that won't cause acne? I've also noticed that since starting Retin-A - my skin, despite it being dry and peeling in texture, it has also been oilier than ever, I'm constantly blotting and powdering. I've been using a gentle wash cleanser (Purpose), do you think it would be beneficial to switch to a hydrating one like CeraVe because my skin is dry now ?

    I'm SO grateful for all your helpful advice and guidance! Thank you for taking the time to read my questions.

    1. Hello Gabrielle,

      I feel your pain, and I know that's very frustrating. I was super oily when I was on Retin-A, and it really drove me nuts. Many people experience the peeling and drying simultaneously with shine, and this means that your skin is really absorbing quite a bit of the medication. Because of that, I would not recommend using any form of exfoliation because that will cause your skin to absorb even more of the medication. I would also suggest using a slightly smaller amount because using too much can over-medicate the skin as well. Be careful when applying over any expression lines or folds of the skin. It's very easy for product to collect in the nasolabial folds, corners of the mouth, and around the nostrils.

      You mentioned that the peeling was mostly on the right side of your face. If you sleep on your side, your laundry detergent or fabric softener may be causing a reaction now that your skin is more sensitive. Skipping fabric softeners and using a fragrance free laundry detergent may help. I recommend All Free & Clear, and so do many dermatologists.

      As far as moisturizers go, Cera Ve makes a good basic one. Their cleanser is quite nice too. You can try them out if you want, but be aware that the oiliness will become more of a problem. The flaking you're seeing isn't actually dry skin. It's the desquamation process that is occurring because your skin cells are turning over so rapidly. You may want to call your doctor if you're miserable and see about getting a lighter dose.

      As far as makeup goes, it's true that it will make any flakiness look worse, but I've found that tinted moisturizers are great because they provide moisture and they contain less pigment. I'm a big fan of Bobbi Brown's Oil Free Tinted Moisturizers, but there are loads to choose from. If you choose to get one, be sure to see how it looks in photos because sometimes the sunscreens can make you look a bit ghostly. You can also make your own tinted moisturizer by diluting your foundation with a light water-based moisturizer like Clinique Moisture Surge. Using a loose powder in the T-zone only will help keep the shine under control.

      I'd be careful about trying too many new products so close to your graduation because you wouldn't want to have a reaction so close to this special event. I know it's tempting to try and manage the side effects with something you can buy OTC, but moisturizers are only a temporary fix and expose your skin to a lot of ingredients that you could potentially react to. If you do choose to purchase anything new, I would be sure to patch test it in a small area first before applying it all over your face.

      I would also recommend stopping the Vitamin A supplements unless you have been advised to take them by your doctor. Vitamin A supplements can aggravate the side effects of Retin-A and can be very dangerous.

      I found that evening primrose oil really helped me while I was taking the Retin-A. I'm prone to eczema, and I really think this kept me from developing retinoid dermatitis, which is the irritation that many people experience when starting Retin-A. Check with a doctor or pharmacist before you start taking anything though.

      I hope this was helpful. Please let me know if you have any more questions. I know this is a rough time for you to be experiencing these problems, but trust me, you will get through this. Keep your chin up because graduations don't happen every day, and they deserve to be celebrated. Forget about those judgmental strangers, and focus on enjoying this time in your life. In twenty years, you'll be glad that you did. =) Good luck!

      Fondly, Elizabeth

    2. Thanks for your advice! I attend my grad last week and it went alright. I just moisturized my skin to keep the flakiness at bay. The pictures turned out not as scary as I thought they would be lol.

      Do you mind explaining more about how to deal with the flakiness? I'm still confused because from what I understand I'm *not supposed to exfoliate. So do I just let the flaky skin..accumulate? Is the flakiness the top layer of skin re-growing? :S I'm on the lowest dose available here 0.025%. I do moisturize on days when I'm not using Retin-A but never both on the same night (ie I never apply moisturizer then use Retin-A or vice versa). For reference I am now on Week 9 of treatment.

      Thank you again for your advice. You are so patient, friendly and helpful. I'm so happy I found your blog.

  36. I was just wondering if it was okay to use Clinique Clarifying lotion 2 in conjunction with Retina A. I have been on Retina A for about 6 weeks now and I use it every other day. I did not know if the ingredients would cause me to have a bad reaction. Thanks

    1. Hello Cherrycherrycola,

      I personally would not use the Clinique Clarifying Lotion 2 without your doctor's approval for a few reasons. For starters, an exfoliating toner really isn't necessary while using Retin-A, and I personally think that using anything you don't absolutely need to use while on Retin-A tends to do more harm than good most of the time. The Clinique Clarifying Lotion also contains a few ingredients that are contraindicated by the manufacturers of Retin-A, including alcohol, menthol, and salicylic acid. The salicylic acid may interfere with the medication, and all three can make your skin much more sensitive to it. If you can't fathom going without the clarifying lotion, you might want to only use it once a day in the morning when you're not using the Retin-A... But if possible, I'd skip it because it's not really necessary in treating your acne and could make you more sensitive.

      Hope this was helpful! Good luck! And let me know if you have any other questions. Thank you for commenting!

      Fondly, Elizabeth

  37. Hello again! I'm sorry it's taken me so long to get back to you, I've been SO busy with school and had barely any free time!
    I went to visit my dermatologist again and she was really happy with my progress, I only had one active spot and marks which she said would fade, she said my skin was looking really good and hopefuly over time it would only continue to improve, so she said she'd like to see me again in January. She also said my pores where completely normal and just because my skin was producing so much oil and they should tighten again. So I suppose thats good! However, she said there was now no need for using sun protection and to avoid any types of moisturiser, even sun protection, however I thought this was a must with Retin-A? Also she told me to continue with the antibiotics and it wasn't until we left we realised I've been on antibitoics continuously for over a year now, which is probably not a good thing! I really should have thought in the appointment but I didn't! I don't want to stop taking them without being told to! Finally these past few days my skin has been unbearably dry, to the point where I've been so close to smothering my face in a rich, heavy moisturiser! I don't know if the weather has anything to do with it because these last few days I've been out a lot and its freezing cold, very windy and even snowy. I doubt that this has caused my skin to suddenly become this bad however because it's literally scaly and visibly flaky,completely tight and dry! I haven't changed anything in my routine at all and previously I haven't had any dryness whatsoever! I tried missing a night with the Retin-A last night but saw no real difference today:( luckily I'm off school this week however I'm dreading going back if it makes makeup unappliable! Finally, I suposse this is just for a bit of hope! I'm really happy with the improvement in my skin however i still (MUCH less frequently) get breakouts, but I notice the time between them gets longer every time, so is there still a chance that I will eventually be fully clear?
    I'm sorry for being so late in responding! I really do appreciate all your help and hope you don't think I'm ungrateful! Hope you are well!
    Connie x

    1. Hey Connie,

      I’m so happy to hear your skin is improving so much! That’s awesome! It sounds like your appointment went really well! =)

      I think the reason your dermatologist told you not to use sunscreen is because he or she has determined that during this time of year the amount of sun exposure you’re getting is so negligible that it doesn’t make much sense for you to use it on a daily basis. I live in the southern part of the United States, and here we get a lot more sun exposure in our daily lives that someone might in the UK. You’re much further North, and this time of year, many skin experts in your area recommend going without sunscreen. I personally will be continuing to use and recommend sunscreen for Retin-A users, but your doctor knows you, your skin, and the area where you live. I would follow his or her advice unless you plan on spending time outdoors.

      As for the antibiotics, I would stick with them, but bring up your concerns at your next appointment. Definitely don’t just stop taking them! Our skin has a memory. It gets used to not breaking out while you’re taking the antibiotics, and if we stop taking them, it will remember that it used to break out and go back to having acne. We have to trick the skin into thinking you’re still taking them if you want to successfully stop using them and maintain clear skin. That means, usually we lower the dosages gradually until eventually you’re taking an insignificant amount, and then you stop taking them entirely. Hopefully that makes sense! Not every doctor does it this way, but many do. But pretty much all doctors will wait until the skin is completely clear before discussing going off the antibiotics. For teens, often these are prescribed a bit longer than they are in adults.
      I would suggest writing down any and all questions you have for your dermatologist before your next appointment. That way you don’t forget anything when you’re in there. It can be quite nerve-wracking seeing the doctor, so most people forget something they meant to ask. Keeping a list can ensure that all your questions get answered for you.

      As for the weather, it is normal for climate changes to affect your skin, and using Retin-A can make you much more sensitive to changes in the weather that wouldn’t have affected you too much otherwise. Using a cold-air humidifier in your bedroom or anywhere you spend a significant amount of time in your home can help with the dryness from the winter, and since you’re changing your environment instead of applying another product on your skin, you don’t have to worry about any unwanted breakouts or reactions. The only downside is that you do have to clean it out, which isn’t very fun. But it can really, really help during the winter months. You may also want to make sure you’re using tepid—not hot water and limit the amount of time you’re unnecessarily exposing yourself to hot water. If you like long, hot showers, shortening them and turning down the temperature can make a huge difference.

      Hope this was helpful. It was great hearing from you! Good luck in school, and let me know if you have any more questions I can help you with! =)

      Fondly, Elizabeth

  38. Hi, I really love this blog and I am hoping that Retin A will help my skin. I am 38 years old and I've had acne since I was 12 y old. I have been using Retin A for the past 4 months, in the beginning it seems to help clear out the blackheads, but so far it hasn't done anything for the cysts.
    What am I doing wrong?
    I use once/day before bedtime, 0.01%
    should I bump the strenght to 0.025% or 0.05?
    will it help to prevent cystic acne?

    I am so fed up with it that I am now considering accutane!

    1. Hello Fabiola,
      It does not sound like you are doing anything wrong. Retin-A alone works best on comedonal acne, which is characterized by blackheads and whiteheads. Cysts usually need to be treated a bit more aggressively. You may need to bump up your dosage, but odds are you’ll need to add in another medication to combat the cysts. Many dermatologists often prescribe oral and/or topical antibiotics in conjunction with a retinoid because cystic acne responds best to combination treatment. (Once the cystic acne is under control, your doctor may wean you off the antibiotics and keep you on the Retin-A for maintenance.) Accutane is a very effective option for cystic acne that doesn’t respond to other treatments, but I think the fact that you are seeing some results from the Retin-A is a good sign.
      Another excellent retinoid that often works very well for more severe acne is Tazorac, but again you will probably need to couple this with something like an antibiotic in the early stages of treatment to fully treat the acne. You can talk to your doctor about this option if you find you respond well to retinoids but need something a bit stronger to prevent your acne from returning.
      Talk to your doctor and let us know about your progress.=)
      Thank you so much for commenting! I am a bit behind on replying to comments, so I apologize if this is long overdue. Good luck!!!
      Fondly, Elizabeth

  39. Hi Elizabeth,

    Thank you so much for the awesome blog! You're so knowledgable, informative and friendly :)

    I'm 38 years old with combination/dry skin and I sometimes get a few pimples here and there, but usually nothing too bad. In fact, the only time I had serious acne issues is when I came off OCP when I was pregnant with my first son (fourteen years ago). Back then I had two large (giant) cysts, apart from normal comedones, that formed on each cheek and which left bad ice-pick scarring on my left cheek. I immediately went back onto OCP and it cleared the cysts right up. I am once again off OCP for good after my last child was born (four years ago) and I don't ever want to go back on it again as I had some serious side effects (mood swings/weight gain/pigmentation, etc). Anyway, about three months ago I decided to try glycolic chemical peels. I had a course of six done this time last year, which were okay but they didnt really make much difference and made me break out quite a bit. This time I went to a different skin clinic and obviously the peels were of a different brand (although also glycolic) but they were very much more harsh. I was started out with a mild % solution which gradually increased each time I went. I had a total of four peels done (once every two weeks) but I could not complete the entire course of six as I broke out with the most awful acne I've ever had. I had at least ten comedones and five cysts at the end of the last peel. I started breaking out with the first peel but it steadily got worse every time I went. It really was horrific! I think I have finally got it under control (today I only have four visible pimples) using Cetaphil Cleanser and Skinoren at night with the Uriage SPF 50 during the day, but I have now got a lot of purple/red marks and scars everywhere (one really bad one that has not lightend at all). The peels definitely helped my pigmentation quite a bit, which I'm happy about, but now I have all these other issues again. I also have the first signs of wrinkles forming so I would like to try Retin A for all the above concerns. I'm just worried that I will have the same reaction as I had to the peels... What do you think? I just want to get your opinion before I make an expensive appointment to see the doctor. Also, if I do go on Retin A I plan to use Cetaphil cleanser and moisturiser. I have used them before and I love them but I'm worried it might be a little too rich (especially the moisturiser). Will it clog my pores over time?

    Hope to hear from you soon! And thanks again for the fantastic blog!!!

  40. Hi Elizabeth

    First I would like to thank you for you post, reaqlly helpful and well done. I have been using Retin A for 2 weeks now on a %0.5 every other day formula. My skin is looking really shine durig the day and I have had some peeling on my cheecks but nothing abnormal. My question is, I am 26 years old with a hispanic olive skin and have very large pores (thanks my genetic) on my nose and cheecks, some acne scars, and a lot of liitle hiperpigmentation spots which I thing were derivated from the pimples I had when teenager, and a lot of blackheads on my nose however pimples are not comon any more only in my period time. I was thinking to do a 20% Salycilic peel one week altering with 70% Lactic peel on the other week. What do you think about it and what do you think of keeping using Retin A while I do these weekly peels? Thank you so much for sharing your knowledge with us.

    Sydney - Australia

  41. Hi Elizabeh, just discovered your blog and it is beautifully informative. Wanted to ask a few questions myself, have scrolled through the comments above but excuse me if I ask something you've already answered. My skin is very dry and suffering with the winter weather yet I've started tretinoin treatment every other day regardless to help with blackheads, acne scarring, crinkly eyes, large pores and this pervasive light spotting over my face (given you have be close to see it but it messes with overall skin quality and smoothness). I'm 27 yrs old. My question is - I've also been using essential oils in Avocado oil (Frankincense, Neroli, Patchouli, Carrot, Rosewood, Thyme, Lavender, etc...) Is this a bad idea with the tretinion, can I apply one after the other or is this too much exfoliation? I've also read not to apply around the eyes, should this be okay every couple of days? I would imagine when people use retinoids for ageing this would often be a focal area, no? Also, it appears that it must be used indefinitely to maintain effects, do you still use it yourself and if you've stopped, are the benefits from having used it still present to any degree?

    Thanks x

  42. Hello,

    My name is Agatha Robby, i have been suffering from Acne for the past two years which has made me to indulge in Make ups to build my self esteem, i have not yet started using Retin A but what i fear most is that my skin is acne prone.

    Could Retin A give it a difference or cause damage to my skin. From Kenya.

  43. Hello,
    I have been using the Retin-a but a generic 0.05%. I use it typically every other day or everyday. My skin is not sensitive and this product hasnt cause any sensitivity or peeling. I am using a clarisonic mia 2 and am using the neutrogena pure line (the organic in a white and green bottle) and occasionally use the orignal orange neutrogena acne cleanser. i used a different acne cleanser last night and am a little irritated today. Should I stay away completely from any other sort of acne medication while using retina a ( i also occasionlly use Mario Badescu drying lotion and buffering lotion) or the healing cream with balsam peru, for when my skin is irritated. Im not sure if im over doing it, the only thing is my skin is a little broken out, but the pimples seem like they are being brought to the surface and that they heal faster. Thank you for your informative blog and knowledge.

    1. Hello Sarah,

      Thank you so much for your lovely comment! As behind as I am in replying to everyone, I really enjoy hearing from each and every one of you, and your kind words brighten my day. =)

      According to the manufacturer’s instructions on Retin-A, it is best to refrain from using OTC acne medications like salicylic acid and sulfur and to avoid using anything drying or irritating like harsh soaps, alcohol, lime, spices, or menthol while using Retin-A. I couldn’t agree more. Unless you have been specifically instructed by your doctor to use these kinds of products (which many do), I would skip them. They just make life too complicated in my experience—especially acne cleansers. They typically contain the forbidden salicylic acid and menthol, and they’re usually designed for oily, teen skin and can be really irritating and unpredictable. If you’re using natural lines, I would also make sure they don’t include willowbark or too many herbs or citrus extracts because this can cause a lot of irritation.

      My suggestion is to pick a gentle, fragrance free, non-comedogenic cleanser and moisturizer preferably from the same line along with a non-irritating sunscreen for daytime and just stick with them for the first few months of treatment. Changing products a lot introduces new variables into the equation, making it hard to identify the source of any problems if and when they arise. It’s really difficult to know if the medication or your products are the issue when you’re not consistent, and furthermore, scientific studies show that consistency gets better results.

      I know how tempting it is to take matters into your own hands when managing your acne, and it takes a leap of faith. I’ve been there, and it’s something that’s much easier to say than put into practice. Good luck!! Let us know how things work out for you, and thank you again for sharing your experiences. =)

      Fondly, Elizabeth

    2. Hey Sarah,

      I also forgot to mention that Clarisonic includes a warning about using their product with any sun sensitizing topical products. If you continue struggling with irritation, you may want to see how your skin responds to gently cleansing with only your fingertips. I used the Clarisonic with my Retin-A, but I couldn't use if for a full minute and had to use the delicate brush head. Forgot to mention this in my last reply. Sorry for commenting twice!! =)

      Fondly, Elizabeth

  44. i am really thankful that i found this article. i've suffered from hormonal acne and hormonal melasma for the last year and finally broke down and made an appointment with my dermatologist. unfortunately, the derm i normally see is very hard to get in with, so i made an appointment with one of her colleagues. he didn't give me any instruction what so ever on using retin a, other than to use it all over in the pm. in addition, he gave me a perscription for benzaclin, to use in the am on my chin, and told me to use the neutrogena clear pore cleanser/mask, which also contains benzoyl peroxide, both am and pm as a face wash. you can imagine how dry my face was! between reading your blog and a little trial and error, i have streamlined my routine and, so far, am much happier with the results. since most of my acne is on my chin, i do need to use the retin a there. that, and the sides of my mouth are definitely the most sensitive areas of my face. i have found that if i buffer with moisturizer (i use cerave pm), my "u zone" tolerates it better. thank you so much for ALL of your tips - your blog is wonderful.

  45. The new skin is lighter after peel and skin shedding. Will it eventually blend in color with the unpeeled skin?

  46. Hello, I have just started using retin-a for a bit more than a week, in combination with doxyciclin, andclindamycin topical solution which i use during the day. i was recommended to apply moisturizer on my skin before i apply retin a at night. is this a good idea?

  47. hi! is it okey for me to use a sunscreen like neutrogena dry touch spf 50 directly over the retin-a since my schedule is such that i have to stay up late hence i wake up late and my room facing east gets a lot of sunlight.

  48. Tretinoin Cream is derived from vitamin A, one of a class of substances called retinoids. Retinoid cream disrupts the wart's skin cell growth.This cream in enforced to resolve skin problems like allergy.

  49. Hello,
    I have never suffered from acne but suddenly at 29 now I have been getting acne last few weeks. I have started using retin A and awaiting results. I wanted to know if i can continue using my Lancome non comodogenic skin care which includes the :
    Lancôme EXFOLIANCE CLARTÉ Clarifying Exfoliating Gel,
    Lancome tonique radiance toner
    Lancome high resolution refill 3x moisturiser with spf 15

    Also how safe is it to get a microdermabrasion during usage of retin A.

  50. hii..i used BRIGHT cream about 6 years ago and it made my face more darker than it was.(i have oily skin)so i went to this doctor and he told me to use A RET GEL 0.025 and GLYCO-A alternatively before sleep.i did this for like 20 days and now my skin is very dry and my skin is more very dissappointed.i trust this doc but the results are negative.i dont know what to my body's colour is much fairer than my face.:-(
    please someone help me would be much appriciated..

  51. Hello. I found your blog while googling Retin-A side effects. I've read through most of the comments and your replies and I think I can see what the problem is but I'll just give you some info to be sure. I'm 53 years old and have always had really good skin. Never had acne ever and very few breakouts of any kind my entire life. Really! So thats the good news. I've been really struggling over the last year with the aging process in terms of fine lines and wrinkles that seem to have appeared overnight,some red patches on my forehead, cheeks and chin and large pores. I made an appointment with my dermatologist and she prescribed 1% Metrogel for what she said was mild Rosacea and Retin-A cream .025%. I used the Metrogel every night for a week and the redness cleared up beautifully then, I discontinued the Metrogel and began using the Retin-A nightly, as prescribed every night after cleansing before bed. I had read that some people have terrible breakouts, flaking skin and other side effects for the first few weeks or months but my skin seemed to be tolerating the Retin-A very well and it even appeared to be evening out the tone and texture within 2 weeks. It seems I was a bit too smug too soon . .lol. I went away this past weekend with a friend to Key West, covered my face in a 70 SPF sunscreen that my friend had and layed in the sun for 2 hours. Well,that was on Sunday and 4 days later my face is covered in red bumps. Some large, some small and mostly on my chin and around my nose and forehead. I am freaked out to say the least. So, I've discontinued Retin-A until it all clears up and used some Metrogel hoping it will alleviate the redness but truthfully I have no idea what to do now. Should have left well enough alone. My skin was gorgeous compared to what I'm looking at now! Very unhappy and worried it will never go away. Please share advice. What to do? Thank you.

  52. I forgot to mention that I purchased the Retin-A from a pharmacy that compounds perscriptions. Tretinoin 025%. Cream.

  53. Hi I just started Retin -A a day ago. I'm wondering will it help clear up my acne scars? They aren't deep just on the surface from some minor pimples i've gotten over the years.

  54. Hi Elizabeth,
    Thank you so much for the awesome blog. I find it very informative and helpful, especially when i'm also using tretinoin at the moment.
    I was prescribed with Locacid treinoin 0.05 cream ( a French brand of retin A with similar ingredients minus the comedogenic one) about 2 months ago, together with Clindamycin and vitamin supplement. My skin got very irritated in the first week, but after 7 weeks i got barely any redness or peeling. The texture is good overall. HOWEVER, i have been breaking out a lot. I used to have a lot of clogged pores to start with, and im using this cream to specifically treat that problem. So far many of them have turned into active acnes (swollen without head) and leaving many scars on my face. It was horrible as i had 2-3 pimples like that every week. However, i decided to stick it out as many reviews said that it was common the in the first 6 weeks of the treatment...But now, i'm on week 8, and i'm still having 3 big red cysts on my cheek that seem to stay for a very long time. They look very inflamed, which really question me if that is normal.
    I have used the cream very properly, just everything you said. My skincare routine is quite simple with cleanser, moisturizer and SPF all from Cetaphil which seem to feel good on my skin. I use Clearasil spot treatment with BP 10% on the active pimples during day time.
    My only question is, is my progress normal, and should i still stick with Tretinoin? It has been 8 weeks and all i see is my skin getting worse day after day :( I cant help but feeling pretty depressed :(
    Looking forward to hearing your opinion on this
    Again, thank you so much for creating this awesome blog :)

  55. Hi,

    I heard about retin A from a friend who had suffered from sever acne before now her face is clear she recommends i start using it. I have also tried everything my question is that i am an african and im fairly light. Will it work on me also I am not afriad of the pain as my self esteem has taken a knock due to the breakout of acne.

    When I say i have used everything i mean everything this is my last attemot then i will just have to accept that my skin will never be that way it was before.

    I await you reply paitently as i will start with the treatment on the 1st of June 2013.

    Thank You

    1. Hello Nomfundo,
      Thank you for your patience! I am so behind on replying to my comments, so I know you have probably started your treatment by now.

      I cannot guarantee whether or not Retin-A will work for anyone and that is why I always recommend getting your Retin-A from a doctor—preferably a dermatologist—who has examined your skin. There is no product that will work for everyone, and even though I think Retin-A is one of the miracle drugs of the 21st century, there are so many things to consider like dosage and whether or not it should be used alone or as part of a combination treatment plan. And, unfortunately, there are always people that cannot tolerate this treatment at all. People of all ethnicities and skin tones have had great success achieving or maintaining clear skin with Retin-A, but everyone should have their treatment monitored by a doctor to avoid unnecessary complications and to maximize results.

      Don’t lose hope though. Even if Retin-A is not the right treatment for you, a skilled dermatologist can assist you in achieving the skin you’re looking for…even if it feels like you’ve exhausted all your other options. Good luck! And please keep in touch to let us know how Retin-A works out for you. =)

      Fondly, Elizabeth

  56. YAY, I am so happy I actually found a blog for vitamin A acid! I have been using this product for 9 weeks now! I have never missed a single night. I quit smoking 9 months ago and developed acne problems since then. I use to have perfect skin.. Anyways my doctor prescribed me this and I have been waiting for it to actually work... My first weeks were awful very single bump whether a black head or white head or sweat bump turned into a zit. I dealt with it, waiting for the 6 week mark knowing it will get better.. Well week 9 and still have acne and they are HUGE! My question is has this product worked for everyone? Should I really continue using this product even thou I have yet to see beneficial results? Has anyone else not seen results past 9 weeks?

    I use spectro gel face wash and clean and clear. I use one in the morning and one at night. In the morning I also use nuetrogena moisturizer.

  57. Thank you for all this wonderful information. I have hope now and plan to slowly re-start my Retin-A creme. One question that you may have answered but I have not read all the posts from this year, once using Retin-A I notice many many of my pores have sebum sticking out of them. How it looks when you would squeeze it out....... I have been washing my face with either plain warm water or pure jojoba oil. Perhaps this is not a good idea. I look in the mirror and see all these "plugs" standing up and what do I need to do to have them fall off?

    1. Hello Trixie,

      You are so kind! Thank you for sharing. I'm sure this can help others in a similar situation.

      I can't diagnose anyone, but it sounds like you're describing sebaceous filaments. These are similar to blackheads, as they occur in oily areas of the face and contain dead skin cells and sebum. The difference is they haven’t oxidized. This can happen to anyone who has oily skin, and it can often become noticeable when the breakouts improve. Additionally Retin-A in some people (like myself) can trigger more oil production, and while it treats the comedones, it doesn’t stop your oil production. That’s controlled by hormones.

      Ironically the best way to treat sebaceous filaments is actually with Retin-A. I would suggest just being sure to adjust your skin care routine to keep your pores as clear as possible, so the Retin-A can do what it does best. Using non-comedogenic, oil-free products, and cleansing twice daily can help.

      If you have oily skin, using an oil to cleanse is only going to add to the problem, so I only suggest using these products if you’re trying to remove makeup before following up with a cleanser designed for your skin type. I really like the oily skin cleansers from La Roche-Posay, but if you’re not used to using a facial wash twice daily, jumping into using something to combat oil may be a bit much--especially if you're getting used to a medication. It’s a bit of a balancing act, but fortunately there are a lot of great cleansers at the drugstore that will help prepare your skin to receive the Retin-A and allow it to work better in addition to helping you manage the oil.

      If you’re really self-conscious about them, a primer can help you draw less attention to them. People with acne have mixed feelings about these products, but there are many available that can make pores look less visible during the day with or without makeup. Just remember to remove them at night with a makeup remover that can break down silicones before using your regular cleanser.

      I would also discuss the issue with your doctor. There are many retinoids available now, and he or she may want to switch you to a form that has a less creamy vehicle or try something like Tazorac if this remains a problem.

      I hope this was helpful. Please stay in touch, and let us know how things work out for you. Good luck! =)

      Fondly, Elizabeth

  58. retin a cream is really a miracle. i got a good experience. i had a severe acne and i used it for 2 months and then miracle happened acne got disappeared.

  59. Hi~ I've been using Retin-A for few months now with a medicated soap.. is it ok to do so?? I was just wondering.. I am recovering from cystic acne but it's quite slow.. n i still have this breakout here and there across my cheek, jawline and upper part of cheek.. :O

  60. Hi I just found ur blog. I am using retin a 0.025% since 3 weeks at night and follow routine with sunscreen, waiting 20 min etc etc. First week was very dramatic. Lots of breakout. My skin is in very good condiTion and it was b4 i started retin.i turned 34 and notice wrinkles and sun spots thats y i decided to start retin a. I know i have to b patient. But so far after 3 weeks my skin looks dry more wrinkles appear and i dont see sun spots fading? It will get better? Y more wrinkles i got? No peeling or flaking just few breakout but now none expept i looj older than before i started?

  61. Hi! Thank you for this most helpful post!
    I must ask your opinion on Better Complexions' 1% retin A cream. I started to use it this week and was putting it on every night for 4 consecutive days which quickly proved to be a terrible idea. It's true what you said about avoiding direct application to the chin, nose and mouth crease and the area above the lips skin is sooo irritated right now I beg for you advice on what I should do. How long do I stay off it? Should I just stop completely? Will my skin ever be normal again? Please help!

    Thank you!

    1. Hello Sofia,

      Thank you so much for commenting and sharing your experience! Unfortunately sometimes we learn the hard way. I have overdone it on acne treatments so many times, and it always shows in that particular area first. So frustrating!!

      The best advice I can give you is to hold off on treatment until your skin recovers, then begin again slowly the way I've described. I can't give you an exact amount of time because everyone's skin recovers from injury at different rates. Take a break from products that contain active ingredients and protect yourself from the sun until the irritation subsides, or your skin will likely just continue to have an inflammatory response to Retin-A.

      I'm actually not familiar with the Better Complexions line, but many medspas have developed their own formulations of Retin-A. The only real differences are the vehicles that the active ingredient comes in. Some are more moisturizing than others to prevent irritation. It can take some experimenting to find the form of tretinoin that works for you. I'd love to know how you end up liking it.

      I hope this was helpful. Good luck!

      Fondly, Elizabeth

  62. I have bad cystic acne. Never had any acne until four years ago when I turned 32, due to hormonal changes. I went on a liver detox program and it fixed it for a while but now only cortisone shots are helping the cysts and user while a spot is still heading a new cyst pops up in the same exact spot.

    Every time I am injected my face caves in so my doctor put me on the micro retina gel.1%. My face is peeling like crazy and even using my clarisonic after I get out of the shower I use an alcohol free Toner as I have very dry skin normally and after I put on my moisturizer for the day, emu oil!!! I start peeling again within 5 minutes.

    This had made my skin even dryer and no matter how much moisture I put on day or night my skin feels like a doggone dessert.
    I am number of control because my hormones are severely low when I went into early menopause full-blown menopause actually at the age of 36 this past year, so my holistic physician put me on all organic amino acid injections to boost my own hormones which are now in the normal levels. My cystic acne is not caused by oil because I have no well and my skin is July or then a desert. It is purely caused by hormones so I'm beginning to think maybe this product although it may work for some is probably not the best for me as mine has to do with hormonal changes, right?

  63. Hi! I realize this is an older post but hopefully you will be able to respond, as I am at a loss. I have been using topical clindamyacine every morning and evening for about 1 year. It seemed to control my acne, but not stop it completely. I recently also started regularly using RetinA. I am now in my fifth week and have been "purging" for a while with no sign of it stopping. I keep breaking out and the new breakouts are causing more red scarring that are not being lightened by RetinA either. I keep trying to give it a chance because I have read a lot about purging, but I read in your post that purging shouldn't be happening? I have struggled with this for a while and would love some insight.
    Thank you!

    1. Hi! Im in the same boat with you. My doc prescribed me clindamycin/benzol peroxide combo together with the RetinA.

      Even though I broke out alot in the beginning, its been 6 months from when I started initial treatment and my face has never been better!

      I honestly think this product is a miracle worker. My face is still very much oily but atleast the acne is gone! Although I still get 1 or two bumps here and there, they are very rare and very tiny! Compared to the mountains I used to get on my face before I started this treatment.


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  66. Hi... I see you haven't been on this blog for a bit so I do hope to hear back from you. I am 36 yeas old and my face has been awful for the last year. My pcp recently wrote me script for Retin A .025. At first my skin was amazing but it only lasted a week. Now I am broke out horribly and my face HURTS! My dr told me to use a mild white soap like ivory or dove so I have been using ivory. I started using it on December 31st and only missed one or two nights because my face was on fire and the pharmacist told me to take a day or two off. My question is.... is my skin going to get better? Or should I go back to the dr.? And what cleanser and sunscreen do you recommend? And should I be moisturizing? My skin is super oily so I use Mary Kay oil magnifier or Mac oil control daily. I am also using Mac studio fix powder foundation. I am up for any suggestion as to what to be using! Thank you in advance for your help and thank you for the info in your blog! I thought I was the only adult in the world that had this issue!

    1. I suggest consulting with your doctor and following whatever plan he recommends for a month to know for certain. Retin-A is not for everyone, but it can definitely be worth it if you find the right products to accompany it. (Personally I could not use soap with it, as it irritated my skin and did not remove my makeup. That does not mean that it might not work for you though.)
      Right not I am having great success with Paula's Choice Pore Normalizing cleanser and her Resist Ultra-Light sunscreen (which mattifies my skin.) Paula's Choice has a variety of options available, and she sells samples of all of her products on her website.
      Whatever you do, remember that there are tons of adults in your situation out there. You are not alone. It may feel like everything is marketed to teens, but this is an increasingly common problem for many people in all stages of adulthood struggling to find the right products to treat their skin.

  67. I used to use Retin A, but the side effects were so bad - my dermatologist recommended the Lady Soma Serum and Lady Soma Somatique Face Wash. It has Retinol Vitamin A in it, WITHOUT the side effects of Retin A. For those of you actually using Retin A, here is my routine... Wash with Lady Soma Somatique Face Wash - then apply the Lady Soma Renewal Serum. In the morning I wash again with this Lady Soma Wash. The Lady Soma stuff also seems to be helping with the intial breakout I got from the Retin A (have not had acne in years! was put on the Retin A for sun damage & fine lines).

    1. I am so glad you found something that worked for you! I have never heard of Lady Soma. Where do you get it?

  68. Hello Elizabeth,

    My doctor has just prescribed me retisol-a and I want to make sure I begin this treatment the right way so I do not have any negative side effects. I am currently using the 3 step proactiv skin care kit. Is it ok to keep using proactive while using retisol-a?

    Additionally, I know you suggested not to do facial when using retisol-a, however I have paid for 3 IPL sessions (intense pulsed light) at my spa to help reduce the scarring I have from acne. Is this treatment ok to do while using retisol-a or should I wait to start using the cream until after my 3 sessions?

    Thank you!


    1. Talk to your doctor and the spa before going in for your appointments. Make sure they know your situation, so they can properly instruct you on how to prepare for any treatments.

      As for the Proactiv, I would not use it with Retin-A. Your doctor should have mentioned whether he wanted you to continue using your current products, but if they've worked to reduce the severity of your acne, you may need to use a disinfectant at the opposite time of day. Again, your doctor should have an idea of how sensitive your skin is, so I would call and ask the nurse if you're unsure. I would try to use a milder cleanser like Neutrogena Foaming Face Wash or any of the gentle fragrance-free options from Paula's Choice appropriate for your skin type.

  69. Hello,
    Your blog is just what I've been searching for! Thanks for all of the great information. I've been checking my face wash and moisturizers as I read along, and I think they're all ok, but my question is about makeup. Is mineral makeup the way to go, or is it just a money grab? I normally only use a light powder, but suddenly this this last year I have acne (never had a problem before). I've been changing everything in hopes of clearing it up and getting my skin back to where it used to be. I used to wear MAC cosmetics, but now I hear that it's not actually good for acne prone skin. Even their "mineralize" products aren't what the name suggests. I ordered a power and blush from Everyday Minerals online, and it seems to be ok. I have been doing a bit of research, and am finding the most mineral makeup isn't actually 100% mineral based. But how do you know which ones to trust? Or is spending all of that money is even worth it? Ideally, I'd like to continue wearing minimal makeup, but now I find I need more coverage to hide my acne. I've only started Retin-A a week ago, so I have a long way to go (or so I read). Any tips or suggestions is greatly appreciated.

    Thanks again for sharing your knowledge with us!

    1. Hello Brittany,

      This is a great comment, and I apologize for not seeing it sooner. In fact, I may even write an entire blog post inspired by your question because it is something I think would interest a lot of readers.

      You're right: Not all mineral makeup is created equal. Many manufacturers slap the name mineral on anything and everything these days. It's become a buzz word for anything that can be marketed to the sensitive skin, nature-loving crowd. However, here's the truth: Minerals have been used in cosmetics for years--even before "mineral makeup" came on the scene. There were plenty of powders available before that could have easily been labelled "mineral makeup." Someone just decided to turn it into a gimmick a few decades ago.

      Now here's the thing... The ingredient found in "mineral makeup" that can be a problem for acne is actually a mineral. It's called bismuth oxychloride, and it's what gives mineral makeup that luminous appearance. It irritates some people's skin, so you might want to patch test any products that you have that contain it. Apply it to a small area near your ear for a few days to see how your skin responds. People that cannot tolerate it find it makes them itch, and they break out rather quickly from it.

      The other ingredient that manufacturers sometimes "sneak" into mineral makeup is talc. Again, talc is technically a mineral, but it's gotten a bad reputation over the years. While some people are sensitive to it, the majority of people can use it without any problems.

      Overall, loose powders--mineral or otherwise--tend to be best for oily, acne-prone skin because they do not contain emollients that can clog pores.

      Pressed powders are the next best option, but you'll want to make sure they're oil free.

      Look for non-comedogenic or non-acnegenic on the label. Also I suggest using matte formulas whenever possible, avoiding overly shimmery products that can irritate the skin.

      As far as makeup brands for acne-prone skin, I usually recommend Clinique, and they have some mineral products available. There are some other great brands out there, but when my skin was freaking out, I went for four months using only their makeup everyday, and it worked wonders for my skin. I especially recommend their powder blushes. If you need liquid foundation, they are a great company, but they have limited shades in their concealer range.

      I actually think MAC makes some great concealers. CoverFX and Dermablend specialize in sensitive skin, so they're another option for concealers.

      Hope this was helpful. Please let me know if you have any other questions about any of this.

      Good luck!

  70. This comment has been removed by the author.

  71. Ive been on Retin-A for 7 weeks now. I am a 30 year old male with chronic, relentless moderate ance and otherwise "Shitty white guy skin". Thus far, Its simply a miracle. I tolerate it rather well, I always use spf 30 every day though. The acne is nearly completely gone and what rare acne does form is very quick to resolve itself. I am looking much younger too.

    I emphasize that in my case, nothing short of RX Retinoids would work. Not proactiv, not clearasil, nothing OTC. Im fortunate that my skin handles Retin A well. The .05 I started with had literally no side effects so long as I use sunscreen. The .1 I moved to dries my skin slightly but I just moisturize with sunscreen.

    1. Hello Sherman,

      Thank you so much for sharing this comment! Sunscreen is so important when using Retin-A.

      I have received many emails from readers who have Retin-A horror stories as a result of not using sunscreen. It's a must!

      It's great to read a success story, and I'm so glad that you've found something that works well for your skin.


  72. This comment has been removed by a blog administrator.

  73. Hello,

    I've been following your wonderful blog for quite sometime and I am really impressed at the level of detail and the genuine concern that you share with the readers :). I am hoping you can address this question for me.
    I've been on tretinoin (0.04%gel) foo about 5 weeks now. Although it has helped with preventing new acne, i still have red marks/bumps left from my previous acne. Can you please suggest some products that i could use that would help me with the scars. Also should i be using them before or after applying the Retin- A? Thank you so very much for your support.

  74. Hello,

    I was just recently prescribed tretinoin/retin-a for my acne. My doctor did tell me how to use it at night and then said that in the morning I could use my previous prescribed medication, clindamycin/benzoyl peroxide. And I was wondering if the two of these were good to use together.

    Also I play lots of outdoor sports throughout the year and am outside in the sun a lot and was wondering if neutrogena sunscreen is a good sunscreen to use. If not what would you recommend?

    Also, I use aveeno moisturizing lotion and was wondering if that is a good moisturizer. If not what would you recommend.

    Thank you so much for your time.