Is my derm an idiot (SKINCELS GTFIH)

prince_

prince_

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Please High IQ people that are able to read i need your help with what i should do
My main questions are bolded but please read the whole thread

In March i went to a dermatologist and she put me on a routine and this is how it went:

LRP effaclar cleanser (PM/AM)
Azelaic acid cream 20% (AM)
Adapalene 0.1% (PM)
Doxycicline antibiotics (1 pill per day)


I saw great improvements with this and i almost had no active acne (probably bc of antibiotic)

In may she took me of the antibiotic bc i've been on it for 6 weeks and completely changed my routine

Benzoyl peroxide cleanser 4% (AM/PM)
Clindamycin 1% solution
Azelaic acid 20% PM one night
Tretinoin 0.1% PM the other night (and the just changing everyday between the 2 to get used to Tret)


In the first week i purged like crazy i got like 10 new inflamed active pimples but then it got better but i still continued to purge and i thought it was normal bc of the Tret purging stage that lasts 2-6 weeks but after 6 weeks i still continued to get acne every few days but not as bad

Yesterday i had an appointment and because my progress is not too good (it doesnt look good i have a ton of hyperpigmentation on my whole left cheek and few actives on my right side on skin where upper maxilla is)

She told me that i might have to use accutane before she touched my face and realised most of it was hyperpigmentation but my sebaceous glands are in overwork because of puberty and hormones and i still constantly get acne
I made peace with the fact that i might need to take accutane although i wouldn't like it

But here is the part thats bothering me
In a few weeks im going on vacation to Greece and i'll stay there for 3 weeks
She told me that under no circumstances i should use Tretinoin while im there bc UV rays are too strong and i could burn my skin which i understand
But wouldn't that reset the progress after i stop a retinoid and after i start again i would have to go trough a purging phase once again?

Here is the most important part:
she told me until my vacation to use Tretinoin 0.1% AM and PM and i've never heard of such thing, its normal to use PM but AM before going out seems mad to me because it makes your skin sensitive to the sun (ofc i use SPF 50) but it still seems dangerous

I don't know if she is a good derm bc in this 4 months i haven't seen much progress as i think i should have, my main problem is that my skin constantly breaks out even tho i do everything i can to stop it

Before you say fix your diet stuff, my diet is great i eat a lot of meat, vegetables and i avoid diary maximally
Also i don't eat any sugary stuff no sweets no sweet drinks or stuff like that

My shit skin is stopping me from living a happy HTN life its so over.
 
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tldr dont go to greece
 
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just get on accutane or use a hydrating/gentle cleanser with tret 0.025% at night and an insane moisturizer + spf in morning
 
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over for your genes then if u have to do skincare boyo.
over for ur genes if u can’t handle slop
IMG 0651
 
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then stop the skincare and it will clear. try it for a bit. i doubt it will get worse
tbh i will try that while im on a vacation i will just wash my face and use SPF to see if it gets better bc she said i could use azelaic acid and benzoyl peroxide but that doesn't do shit without retinoid so maybe its better to give my skin rest from all that shit
was your acne severe?
 
tbh i will try that while im on a vacation i will just wash my face and use SPF to see if it gets better bc she said i could use azelaic acid and benzoyl peroxide but that doesn't do shit without retinoid so maybe its better to give my skin rest from all that shit
was your acne severe?
yes don’t even use clenser, just water. at most use moisturiser
 
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Skincel here. Inaccurate to expect tretinoin purging to end after 2-6 weeks. For many people it takes months. I think I saw real improvements from Tret after the 4-5 month mark.

Tret 0.1% is the strongest version. Absolutely do not use it twice a day; only at night. Dont know why she would tell you to do that. BP cleanser, Tret 0.1 and 20% azelaic at the same time is a lot for most people’s skin to handle.

Its good that you’re switching on and off between AA and Tret to decrease irritation, but you need to focus on keeping your skin barrier intact. Moisturize heavily, use a moisturizer including ceramides. If you start noticing broken skin barrier symptoms (red face, burning/stinging, flaking, tightness) the first thing I’d do is stop using the BP wash. Take a 1-2 nights off tretinoin to sleep with your face covered in Vaseline.

You mentioned hyperpigmentation from the purging outbreaks. Tretinoin 0.1 and prescription azelaic acid are the best things you can use for PIH/PIE. So you’re on the right track. Both of these things combined should get rid of all scarring and hyperpigmentation quickly. If you’re still getting acne it’s important to focus on calming the inflammation and not picking/popping them to prevent further scarring.

The most important thing is keeping your skin barrier intact, keeping skin hydrated and moisturized.
 
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The tret definitely broke you out. People recommend tret way too much here and 90% of the time it's not needed unless your old and want to smoothen your skin.

Personally, tret gave me and made my PIH/PIE worse, azelaic acid works though.
 
Skincel here. Inaccurate to expect tretinoin purging to end after 2-6 weeks. For many people it takes months. I think I saw real improvements from Tret after the 4-5 month mark.

Tret 0.1% is the strongest version.
BP cleanser, Tret 0.1 and 20% azelaic at the same time is a lot for most people’s skin to handle.

Its good that you’re switching on and off between AA and Tret to decrease irritation, but you need to focus on keeping your skin barrier intact. Moisturize heavily, use a moisturizer including ceramides. If you start noticing broken skin barrier symptoms (red face, burning/stinging, flaking, tightness) the first thing I’d do is stop using the BP wash. Take a 1-2 nights off tretinoin to sleep with your face covered in Vaseline.

You mentioned hyperpigmentation from the purging outbreaks. Tretinoin 0.1 and prescription azelaic acid are the best things you can use for PIH/PIE.
So you’re on the right track. Both of these things combined should get rid of all scarring and hyperpigmentation quickly. If you’re still getting acne it’s important to focus on calming the inflammation and not picking/popping them to prevent further scarring.

The most important thing is keeping your skin barrier intact, keeping skin hydrated and moisturized.
First of all thank you for this amazing response!
Moisturize heavily, use a moisturizer including ceramides.
I use this moisturizer i think its good thats what she told me use
1720040972634

flaking, tightness)
my skin peels a bit the day after using Azelaic acid but day after using Tret it doesn't and about tightness i barely feel it after washing my face bc cleanser dries it out

Tretinoin 0.1 and prescription azelaic acid are the best things you can use for PIH/PIE.
I don't know why but i just doesn't do anything my left side is almost active acne free but full of hyperpigmentation and on the places where i didn't get acne for months there are still marks and they are not fading away...

calming the inflammation and not picking/popping them to prevent further scarring.
how do i do calm the inflammation, i don't pop my pimples anymore i've learnt that the hard way

Absolutely do not use it twice a day; only at night. Dont know why she would tell you to do that.
Thank you i knew it seemed absolutely crazy to me to use such strong retinoid twice a day, should i use something else AM or just moisturize the skin?

give this guy a rep for this great response really helpful
 

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First of all thank you for this amazing response!

I use this moisturizer i think its good thats what she told me use
View attachment 3012377

my skin peels a bit the day after using Azelaic acid but day after using Tret it doesn't and about tightness i barely feel it after washing my face bc cleanser dries it out


I don't know why but i just doesn't do anything my left side is almost active acne free but full of hyperpigmentation and on the places where i didn't get acne for months there are still marks and they are not fading away...


how do i do calm the inflammation, i don't pop my pimples anymore i've learnt that the hard way


Thank you i knew it seemed absolutely crazy to me to use such strong retinoid twice a day, should i use something else AM or just moisturize the skin?

give this guy a rep for this great response really helpful
I don’t know what this moisturizer is, we are from different countries. But you want one with ceramides specifically to maintain skin barrier- I use “vanicream daily facial moisturizer” with hyaluronic acid and ceramides. Find an equivalent of that in your country.

Hyperpigmentation can take a long time to fade. It shouldn’t take extremely long once you get adjusted to Tret and azelaic acid, though. It’s also very important to use sunscreen because UV will make your scars look more red.

You can calm inflammation by hydrating your skin with something like the moisturizer I mentioned. Putting Vaseline or petroleum on your face at night after you moisturize also helps. Just don’t do this after you use Tret.

Generally people use azelaic acid in the morning and tretinoin at night, although I would continue doing alternating days until you know your skin is adjusted to it. Yes, in the morning you can just wash your face and use moisturizer + SPF.
 
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why not just hop on Accutane? been to about 8 dermatologists nothing helped, tried isotretinoin and after finishing it after 1 year, my acne never breaks out again and it has been 3 years, well i do get one or two pimple once in a while, but thats because i eat shit food sometimes.
 
Please High IQ people that are able to read i need your help with what i should do
My main questions are bolded but please read the whole thread

In March i went to a dermatologist and she put me on a routine and this is how it went:

LRP effaclar cleanser (PM/AM)
Azelaic acid cream 20% (AM)
Adapalene 0.1% (PM)
Doxycicline antibiotics (1 pill per day)


I saw great improvements with this and i almost had no active acne (probably bc of antibiotic)

In may she took me of the antibiotic bc i've been on it for 6 weeks and completely changed my routine

Benzoyl peroxide cleanser 4% (AM/PM)
Clindamycin 1% solution
Azelaic acid 20% PM one night
Tretinoin 0.1% PM the other night (and the just changing everyday between the 2 to get used to Tret)


In the first week i purged like crazy i got like 10 new inflamed active pimples but then it got better but i still continued to purge and i thought it was normal bc of the Tret purging stage that lasts 2-6 weeks but after 6 weeks i still continued to get acne every few days but not as bad

Yesterday i had an appointment and because my progress is not too good (it doesnt look good i have a ton of hyperpigmentation on my whole left cheek and few actives on my right side on skin where upper maxilla is)

She told me that i might have to use accutane before she touched my face and realised most of it was hyperpigmentation but my sebaceous glands are in overwork because of puberty and hormones and i still constantly get acne
I made peace with the fact that i might need to take accutane although i wouldn't like it

But here is the part thats bothering me
In a few weeks im going on vacation to Greece and i'll stay there for 3 weeks
She told me that under no circumstances i should use Tretinoin while im there bc UV rays are too strong and i could burn my skin which i understand
But wouldn't that reset the progress after i stop a retinoid and after i start again i would have to go trough a purging phase once again?

Here is the most important part:
she told me until my vacation to use Tretinoin 0.1% AM and PM and i've never heard of such thing, its normal to use PM but AM before going out seems mad to me because it makes your skin sensitive to the sun (ofc i use SPF 50) but it still seems dangerous

I don't know if she is a good derm bc in this 4 months i haven't seen much progress as i think i should have, my main problem is that my skin constantly breaks out even tho i do everything i can to stop it

Before you say fix your diet stuff, my diet is great i eat a lot of meat, vegetables and i avoid diary maximally
Also i don't eat any sugary stuff no sweets no sweet drinks or stuff like that

My shit skin is stopping me from living a happy HTN life its so over.
alright so, first things first.

the reason the dermatologist put you off the antibiotic is because the antibiotic isn’t an selective agent that kills p.acnes. no, it affects all bacteria via its spectrum (including the good gut bacteria which is why you can’t be placed on life).

now you can still use tret even at your vacation, just make sure to use sunscreen and reapply it multiple times throughout the day.

yes, tretinoin will cause purging as it increases cell turnover and don’t expect it to work immediately as it takes 6months of tretinoin 0.1 use, everyday to show clinical results.
Don’t use tretinoin in the AM please, not even when your dermatologist says so.

isotretinoin is fine, i dont know why you’re scared of it. it also can help with hyperpigmentation as it increases cell turnover.
 
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why not just hop on Accutane? been to about 8 dermatologists nothing helped, tried isotretinoin and after finishing it after 1 year, my acne never breaks out again and it has been 3 years, well i do get one or two pimple once in a while, but thats because i eat shit food sometimes.
i know thats the easiest way out but there are a lot of side effects of accutane and possibly it can close the growth plates and i feel like i can grow at least an inch or half an inch more
 
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now you can still use tret even at your vacation, just make sure to use sunscreen and reapply it multiple times throughout the day.
and what if i stop for those 3 weeks will i purge again?
isotretinoin is fine, i dont know why you’re scared of it.
i know thats the easiest way out but there are a lot of side effects of accutane and possibly it can close the growth plates and i feel like i can grow at least an inch or half an inch more
 
Please High IQ people that are able to read i need your help with what i should do
My main questions are bolded but please read the whole thread

In March i went to a dermatologist and she put me on a routine and this is how it went:

LRP effaclar cleanser (PM/AM)
Azelaic acid cream 20% (AM)
Adapalene 0.1% (PM)
Doxycicline antibiotics (1 pill per day)


I saw great improvements with this and i almost had no active acne (probably bc of antibiotic)

In may she took me of the antibiotic bc i've been on it for 6 weeks and completely changed my routine

Benzoyl peroxide cleanser 4% (AM/PM)
Clindamycin 1% solution
Azelaic acid 20% PM one night
Tretinoin 0.1% PM the other night (and the just changing everyday between the 2 to get used to Tret)


In the first week i purged like crazy i got like 10 new inflamed active pimples but then it got better but i still continued to purge and i thought it was normal bc of the Tret purging stage that lasts 2-6 weeks but after 6 weeks i still continued to get acne every few days but not as bad

Yesterday i had an appointment and because my progress is not too good (it doesnt look good i have a ton of hyperpigmentation on my whole left cheek and few actives on my right side on skin where upper maxilla is)

She told me that i might have to use accutane before she touched my face and realised most of it was hyperpigmentation but my sebaceous glands are in overwork because of puberty and hormones and i still constantly get acne
I made peace with the fact that i might need to take accutane although i wouldn't like it

But here is the part thats bothering me
In a few weeks im going on vacation to Greece and i'll stay there for 3 weeks
She told me that under no circumstances i should use Tretinoin while im there bc UV rays are too strong and i could burn my skin which i understand
But wouldn't that reset the progress after i stop a retinoid and after i start again i would have to go trough a purging phase once again?

Here is the most important part:
she told me until my vacation to use Tretinoin 0.1% AM and PM and i've never heard of such thing, its normal to use PM but AM before going out seems mad to me because it makes your skin sensitive to the sun (ofc i use SPF 50) but it still seems dangerous

I don't know if she is a good derm bc in this 4 months i haven't seen much progress as i think i should have, my main problem is that my skin constantly breaks out even tho i do everything i can to stop it

Before you say fix your diet stuff, my diet is great i eat a lot of meat, vegetables and i avoid diary maximally
Also i don't eat any sugary stuff no sweets no sweet drinks or stuff like that

My shit skin is stopping me from living a happy HTN life its so over.
Bro I use tret 0.1% from skinorac for a long time now to maintain my gay glow so you can use it till your vacation
 
Don't listen to retards on here, I've been where You are with exact same routine, your dermatologist is mostly correct, although don't use tret in am unless you live in a sunless place(like 0 sun) although yes maybe change dermatologist/get second opinion because using Tret in morning is stupid
 
Don't listen to retards on here, I've been where You are with exact same routine, your dermatologist is mostly correct, although don't use tret in am unless you live in a sunless place(like 0 sun) although yes maybe change dermatologist/get second opinion because using Tret in morning is stupid
If you want I'll ask my dermatologist if i can use tret in morning in a few days when i see her
 
Please High IQ people that are able to read i need your help with what i should do
My main questions are bolded but please read the whole thread

In March i went to a dermatologist and she put me on a routine and this is how it went:

LRP effaclar cleanser (PM/AM)
Azelaic acid cream 20% (AM)
Adapalene 0.1% (PM)
Doxycicline antibiotics (1 pill per day)


I saw great improvements with this and i almost had no active acne (probably bc of antibiotic)

In may she took me of the antibiotic bc i've been on it for 6 weeks and completely changed my routine

Benzoyl peroxide cleanser 4% (AM/PM)
Clindamycin 1% solution
Azelaic acid 20% PM one night
Tretinoin 0.1% PM the other night (and the just changing everyday between the 2 to get used to Tret)


In the first week i purged like crazy i got like 10 new inflamed active pimples but then it got better but i still continued to purge and i thought it was normal bc of the Tret purging stage that lasts 2-6 weeks but after 6 weeks i still continued to get acne every few days but not as bad

Yesterday i had an appointment and because my progress is not too good (it doesnt look good i have a ton of hyperpigmentation on my whole left cheek and few actives on my right side on skin where upper maxilla is)

She told me that i might have to use accutane before she touched my face and realised most of it was hyperpigmentation but my sebaceous glands are in overwork because of puberty and hormones and i still constantly get acne
I made peace with the fact that i might need to take accutane although i wouldn't like it

But here is the part thats bothering me
In a few weeks im going on vacation to Greece and i'll stay there for 3 weeks
She told me that under no circumstances i should use Tretinoin while im there bc UV rays are too strong and i could burn my skin which i understand
But wouldn't that reset the progress after i stop a retinoid and after i start again i would have to go trough a purging phase once again?

Here is the most important part:
she told me until my vacation to use Tretinoin 0.1% AM and PM and i've never heard of such thing, its normal to use PM but AM before going out seems mad to me because it makes your skin sensitive to the sun (ofc i use SPF 50) but it still seems dangerous

I don't know if she is a good derm bc in this 4 months i haven't seen much progress as i think i should have, my main problem is that my skin constantly breaks out even tho i do everything i can to stop it

Before you say fix your diet stuff, my diet is great i eat a lot of meat, vegetables and i avoid diary maximally
Also i don't eat any sugary stuff no sweets no sweet drinks or stuff like that

My shit skin is stopping me from living a happy HTN life its so over.
Just stop with all of those cope shit it clearly is not working
Go on accutane and call it a day
Don't forget sunscreen
 
If you want I'll ask my dermatologist if i can use tret in morning in a few days when i see her
im not using it AM it just doesn't make sense i use only PM
in few days i will have to stop using Tret bc im going on a vacation and im going to make a thread about my research that i will do on my vacation basically stopping complicated skincare and doing minimum to see if that helps
 
Just stop with all of those cope shit it clearly is not working
Go on accutane and call it a day
Don't forget sunscreen
eventually i think i will have to go on accutane but i can't yet bc its summer and the UV is too high probably from september
 
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eventually i think i will have to go on accutane but i can't yet bc its summer and the UV is too high probably from september
Jew cope
I am on accutane all summer and nothing fucking happens
Just say that you want to be a pizzaface
 
Jew cope
I am on accutane all summer and nothing fucking happens
Just say that you want to be a pizzaface
you probably started before summer and on accutane skin cell turnover speeds up like crazy and old skin sheds while new skin that is sensitive is more prone to sunlight its risky even while using SPF 50 so for now i will rather listen to my derm but my acne is so stubborn and i don't think any topical products will work so i've made peace with the fact that i might have to use accutane mainly to stop my sebaceous glands bc i constantly get new breakouts and i don't know why
 
you probably started before summer and on accutane skin cell turnover speeds up like crazy and old skin sheds while new skin that is sensitive is more prone to sunlight its risky even while using SPF 50 so for now i will rather listen to my derm but my acne is so stubborn and i don't think any topical products will work so i've made peace with the fact that i might have to use accutane mainly to stop my sebaceous glands bc i constantly get new breakouts and i don't know why
You get new breakouts cause you live in a shit world. We all do. Even if you ate the 'right' things, like meat, meat is contaminated with a whole lot of other things. Affording real healthy food is not for the masses.

You don't have to 'make peace with the fact that you have to use accutane', just stop being a high inhib pussy, and get on it.
I promise I have heard all the cope like UV index etc., you won't say anything new.
Just get on it and thank me approximately 6-8 months later
 
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All dermatologists are phony salesman

it’s all fake n gay, just wash face with water, moisturize, tret, SPF
 
All dermatologists are phony salesman

it’s all fake n gay, just wash face with water, moisturize, tret, SPF
I've been using Tret 0,1% for 2.5 months now and i still breakout almost daily and before that i had used adapalene 0,1% for 2 months
 
u can use tret in greece, just apply a SPF50+ with dual band blocking and reapply every 2 hours.
alternatively switch to tazarotene or adaplane which is photostable, you will still need to wear sunscreen to stop irritation but not as big issue as with tret.

what she is doing seems normal, but I have no idea why she switched u from adaplane to tretinoin if u were getting good results with adaplane.

also the 2x a day can be done if your skin can tolerate it, she might have said that so your skin purges faster and is done with it before greece.
 
tell ur derm u need accutane dont waste ur time with skincare
 
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tell ur derm u need accutane dont waste ur time with skincare
i think i will do that when i get back from my vacation bc i can't take this shit anymore everytime i think its getting better it just gets so much worse in 1 day like my skin started to look better these last few days and then yesterday i got 7 new pimples out of nowhere
 
did you take it? and was your acne severe?
No but I wish I had, I’ve been using antibiotics, eat very healthy, and have a good skincare routine but I still have a bit of acne, I only have 3 more days of antibiotics and if my acne comes back I’m definitely going to hop on accutane, I’m just recommending it to you so you don’t waste your time like I did.
 
No but I wish I had, I’ve been using antibiotics, eat very healthy, and have a good skincare routine but I still have a bit of acne, I only have 3 more days of antibiotics and if my acne comes back I’m definitely going to hop on accutane, I’m just recommending it to you so you don’t waste your time like I did.
i also took doxycicline for 6 weeks and it actually helped and i was on adapalene but then when i stopped and started 0.1% Tret it came back
 
i also took doxycicline for 6 weeks and it actually helped and i was on adapalene but then when i stopped and started 0.1% Tret it came back
Same the antibiotics work, I’m taking minocycline rn and my acne is almost gone, but I feel like it’s gonna come back once it’s over, and I don’t want to take it again because you’re not supposed to use for long periods of time because of health effects.
 
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I don’t know what this moisturizer is, we are from different countries. But you want one with ceramides specifically to maintain skin barrier- I use “vanicream daily facial moisturizer” with hyaluronic acid and ceramides. Find an equivalent of that in your country.

Hyperpigmentation can take a long time to fade. It shouldn’t take extremely long once you get adjusted to Tret and azelaic acid, though. It’s also very important to use sunscreen because UV will make your scars look more red.

You can calm inflammation by hydrating your skin with something like the moisturizer I mentioned. Putting Vaseline or petroleum on your face at night after you moisturize also helps. Just don’t do this after you use Tret.

Generally people use azelaic acid in the morning and tretinoin at night, although I would continue doing alternating days until you know your skin is adjusted to it. Yes, in the morning you can just wash your face and use moisturizer + SPF.
What if vanicream irritantes and reddens your skin? It did that to me
 
You eat vegetables and wonder why you have acne 😂
 
What if vanicream irritantes and reddens your skin? It did that to me
The daily facial moisturizer? That stuff made my face burn and sting when my skin barrier was not strong. I focused more on hydrating and healing my skin, and then it didn’t burn. Once you get to a point where it doesn’t burn, keep using it because it’s great for maintaining healthy skin barrier
 
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