Is my derm an idiot (SKINCELS GTFIH)

[prince_]

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.

 

[SubhumanForever]

In may she

>SHE
JFL AT LISTENING TO WHAT FOIDS SAY

 

[ROPEBYATHOUSANDMOGS]

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

What did you do to build up your skin barrier? I think it's going to be harder for me because u have combination skin. The only thing I feel that works is the creme shop gelee masks but I heard those are shams and aren't that effective.

 

[RealNinja]

What did you do to build up your skin barrier? I think it's going to be harder for me because u have combination skin. The only thing I feel that works is the creme shop gelee masks but I heard those are shams and aren't that effective.

If it’s broken, you need to stop using actives until it’s fixed. Dont use cleanser, wash your face with water. Use humectants like hyaluronic acid on your face while it’s still wet and then moisturize. Using hydrating ingredients and moisturizer with a wet face is best because they absorb better on damp skin. Before bed, moisturize and cover face with Vaseline.

If your skin barrier consistently feels damaged you either need to cut back on frequency of actives, get a more gentle cleanser, or up your hydration/moisturizing game

 

[ey88]

Yes she’s an idiot, she’s just selling you as many products as she can to get money, using all that at the same time is just gonna destroy your skin barrier and make you skin look worse.