It is normal for acne to flare when starting a
retinoid. It is working by exfoliating the skin, opening up the pores and
unclogging the trapped oil, so expect this for the first 2-4 weeks. It normally
takes 6-12 weeks to start noticing improvement of acne when starting any new
acne regimen. It is actually helpful to know about your history of ulcerative
colitis. New research shows a strong link between inflammatory bowel disease
and acne, as well as other inflammatory conditions.
Flaring of acne after starting retinoids like Epiduo is not unheard of, and many patients do. This should have been explained to you when you were having your initial consultation. A board-certified dermatologist should be the person you are seeing for your acne, and you should be made aware that Epiduo by itself can take up to 12 weeks for its full effects to kick in, and therefore, sometimes, additional topicals or oral medications are often used with this very effective retinoid.
Follow-up with your dermatologist is important, and learning all the different techniques and procedures to make you better is crucial for the best outcome.