I tried the salicylic acid face wash and it had this cooling effect that was kind of mild and intense. Is that normal?

An overly dry and flakey skin is a regular 'complaint' from compliant users of tretinoin and I recommend water-based creams or lotions to help counteract the dryness.  You may also benefit from reducing your daily application of tretinoin to every other day and/or...

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong...

Ochronosis is associated with prolonged use of hydroquinone (generally greater than 3 months).  Unfortunately, once you get, it can be quite difficult to treat especially with darker skin types (Fitzpatrick 4-6). You can try to various lasers but the safest and most effective would be...

Your regimen is a reasonable one.  Not everyone can tolerate this regimen due to dryness, irritation, etc.  It is ok to follow with a moisturizer at bedtime.  However, if this regimen causes to much dryness or irritation, stop and consult with a dermatologist.

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong...

It's hard to advise you without photos or an in-person evaluation, but from what you're describing there are a number of possible treatment that could help. Stress and illness can definitely lead to premature aging, so you may see some improvement once you're feeling better. If there are lasting...