I am using epiduo for 4 weeks and still get whiteheads - what should I do?

Doctor Answers 1

Anti Acne Medications Typically Take Eight To Twelve Or More Weeks To Work

The short answer to your question is that just about all anti-acne medications, including oral medications, are typically best for preventing new outbreaks--whether of comedones (blackheads and whiteheads) or papules (pimples)--and typically take somewhere between eight to twelve or more weeks to begin to do their job. So, after only four weeks of Epiduo, a very good topical in my opinion, new outbreaks of whiteheads is hardly surprising, and your doctor may perform a cleaning out of these in the office. .Your question to RealSelf regarding Epiduo, however, immediately raises several concerns. Acne is a very distressing condition, whose causes, treatments, expectations for treatment success,  duration of therapy, as well as the role of cleansing, diet, stress, maintenance regimens, and questions of postinflammatory skin stains vs. true scars, is a very long and complicated story. It is for that reason, I typically set aside 1.5 hours in my office for a new acne patient to explain these issues and others in detail, so that there does not need to be undue and unnecessary anxiety, as in your case, as to issues, such as whether Epiduo is working after only four weeks of treatment. This vital issue (as well as many others) should have been covered when the prescription was written for you. It is not enough to simply hand  patients prescriptions and send them on their way.
A second red flag regarding the doctor-patient relationship here is that you are querying the doctors on RealSelf, rather than directly contacting, either by phone or email, the physician that wrote the prescription for you. Since small things often speak volumes about things, the above suggests to me that you might do well to ensure that you receive care from a board certified dermatologist who is willing and able to devote the time and effort that is necessary and required for dispensing proper care to acne sufferers. Best of luck to you.

New York Dermatologic Surgeon
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