Battling Acne for 15 Years Now...Kansas City, MO

I'm one of the unfortunate ladies that has battled...

I'm one of the unfortunate ladies that has battled acne for most of my life. I haven't seen 100% clear skin since age 10 (I'm 24). I had severe, Grade 3 acne by age 12 (the scale only goes to 4). At age 14 I got a free trial of Proactiv, fully expecting it to gather dust in my drawer with the dozens of other products that failed miserably to make even a dent in my acne (I had tried "everything"). I was pleasantly surprised (to say the least) that it turned out to be my personal holy grail of skincare. Proactiv eliminated 90+ percent of my acne. I know it sounds cheesy, but it really did change my life.
Fast-forward ten years, I moved from Sacramento, CA to Kansas City, MO. I've lived here several months now. The climate here completely changed my skin; I'm dealing with some unknown beast. Proactiv doesn't cut it anymore. It's not as bad as it was when I was a teenager, but it's definitely out of control.
I was prescribed Retin-A way back when, but I was never given any real instructions about how to use it. I did all the things you aren't supposed to and suffered the consequences. I had all the side effects and reaped none of the benefits, and discontinued it after a couple weeks. It gathered dust in the aforementioned drawer.
I was reintroduced to Retin-A here on RealSelf, and I'm quite eager to give it a try again! Now that I know what to do and what NOT to do while using Retin-A, I am feeling pretty optimistic that it will give me a handle on my acne (and perhaps smooth away some fine lines and scarring).
I got a prescription for the off-brand 0.025% tretinoin gel for $10 with my health insurance (full price is approx $75). That is already less than I pay per-month for Proactiv.
Today is day one! :)

It's been almost a week!

It's been almost a week! I have been taking photos on my phone but haven't had the opportunity to upload yet. I will though!
First off, I am happy to say I have not been experiencing the side effects this time like I did before! When I tried Retin-A the first time (over a decade ago) I used it alongside my other products (containing benzoyl peroxide and salicylic acid) and basically did everything you're not supposed to. I had no idea I was sabotaging myself! My skin peeled like a reptile - I would literally have these scales falling off my face by the afternoon, exposing raw, pink and *painful* skin underneath.
This time the peeling is much more minimal and not at all painful or inflamed. I've discontinued all other skincare products except sunscreen and a mild moisturizer, and I wash my face with Cetaphil. This took a huge leap of faith for me... But I appear to be reaping the benefits! The blemishes I had before I began treatment are about halfway healed; however there are still new ones surfacing, just not as many. It's sort of a 2-steps-forward-1-step-back deal.
I'm not sure if this is from beginning Retin-A, discontinuing Proactiv, or just from the weather, (or maybe a combination) but my skin has been a lot oilier this week... And I had a very oily complexion to begin with. So that's annoying... But I would rather have more-oily skin that is clear than less-oily skin that is full of acne.
I haven't noticed any changes in my scars or fine lines yet, but I'm sure it takes plenty of time to see change in that level of the skin. I can be patient!

Week 3 Coming to a Close...

Tomorrow will be the end of my third week on Retin A. Hate to admit it, but my acne has gotten worse. I'm even breaking out on my forehead and hairline, and even my eyebrows - Areas I very rarely saw a zit before. My cheeks and chin are worse too...
Side effects are minimal, and I'm applying Retin A every night. I experience some mild peeling on the bottom third of my face and sometimes mild discomfort on my cheeks, but nothing compared to my first time using it.
I'm considering calling my doctor to talk about increasing from 0.025% to the 0.05% strength medication... But then I'm not sure if this is normal? I don't know if my skin is just "purging" or "acclimating" or whatever, or if I should be reconsidering my dose.
I've read a lot of confusing (conflicting?) information regarding this medication... I read that you can't use anything with benzoyl peroxide if you use Retin A because the two actually like "cancel" each other out - So you don't get the benefits of either but you get all the horrible side effects. But then I read about people who were prescribed Retin A in combination with something else containing benzoyl peroxide, or maybe salicylic acid... I've also read that you don't want to apply anything else to your skin at the same time as the Retin A because any moisture will increase side effects, but then I read other doctors talking about applying a moisturizer before Retin A to decrease side effects...?? It's all so confusing... All I've been using is sunscreen (spf 50) and primer in the morning, Retin A at night, and washing my face twice a day with Cetaphil.
I feel like I have to figure all this out myself, because my primary car is the one who prescribed and I... am not convinced he's very well-versed in this stuff. No disrespect.
Perhaps it's time to consider requesting a referral to an actual dermatologist...

It's been about 6 weeks...

It's been about a month and a half since I started Retin A 0.025% treatment for acne.
I went off the grid for a while because my acne got SO much worse and I didn't feel much like telling the world about it :\ Weeks 3 and 4 I was breaking out SO badly. I felt like I couldn't leave the house without plastering my skin with full-coverage foundation, and I hadn't felt THAT insecure about my skin since junior high. Thankfully I married a great man and he really helped me through the emotions during this phase.
However, even though my acne hasn't responded as I'd hoped, I have noticed a subtle smoothing of fine lines and scars and overall firmer skin! It's subtle, but it's there, and I'm sure it will continue to get better.
I spoke with my doctor last week and he approved a dosage increase to Retin A 0.05% which I will begin tonight. After week 4 on the 0.025% my skin began to calm down a bit, but now I'm basically back where I started. It looks noticeably better than it did during week 4, but only slightly better than it did when I first started at the end of January.
I'm planning on flip-flopping between the 0.025% and the 0.05% at first so my skin has time to adjust to the new dose. Wish me luck!

It's been about 3 months!

I spent about 6 weeks on the 0.05% concentration. It made a relative amount of improvement, but only in that my acne was only as bad as it was before I started Retin A treatment (because my acne got noticeably worse when I first started Retin A with the 0.025% concentration).
My doctor switched me up to the 0.1% concentration a few weeks ago. It made all the difference in the world! My skin is now at about 90% clear compared to how it was at its worst. I'm still experiencing a random few little pimples, but I'm hoping I will continue to improve! Also, I cannot remember a time in my life when I had so few blackheads! I don't even need pore-strips for my nose!

Here is my skincare regimen at this time. It's kind of involved but it's what I've found works best for me at this time...

Morning-
Wash with Neutrogena Clear Pore Cleanser/Mask. It has 3.5% BPO, a clay-like consistency, no abrasive granules, and it has a cooling tingle. (I was hoping I could ditch BPO altogether, but I've found that it is a crucial ingredient for me to be clear) After I've rinsed the cleanser off, I perform some "manual exfoliation." I'll explain. Basically, I've found that the best way to rid my face of the peely dead skin that seems to accrue overnight on Retin A is to use the friction of my fingers pushing against my skin. It works really well! Better than a scrub or a cleansing brush, both of which just weren't cutting it, but it's also not abrasive enough to over-exfoliate and leave you raw. I do this AFTER I've rinsed off the cleanser, because cleansers will decrease the amount of friction you can generate, but using just water provides the perfect level of friction to slough-off the dead layers. After I've rubbed my face until I can't produce anymore clumps of skin (gross I know), I rinse again, and then use the cleanser again on the areas that peeled most (for me it's around my mouth and chin) so that all my *living* skin gets clean and dosed with BPO.
After cleansing/exfoliating, I use the Proactiv "Rejuvenating Toner" followed by the Proactiv "Repairing Treatment." The toner has witch hazel and glycolic acid, so it helps to further exfoliate and refine the skin surface. The lotion has 2.5% BPO, which in itself is great, but also for some reason this is the only product in the whole world that reduces the level of oil my skin produces. .
After the lotion, I apply my favorite sunscreen ever: Neutrogena Pure and Free Liquid Sunscreen SPF 50 (followed by my make-up primer). You MUST use sunscreen (with a decent SPF) if you're on Retin A!

***A note about Proactiv: I am planning on canceling my account with them. I recently discovered that Equate by Walmart and Up&Up by Target both have a dupe of the Proactive 3-step kit available, and most of what I've read online says that they work as well as the "real" stuff or BETTER. I couldn't resist sharing this!! I'll take $12 for a generic over $40 for a brand name any day!! I wonder how many of my hard-earned dollars were "wasted" subscribing to this brand for the last decade...

Evening-
I apply the Cetaphil Daily Facial Cleanser, and then I use my Olay ProX Facial Cleansing Brush for about 1-2 minutes to effectively remove my make-up. The little bristles are great for lifting off make-up, but I don't really use the brush to *exfoliate* per se. Usually I don't need to "manually exfoliate" in the evenings, but on the off chance my skin looks a little peely then I will rub it smooth with my fingertips.
After I dry my face, I take about 8 drops of Hemp Oil and rub it all over my face. It's non-comedogenic, absorbs easily, moisturizes super well, and it seems to help calm-down the redness in my skin.
I wait at least 20 minutes after this to apply my Retin A 0.1%. I use it on my whole face except for my eye area. I've started using what's left of my 0.05% prescription in small amounts around my eyes twice a week, and I'll work my way up from there. The skin around your eyes is (obviously) a lot more sensitive, and so it will take me a while to work up to using the 0.1% everyday. I am in my mid-twenties, so I'm just beginning to see the finest lines around my eyes. Hopefully incorporating the Retin A will slow down the progression of crows feet!

5 months with Retin A

I have been on the 0.1% dosage for a while now. My skin is mostly clear, but not as clear as I'd hoped. I still have 5-8 visible blemishes at any given time, granted they are smaller and heal faster than the ones I had before. But still, I'm tired of getting the "zits" I was promised would stop haunting me once I got through my teens.
As far as fine lines go, I've noticed a peculiar trend: my "vertical" lines have smoothed out but my "horizontal" lines almost seem worse (or maybe I'm seeing things). So my "frown lines" between my brows and nasolabial lines have almost completely disappeared. But my "laugh lines" around my eyes plus the line that's making it's way across my forehead all seem more noticeable now. Everything I read says it's the best stuff for wrinkles though, so I'm just going to keep with it.

My skin care routine has changed. I'm hoping this might finally give me an edge over my acne.
Morning:
Cleanse face with Cetaphil, followed by manual exfoliation (see previous entry). After cleansing, I use Proactiv's rejuvenating toner. I finish with Clearasil Daily Clear Vanishing Cream (10% BPO) and of course Neutrogrena liquid sunscreen.
Evening:
Cleanse face with Cetaphil, using a "Lil Scrubbie" to remove make-up, followed by manual exfoliation. With a cotton ball, apply isopropyl alcohol 70% solution to problem areas. When dry, apply 3-4 drops of hemp oil to moisturize. After 20 minutes, apply Retin A 0.1%. Every third night, apply Retin A 0.05% around eyes.

I started using alcohol on my skin in the evening because I figured the Retin A gel is alcohol based, so it must be fine to use with Retin A cream, plus it kills bacteria. Also, the skin around my eyes has adapted to the 0.05% ever-third-night thing, so starting next month I'm going up to every-other-night. All-around, cautiously optimistic.
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