Retin-A + Doxy = My Solution - Toronto

At 30 I randomly developed horrible acne. My derm told me that it was due to blocked pores and put me on Retin-A. I followed so many people's advice, washing first, drying, using lotion, only at night, etc. etc. No matter what I did my acne got worse, and worse, and worse. At four months I'd had enough and went back to the derm. My acne was horrendous (and cystic). It hurt. She said that my pores looked like they weren't blocked any more so I could stop the Retin-A and start doxycycline. I didn't listen to her, and continued with the Retin-A and *added* doxycycline to the mix. What I realized was that while Retin-A was helping to clear everything out, it was also inflaming what acne was already there below the surface. Doxycycline was the magic ingredient that let Retin-A do its work, without having to deal with the nasty cycstic acne that Retin-A can cause while it sorts everything out. Within two weeks I started noticing that my acne had mostly stopped *coming* but I was still devastated by the red marks left and felt I'd never have good skin again. I stayed on doxy and Retin-A for about six months and the improvements never stopped coming. It was about 10 months ago that I started Retin-A, and last month that magical moment happened when people started saying on a REGULAR basis that I look like I'm glowing. It hasn't changed my life, but it's helped me to live my life without the constant awareness of my face and its acne-covered reality. I haven't gone off the

What I'm glad I knew beforehand: People post on these forums that at some point people started to say they were glowing. They said that the transition was one of the hardest parts of their lives (because somehow starting Retin-A really can make things a LOT worse before they get a LOT better), but that they were thankful they had stuck through it because they finally achieved the results they wanted. I am so thankful for their testaments because they were the only thing that gave me the hope that things could actually get better. It did.

What I wish I knew beforehand:
- I should have been put on Doxy and Retin-A at the same time, and wish that I'd insisted for as much. As soon as I started Doxy, it kept the bacterial inflammations at bay while the Retin-A was re-structuring my skin, opening pours and healing whatever was contributing to the problem in the first place

What I learned from experience:
- Every single lotion (including cetaphil) I ever used for dry skin caused breakouts. The only one that didn't was the Spectro line. This included every single sunscreen I tried (all of which were non-comedogenic and oil-free). Avoiding a tonne of sun was easier than dealing with the break-outs sunscreen gave me.
- Half of what was causing my skin to get so dry and red and horrible was washing my face and then letting it dry before using retin-A. I now forgo washing my face beforehand and just put it on. All the prep steps were not only unhelpful for me, they made the whole situation worse. If I *do* apply it after washing my face, I do so BEFORE my skin dries completely. This works WAY better for me - I'm not sure if others have experienced this, but when I use retin-A I find that my skin actually produces more oil.
- I use one of the lower strengths and always thought that moving higher up might make it work faster. I wish I'd tried it to see - but at this point I don't have any need to use a higher concentration as I have the skin that I want
- When I started Doxy I was so desperate for it to work I wouldn't eat for two hours, take it, and then not eat for another hour. For months I constantly felt horrible - sick, nauseous, no appetite. When I started taking doxy with food the side effects completely went away for me, and the benefits didn't stop coming. I should never have tortured myself like that - I wish I had been a little more patient (but I also forgive myself for being so desperate - I wanted to go out in public again!)
- Over-application for me was more of a red herring than a real problem. I use slightly less than a pea sized amount on each side of my face (in total about the amount of a large chickpea

Because I was using it for acne, if I were to do this again, I would INSIST on Doxy *in combination with* retin-A from the very beginning (and only take doxy with food). I would ignore the pre-retin-A face washing ritual as it left my skin more vulnerable to dryness and irritation. I would avoid buying a million and one face washes, creams, sunscreens, and stick to the simplest routine which I described above.

What my current/final/working solution has been (to GREAT skin):
- Washing in the morning with Spectro Jel (cetaphil wash made me break out)
- Use a 5% benzoyl peroxide gel right afterward (before face is dry)
- If I experience dryness during the day, Spectro lotion does the trick without making me break out.
- I take Doxy with breakfast and dinner. Not exactly 12 hrs apart but way better than the side effects.
- At night, I apply the retin-A right before bed, without having washed my face.

My "Take Home Message": This combination took my skin from so acne-ridden I cried before I had to go out in public, to so clear (and younger looking) that people say I am glowing on a regular basis. Those months were some of the hardest in my life, but I listened to other acne sufferers. I made the choice between having moderate acne for the rest of my life and horrific acne for 6 months. Everyone has to listen to their body and do what feels best for them - and sometimes this means not listening to your doctor.

Final thoughts: Don't just listen to your doctors. Read the articles and books that are written for them and teach yourself about the science and biology of acne. You're the only one who knows your skin, and the way doctors diagnose and treat is often based on merely minutes of observation. The best thing I read about acne treatments was called "Expert Committee Recommendations for Acne Management" by Andrea L. Zaenglein and Diane M. Thiboutot - it can be found by searching on google. If you can take the time to read it and learn it, you can figure out what YOU need to do, and communicate with your doctor in a way that may actually help.

BELIEVE IN YOURSELF!