Struggling with Breakouts After Starting Tretinoin – Seeking Advice

Acne
1

Hey peeps,

I’m looking for some advice or insights about my recent skin issues. Here’s a bit of background:

I had severe cystic acne in my late teens and completed a course of Accutane, which basically cured it. Since then, I’ve been able to keep my skin under control with topicals. In May 2024, I started using tretinoin 0.025% cream after having success with Aklief and Epiduo Forte in the past. At first, I wasn’t consistent with the tretinoin – maybe using it three times a week – but about six weeks ago, I started using it every night.

Now, my skin hasn’t broken out this much since before Accutane. I initially thought it was just purging, but now I’m wondering if the tretinoin is irritating my skin instead.

Here’s my current routine:

  • Morning: Cleanse with Cerave Hydrating Toner, moisturize with La Roche Posay Toleriane, apply azelaic acid (just switched from clindamycin 1% lotion a week ago), and use Estée Lauder Futurist Hydra Foundation with SPF 45.
  • Night: Cleanse with BPO 4%, apply Avene Tolerance Control (though I’ve been using Aquaphor more recently), and then use tretinoin 0.025% cream.

I’ve attached some pictures showing the progression: the first is from June 4, 2024, the second is from July 9, 2024, and the third is from today (though it’s not letting me label them).

Does anyone have any thoughts on what might be going on? Is this still purging, or could the tretinoin be too harsh for my skin? :blush:

2

Yooh, sounds like your skin’s been on a bit of a rollercoaster. Tretinoin can sometimes cause a rough patch before things get better—kind of like your skin’s way of showing it’s adjusting. But if you’re seeing more breakouts and irritation, it could be too strong for now.

Maybe try cutting back a bit and see if that helps? Also, check if the azelaic acid and BPO are mixing well with your routine. Sometimes, less is more :thinking:

3

I had a horrible breakout of acne when I was 22 years old and started using tretinoin, sometimes known as Retin A. It took me almost two weeks to see a significant improvement, but the pimples were completely gone. It took them almost one additional week to disappear. For around a month, I did have red spots, but my skin was smooth and I could conceal them with makeup. I never quit using it because I thought my acne would return. It wasn’t hard for me to decide to keep using it after learning about its anti-aging benefits approximately ten years later, even though eventually my health insurance started classifying it as “cosmedic” and I had to pay full price for a prescription.
I’ve been taking tretinoin for 42 years, and I’m 64 now. Naturally, for the anti-aging impact rather than for acne right now. Are there wrinkles on me? Yes, a few, but I do believe that using this has made a big difference in keeping them moderate.