If you haven’t read part I, you can click here. But in September 2019, I started the second war on my acne. I know, war sounds a little dramatic but I have small and large battles with my acne almost every day. This, however, was a war with determination, frustration, and intention behind it. I was completely fed up with having this level of cystic acne at the age of 25 and I was/am willing to do the research, try the products, meet with doctors, and go through the pain and struggle of finding a solution that works for me. I’m going to beat this.
Fast forward 4 months, and you’ll find yourself right here. I’ve been using a .025% Retin-A, a.k.a retinoid, a.k.a tretinoin. I started out gradually-- using it 1 night a week for 2 weeks, 2 nights a week for 2 weeks, and so on until my skin could tolerate it every night. You know when you get so excited to incorporate something new into your routine that you just want to use it all the time? That’s how I felt about tretinoin even though it’s way too strong to start globbing it all over your face. It took all the restraint I had not to dive deep and apply a generous amount every night because I thought that I would see results faster.
Rough Patch (literally)
I had a few weeks where I needed to scale back because the dry skin and flakiness was too much for me. The exfoliation from the tretinoin along with winter weather was too drying. I found myself needing to switch to a more hydrating face wash as well as continue with 3 days of application for another two weeks until my skin had the time to adjust.
Out of the Woods
When I finally got to four days a week, that’s when it was really beginning to work. My skin looked so much better on the mornings I had applied my tretinoin the night before. It was like having fresh new skin. My pores seemed seamless and clear, my acne marks were fading, and the cysts I had shrunk. It didn’t get rid of them overnight by any means, but it helped the redness and marks fade so much quicker. I almost didn’t mind the giant pimples as much now since the skin all around it was so much more smooth and clear.
Retin-A Can’t Do It All
But I don’t think tretinoin is the only ingredient to thank here. Along with my now nightly application of tretinoin, I also bumped up my spironolactone prescription from 25mg to 50mg after 3 months and I think this has made a significant difference as well. Thirdly, I apply a 15% azelaic acid cream to my face 20-30 minutes after the tretinoin. (This I learned from my dermatologist. Depending on the active ingredient, you may have to wait for the retinoid to absorb to avoid inactivating the retinoic acid.) With the combination of these three prescriptions, I’ve reached this point but I don’t think I would have gotten here with tretinoin alone.
Takeaway
Right now, I’m incredibly happy with how my skin is looking but I know it’s not permanent. I still have bad days. I still have scars. I still have hyperpigmentation I want to fade. I don’t know how long I want to or how long I can stay on spironolactone in the long term but it’s working for now. Cystic acne will always be a constant battle for me, but I feel like I’ve almost won this war.
Maybe I’ll find some other solution, maybe I’ll get back on Accutane, maybe I’ll try a higher strength retinoid, but whatever it is, I’m grateful for the skin I have right now. I am taking better care of my skin now than I ever have and I can’t wait to keep you all updated along my journey.
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