10.02.2016

6 Month Retin-A Review - The Acne Experiment

6 Month Retin-A Review - The Acne Experiment

I scraped all my notes together and compiled a gigantic 6 month review of Retin-A (aka tretinoin, 0.05%, cream). Retin-A is not a natural cure, and I did get a prescription. I apologize to anyone that thought I'd only test OTC topicals. Please, good sirs, let me explain.

I had excellent success with Retin-A in my twenties, but at some point during my last few years on it, that success shifted. I had always struggled with cystic hormonal acne on my chin, but I began to develop the same fine red forehead bumps that prompted me to begin using Retin-A in college. In my mind, the Retin-A had stopped working; I began dabbling in alternate acne treatments. After about a year of this, I started The Acne Experiment in earnest. That was two years ago.

I began The Acne Experiment with the goal of putting together a streamlined routine, and in many ways that goal has been achieved. I discovered foaming cleansers were triggering frequent nasty chin zits, I folded a bunch of great holistic spot-treatments into my routine, I rediscovered a fantastic three ingredient skin mask, and – perhaps most important of all – I learned that certain "acne cures" just don't work for me. By testing a range of products & treatments, I stopped feeling like I was missing out on something, some holy grail product that would make me feel good about myself again.

At the same time, during these last two years of methodical testing, I wasn't getting the results I wanted. During some trials, I felt like complete garbage. On the days I was struggling with other issues, a face full of seemingly self-inflicted acne made me mentally bottom out. (Remind me later to tell you about my very suburban breakdown in front of the Apple store at the mall.)

I'm stubborn, and it was preventing me from trying the one product that worked well for me in the past. And ironically, how very unscientific of me to NOT do a proper Retin-A trial. It's only one of the most consistently effective acne treatments of all time.

Ingredients:
  1. Procure tretinoin.
  2. I've done this before, so I'm practically a dermatologist.
  3. Here's what I do: Wash face, wait 10-30 minutes, apply a pea-sized amount of tretinoin (or less), wait 10-30 minutes, apply moisturizer. I could do this in my sleep.
  4. Purge? Purge who? I don't know her.
  5. Oh ok, right, this is a purge.
  6. Patiently wait for buttery soft skin like I had when I was 21.
  7. Mix up your routine girlfriend! Be flexible! Smile more!
  8. Patiently wait for buttery soft skin like I had when I was 21.
  9. Patiently wait for buttery soft skin like I had when I was 21.
  10. I (sobs) I'm not actually 21 anymore??

    (These aren't very good instructions. I have better ones for you here.)
Conclusions:

To clarify, I did go through a purge when I first used Retin-A in my early 20s. I don't remember how long it lasted, but I'm sure my baby brain thought it was the worst my skin would ever look. That compounded with the fact that I was frequently marinating in PBR and wine-in-a-sack means my memories probably aren't reliable either. Anyway, in the name of science, I decided to plow through and apply the Retin-A every night, purge be damned. I kept a journal of sorts, because my baby brain is now a lady brain that was likely damaged by the cheap booze I drank in my youth.


Week 0 – Press GO

Before 6 Month Retin-A Review - The Acne Experiment

Look at what a happy little chipmunk I am.

Week 0.5 – This is purging.


Here we go... I've got purging + dryness on forehead, nose, and chin; My eyebrows have become a home for skin flakes.

Week 1 – Haha no this is purging.

Retin-A Purge – 6 Month Review :: The Acne ExperimentWeek 1 on Retin-A :: The Acne Experiment 

My forehead is paining.

Week 2

2 Weeks on Tretinoin – 6 Month Review :: The Acne Experiment Week 2 on Retin-A :: The Acne Experiment

I am splotchy as hell and bleeding everywhere.

Week 3 

I'm still breaking out. There are new spots, but no big/nasty/inflamed situations.

Month 1.5

Month 1.5 on Retin-A :: The Acne Experiment

About a week ago, I started seeing improvements. Things look smoother, but I still have red spots. I'm still dry on my hairline and chin.

Month 2

2 Months on Tretinoin Cream :: The Acne Experiment Month 2 on Retin-A :: The Acne Experiment

My temples & chin are still dry. I've started using jojoba/tea tree oil as a kind of "spot moisturizer" a couple times a week. My forehead is mostly smooth, save for a couple superficial spots. Hyperpigmentations remain just about everywhere. My cheeks have gotten a little rough and dry. I'm not sure what that's about.

Month 3

3 Months on Tretinoin 0.05% :: The Acne Experiment

This is the point in every product trial when you look in the mirror and say "Wow. This acne treatment is really working." The acne fairy will then with gift you with 3 huge forehead zits.

(Pardon the abnormal progress pic – it's all I got of my huge forehead zits.)

Month 3.5

3.5 Month Tretinoin Cream Progress (!) :: The Acne Experiment Month 3.5 on Retin-A :: The Acne Experiment

I'm seeing progress, baby! I figured out that by giving my skin a tretinoin break by using a clay mask once or twice a week really helps with the irritation. Also, if I do a cold water wash (with a wash cloth) before applying, I notice less problems.

Month 4.5

I should have been buffering with oil this whole time. It really helps with the irritation. I use jojoba with a teensy bit of tea tree oil in it. One drop for my chin, one drop for my temples/hairline, then spread it around my face. I've also been testing a morning toner (Andalou Naturals).

Month 5

Retin-A Irritation (Month 5) :: The Acne Experiment

Some redness/little bumps are cropping up around my temples. I'm not using the toner anymore, but I'm still using the oil.

Month 6

6 Months on Tretinoin/Retin-A :: The Acne Experiment Month 6 on Retin-A :: The Acne Experiment

I'm still using the oil, but I also started testing micellar water (Marcelle) for the first time this month. I saw some nice improvements. It's not quite butter skin, but it's as close as I've gotten in the last two years. This is a win!



Here are some side-by-sides:

Retin-A Before/After - 6 Month Review :: The Acne Experiment

Retin-A Before/After :: The Acne Experiment

Retin-A Before/After - Chin:: The Acne Experiment

For this trial, I used a variety of lighting for the progress pictures – almost all the journal pics were taken with indoor light, while most of the before/afters have natural lighting. As a rule, I take my Acne Experiment progress pictures directly in front of the same window at the same time of the day. It's an attempt to normalize the light, but it can wash out my skin in photos and make it look much better than it would in, say, the oppressive lighting inside a Target store. To counteract this, I took some progress pics in the nastiest lighting I could manage:

Retin-A Before/After - Forehead :: The Acne Experiment

Oh hai! I'm still relatively clear in the after pic! It's not perfect but is so much better than where I started. Things did get a little splotchy almost immediately after I took the month 6 photos, and for a period of time I thought that Retin-A wasn't going to work as well for me anymore. I thought maybe it was too harsh, or perhaps something else was going on.

Last week a commenter brought to my attention the issue of isopropyl myristate in Retin-A cream. Isopropyl myristate is a problem ingredient for some people. It is believed to be comedogenic*, which may seem odd given that Retin-A is primarily an acne medication.

Ultimately, in my case, I figured out that it was more of a method & additional product issue, rather than an issue with the Retin-A itself, which was a relief. At this point, I've been using Retin-A for 8 months. I'll be reviewing all the products that I tested concurrently with tretinoin along with the a couple of cleanser trials I did after month 6: Dermalogica Ultra Calming Cleanser & a cult-favorite micellar water (Bioderma).

Yay progress!

0.05% Tretinoin Cream Before/After :: The Acne Experiment

Next Up: Andalou Naturals Clementine + C Illuminating Toner

--

*Here's my take on comedogenic ratings:  they are a good guideline, and can help pinpoint ingredients that are causing your skin problems, but they shouldn't be taken as gospel. This is because comedogenic ratings are made in a lab setting (ie not everyday conditions) on friggin' rabbit ears (ie not real human skin) at 100% concentration (eeeee). They don't take into account all the other variables that come into play with skincare, like hormones, allergies, nutrition, other products being used, concentration, other inactive/active ingredients, night drooling, etc etc. To compound this even further, everyone's skin is different. An ingredient that causes one person to break out could be completely benign on another. In the case of Retin-A, tretinoin is such a powerful topical that any negative pore-cloggy effects from the inactives is probably going to be nullified. So yeah, don't let the isopropyl myristate freak you out too much. Or, you know get some Retin-A micro instead.

If you want to read more about retinoids, I have a 3-part series that may be of interest to you:

Part 1:  A Beginner's Guide to Retinoids
Part 2:  10 Things to Know Before Using Retin-A
Part 3:  How to Use Retin-A & Survive the Purge

ALL Acne Experiment Posts are listed at The Acne Experiment MOTHER HUB.


6 Month Retin-A Review :: The Acne Experiment
6 Month Retin-A Review - The Acne Experiment
All Images © Crappy Candle / The Acne Experiment
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5 comments

  1. Did I see you mention in another post that you've struggled with perioral dermatitis? Any POD-related impacts or side effects with the retin-a? I used an otc retinol (paula's choice 1%) with some success a couple of years ago but since discontinued (why? I don't remember right now). In the meantime I've been dealing with some stubborn POD and >weee< a resurgence of acne. Thinking about trying the paula's choice retinol out again but I don't want to make the POD worse. Thoughts?

    ReplyDelete
    Replies
    1. I have mildish POD, but it's a stubborn little sucker (5 years!). I tried a little bit of Retin-A on it in the beginning of this trial, and learned that POD does not mesh with tretinoin. I would imagine retinol would have a similar effect. I apply the retin-a on my forehead, nose, and cheeks, but I don't apply anything below my mouth -- I draw an imaginary line from my mouth to about an inch below my ear and call that area the danger zone. I also avoid applying above the top of my cheek bone (ie my eye area) because I started getting a wee bit of periocular dermatitis this year.

      I figured out that the only thing that doesn't cause the POD to flair is jojoba + tea tree oil. I'm in the process of treating it with a prescription regimen right now. I'm hoping that once it clears up, I'll be able to apply the retin-a everywhere without worry.

      Delete
    2. Awesome, good to know! I had mild POD that flared up pretty bad this summer so I went on a round of doxycycline, which worked well for the POD but I had to go off of it after a while because of bad side effects. Then after a few months it came back, mostly in between my nostrils & mouth and a little under my lower lip. After some experimentation I suspect that at least one thing that triggers it for me is SLS/SLES, which is of course in fucking everything. Shampoo, hand soap, laundry detergent, toothpaste, even KLEENEX. In the meantime while I've been eliminating/finding substitutes for those products I tried out several wacky suggestions I found on different websites, and so far the thing that has (truly shockingly) worked is ozonated olive oil paste and powdered sugar. I know. It sounds totally crazy, but I don't care because it makes those awful little bumps go away. (Def have to put a hand towel on my pillow at night though.) I'll try the jojoba & tea tree though, since I already have both those in my cabinet. Thanks for the advice! And good luck kicking the POD to the curb :)

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  2. Piece of advice. Please watch Dr Dray on YouTube. You'll not regret it. No more alcohol/essential oils/perfume on the skin. Hydrate, hydrate, moisturize, no face masks (excluding the moisturizing masks), use cold pressed oils as emolients.

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  3. Go to acne.org and EVERYTHING there is helpful.

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