This is a long post but I would greatly appreciate feedback!!
First post ever and in need of some advice! I am on the 2nd day into my 10th week of Tretinoin gel 0.01%. 10 weeks ago I was having a pretty bad breakout that wouldn't go away after months(never had very bad acne, but this was horrible &all over) Anyways, they were mostly Papules on my cheeks, few Pustules..but there were some, and a lot of skin colored bumps (not deep ones, weren't painful. They just would never go away nor would they turn into anything) mostly on my forehead and also on cheeks. Nothing really on my chin. About twice a month I would get a nodule that would be deep and hurt, but they would go away within a couple days. So I went to my doctor and he put me on retin A 0.01%. About 6 weeks in I was noticing my skin was looking a lot better. But didn't last longer than a week or two and from then on my skin has been horrible. At the moment, I have a huge breakout of tiny whiteheads and tiny Papules(I think) on my chin and mostly pustules/Papules(although, they have dramatically gone down from a couple weeks ago) on my cheeks. The same skin colored bumps are on my forehead along with some little red bumps. (the skin colored pimples are gone from my cheeks) I also have a few little whiteheads under my nose/above my lips. Which I never got before. I will also get these deep pimples (not huge ones) on my cheeks, (maybe two at a time, every other week) that will start as a deep under the surface pimple then after a couple days it will feel as if it is "full" and be able to be popped..sometimes just touching them will make them burst. My question is, why have I not heard of anyone using Tretinoin/retin a gel 0.01%? I usually hear about .1 or .05%. Should I go up in dosage or what? I have extreme dryness &horrible redness, although right now I am doing okay on the dryness, but I would rather have dryness than acne. Should I be seeing more results by now or is this typical to be going so back and forth and then just pretty much stop seeing results for a few weeks? Any advice is welcome, really!
Thank you so much x
Yeah, you should be seeing better results than this right now, but it is not unheard of to have a worsening of acne during the first 3 months of retin use. The .01% gel is the highest strength or retin a available, so no, you cannot move up in strength. Try not to pop or pick your zits if you can help it, as retin a can make your skin very fragile and more prone to scarring.
Anyways in case you ever come back here and catch this in time: you should go back to your doctor and ask for spiro. It's an anti-androgen that suppresses the evil zit hormones, and it's safer than accutane (takes just as long though).
Nope. .025% is the lowest percentage of retin a, then it's .04% for retin a micro, and .05% and .01% for tretinoin. I've been using retins forever so I am very familiar with them (i am supposed to be using the .01% myself but I've been alternating with the .025%). Maybe you're actually on Differin gel? The lowest percentage of differin gel is .1%, so that'd make sense. Either way, you should definitely go see your dr about getting on an oral antibiotic to help with your breakout. It sounds pretty brutal (i feel for you!).
*oh just to clarify, the reason you probably don't see people mentioning the .01% is because they just don't bother making the distinction as there is no other .1% tretinoin (only .025%, or .05%) Also the .01% gel is basically the strongest form of tretinoin (well there is a liquid which is also .01% but not many use it) so most people find it extremely irritating and either have to work up to it, or only use it for 6 months at a time--usually in cream form, as the gel is really drying.
Last edited by crookedhearts; 08-28-2012 at 08:44 PM.
Hmm, I was under the impression that Tretinoin was retin a, just the generic brand.. I am on Tretinoin .01%. Sorry for the mixup! I am ill-educated in the whole acne-medication-stuff.
I have definitely gotten a lot clearer since I last posted.
I am thinking I got the names of the types of acne/pimples that I have wrong(when I was describing my acne), because even at the time of the breakout, I would never say it was brutal or anywhere near severe.
As of now, halfway through my 11th week, my breakout on my chin is completely gone and my skin is not dry, nor is it red anymore(for now). But, I do still have the skin colored bumps that seem to never go away on my cheeks. You cannot see them when you are looking straight at my face or in a bathroom mirror, but when I catch a glimpse of my cheeks (more so my right cheek) in the sun through my mirror, I can see it is bumpier then I initially thought. My skin appears very clear besides those bumps. Some of the bumps are a tiny bit pink but they are not like a regular pimple, because they do not come to a head/ever have anything in em.
Not surprising, it's an easy mistake to make (i only know the strengths cause I've been on all of them) but you are right about tretinoin being retin a in generic form.
Anyways about the flesh colored bumps, I think I know exactly what you're describing! Do they look like enlarged pores? Sorta like weird almost orange peel type texture? I think this is just what retin a does over time, and it's why i HATE using the .01%. The way retin a works is that it literally pushes the crap (plugs) out of your pores as it speeds up your skin shedding cycle. I also seems to make the skin more fragile and because of this, I think it sometimes leaves little crevices that don't get filled in while your skin's growing back, you know? Retin a is also like a light chemical peel so it's also exfoliating the top layer of your skin every night--maybe these are also little old scars that were hiding under there, who knows?
Anyways, like i said, I've been using retins for a while and this weird texture phenomenon is something that I've seen other people complaining about in other threads across the internet. Doctors always act completely unaware of it. My solution is to step down my retin a usage. I've switched back and fourth between strengths and was recently on the .01% until even more recently I switched to the .025% and now I only use that one every other night if I can get away with it. It's all about balance, because you gotta give your skin time to heal from it.
Hmm..I have been noticing I have larger pores since being on this medicine. Which, before my pores were not visible at all. But, I definitely see what you are talking about when you say that they may not be 'getting filled back in' when my skin grows back.
But actually I was referring to bumps on my cheeks that are not red in color, that are just kind of there &never go away.. (or very slowly)
The .01% seems to be doing okay on side effects for me if it is indeed the highest dosage, as I would expect way worse with a stronger dosage.
I did have reaaaally bad flaking up until about 2-3 weeks ago, though. And very red skin. (under makeup I looked pink, ha!) But I can't imagine why my skin would go back to being red/super flaky if I continue on the same dosage/doing exactly what I've been doing. Although, it seems everything is pretty much up in the air with Retin A. :/
I guess it is pretty much is up in the air because I've experienced increased irritation at times too! It's weird, cause I got switched from the .05% cream--which I found pretty irritating the whole 6 months I was on it--to the .01% gel (which I assure you is the strongest), yet I experienced less irritation with the .01% gel--until about 2 months in when my skin started getting that annoying burning sensation. My doctor only switched me to the .01% gel b/c I had complained that the cream might be clogging my pores so she didn't know about the irritation (she always tells me just to keep using it). I think the gel is easier on my skin because it's a lot easier to spread, so I barely use any. Maybe I was applying it too liberally in the second month--I dunno, but my skin was clear and I decided it was time to switch to the .025% because I was beginning to see that orange peel effect and decided it was time to back off. I have experienced this orange peel effect from time to time with both retin a and differin gel but it always gets better when I back off. As for the flesh colored bumps I'm not sure what that could be. If you think it might have something to do with retin a I would say scale down your usage to once every few days to see if it improves and if it doesn't ask your dr. Though I've found drs to be pretty unhelpful about stuff like this (sometimes they just blow you off).
Okay, so I went to the doctor's today and he said that .01% is definitely the lowest dosage of tretinoin gel. Which I am on. So, he bumped me up to .025%. Are you sure you're not thinking of the dosages for the cream?
No, the bumps are not resulting from the retin a. I had them before, they're just pimples that never come to a head, nor do they hurt, they just make my skin look bumpy.
Well now I'm just confused cause my doctor switched me to the .01% gel from the .05% cream, and then a couple of months later I told her I thought it was irritating my skin so she switched me to the .025% gel, which she said I could alternate with the .01% if I needed to (like in case I started getting clogged again).
But maybe you're right and it IS more concentrated? I dunno it would make sense cause I DID notice how the .025% comes in a smaller container...lol, that would suck cause it means my dr is even stupider than I am...or maybe she just doesn't care, cause to be quite honest, I have not noticed much difference between the two of them at all! I used the .025% every other night last month, but for the past week I've only used one of them every 3 days (like just to see if one was more irritating) and the week before that I tried using the .025% every night. Didn't notice any difference at all, though my face burned a bit by the end of the week that I used it everyday. Lol, my skin does not flake anymore no matter what (nothing left to flake, probably), so who knows. Anyways, let me know if you feel a difference--i am really curious now!